Factors affecting sarcopenia in older patients with chronic diseases

Sarcopenia is an age-related disease characterized by a progressive loss of systemic muscle mass and/or decreased muscle strength and physical function. The occurrence of sarcopenia in patients with chronic diseases will not only cause further deterioration of diseases and adverse clinical outcomes, but also lead to high medical cost, suggesting a necessity and a great significance to explore the associated factors of sarcopenia in chronic patients in order to improve their quality of life. This study aimed to investigate factors affecting sarcopenia among older hospitalized patients with chronic diseases.

A total of 121 older patients with chronic diseases admitted to the Department of Geriatrics of Affiliated Kunshan Hospital of Jiangsu University from May 2019 to April 2021 were enrolled. According to the diagnostic criteria of sarcopenia formulated by the Asian Working Group for Sarcopenia (AWGS), the subjects were divided into a sarcopenia group (n=57) and a non-sarcopenia group (n=64). We analyzed the associated factors including bone mineral density, nutritional biomarkers, hormone levels and inflammatory cytokines.

Compared to the non-sarcopenia group, the sarcopenia group was of older average age (P<0.001), exhibited a lower body mass index (BMI) (P<0.001), a lower bone mineral density (BMD) of the femoral neck (P<0.01), and a higher incidence of osteoporosis. In terms of hematology, the sarcopenia group exhibited significantly lower serum iron and zinc levels (both P<0.05), a higher growth hormone (GH) level (P<0.05), a significantly lower IGF-1 level (P<0.01), and a lower level of iron (P<0.01). Poor nutritional status (assessed via measurement of albumin and prealbumin levels) positively correlated with sarcopenia (P<0.01).

Sarcopenia is closely associated with aging, and has a close relationship with osteoporosis. Anemia, malnutrition, vitamin and trace element deficiencies, changes in hormone levels, and chronic inflammation are correlated with sarcopenia. Patients with these features above call for the screenig of sarcopenia. Additionally, these characteristics may help providing clues for further research on the pathogenesis and risk factors of sarcopenia, along with disease prevention and intervention.