The aim of this study is to identify the prevalence, assess the metabolic profile, and key differences (versus healthy) in a cohort of subjects with sarcopenia (S) and in sarcopenic obesity (SO) hospitalized elderly. A standardized comprehensive geriatric assessment was performed. We enrolled 639 elderly subjects (196 men, 443 women) with a mean age of 80.90 ± 7.77 years. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences between groups. The prevalence of (S) was 12.42% in women and 23.47% in men. (SO) was 8.13% in women and 22.45% in men. Data showed that either groups had a functional impairment (Barthel index  15 mm/h), CPR (>0.50 mg/dl) homocysteine (>12 micromol/l), and hemoglobin ( 145 mcg/dl) was detected in either cohort (due to inflammation). (SO) had glycemia (>110 mg/dl). Key differences in (S) cohort (versus healthy) were a reduction in functional impairment (p < 0.001), an increase in white blood cell (p < 0.01), a decrease in iron level (p < 0.05), in electrolytes balance (Na: p < 0.01 and Cl: p < 0.01), and tyroid function (TSH: p < 0.001). In addition, (S) had higher state of inflammation (erythrocyte sedimentation rate: p < 0.05 and C-reactive protein: p < 0.01), and an increase of risk of fractures (FRAX: OR 1.07; p < 0.001), risk of malnutrition (mini nutritional assessment: p < 0.001), and risk of edema (extra cellular water: p < 0.001). In (SO) cohort, an increase in white blood cell (p < 0.001) and erythrocyte sedimentation rate (p < 0.05) was observed. (S) subjects appears more vulnerable than (SO). Sarcopenia is closely linked to an increase in the risk of hip–femur fractures, inflammation, edema, and malnutrition. The (SO) subjects seem to benefit from the “obesity paradox.”

/pdf/sarcopenia-and-sarcopenic-obesity-in-comparison-prevalence-3g9wehj1cf.pdf

Sarcopenia and sarcopenic obesity in comparison: prevalence, metabolic profile, and key differences. A cross-sectional study in Italian hospitalized elderly

Introduction: Omentin-1, secreted by visceral adipose tissue, has been indicated in the regulation of bone metabolism in girls with anorexia nervosa (AN). The aim of the study was to evaluate the relationship between omentin-1 and bone metabolism in girls with AN as well as the potential involvement of OPG and RANKL in this relationship. Material and methods: Serum omentin-1, OC, CTx, OPG, and sRANKL were determined by ELISA in 49 girls with AN and in 30 healthy controls, aged 13 to 17 years. Results: Girls with AN exhibited significant reduction in body weight, BMI, and Cole index as well as a significant increase in serum omentin-1 levels, compared to healthy participants. These changes were associated with a significant decrease in serum OC and CTx levels and a significant increase in OPG and sRANKL while the OC/CTx and OPG/sRANKL ratios were significantly decreased. BMI and the Cole index correlated negatively and significantly with omentin-1 levels, positively with CTx levels and the OC/CTx ratio in the control group (C), girls with AN, and all study participants (C + AN). Girls with AN showed a significant negative correlation between BMI, the Cole index, and OPG levels. The combined group (C + AN) showed a significant positive correlation between BMI, the Cole index, and the OPG/sRANKL ratio. Omentin-1 levels correlated negatively and significantly with OC and CTx levels as well as with the OC/CTx and OPG/sRANKL ratios in the C, AN, and C + AN groups. Conclusions: The relationship between omentin-1, bone markers, and the OC/CTx and OPG/sRANKL ratios observed in girls with AN indicates the involvement of this adipokine in the regulation of dynamic balance between bone formation and resorption processes. Omentin-1 might exert a negative effect on bone remodelling in girls with AN by inhibiting both bone formation and resorption. The OPG/sRANKL system plays an important role in the latter. (Endokrynol Pol 2015; 66 (6): 514–520)

/pdf/association-between-omentin-1-bone-metabolism-markers-and-55r7bf3tel.pdf

Association between omentin-1, bone metabolism markers, and cytokines of the RANKL/RANK/OPG system in girls with anorexia nervosa.

Introduction: It has been indicated that disturbances in the production of certain pro-inflammatory cytokines might contribute to the development of osteoporosis in girls with anorexia nervosa (AN). The aim of the study was to determine whether girls with AN exhibited a relationship between IL-1β, IL-6, TNF-α, bone turnover markers (OC and CTx), OPG, sRANKL, and the OPG/sRANKL ratio. Material and methods: Serum IL-1β, IL-6, TNF-α, OC, CTx, OPG, and sRANKL were determined by ELISA in 59 girls with AN and in 17 healthy counterparts, aged 13 to 17 years. Results: Girls with AN showed significant reduction in body weight, BMI, BMI-SDS, and Cole index compared to the controls. These changes were associated with a significant increase in IL-1β, IL-6, TNF-α, OPG, and sRANKL concentrations and a decrease in bone markers and the OPG/sRANKL ratio. Significant negative correlations were found between BMI, the Cole index and CTx, OPG (girls with AN); between BMI and OC, CTx as well as the Cole index and CTx (the control group — C); between BMI, the Cole index and IL-β1, IL-6, TNF-α, CTx in all study participants (group AN+C). The combined group AN+C also exhibited positive correlation between BMI, the Cole index, and the OPG/sRANKL ratio. Girls with AN showed positive correlations between IL-1β, IL-6, and CTx as well as between TNF-α and sRANKL whereas the correlation between TNF-α and the OPG/sRANKL ratio was negative (IL-6 and IL-1β were identified to be independent predictors of CTx, TNF-α and IL-6 independently predicted sRANKL while TNF-α, IL-6, and IL-1β were independ- ent predictors of the OPG/sRANKL ratio). The control participants exhibited negative correlations between IL-1β and OPG and positive correlations between IL-1β and sRANKL (IL-1β was found to be an independent predictor of OPG and sRANKL). In the AN+C group, IL-1β correlated negatively with OC and OPG and positively with sRANKL, while IL-6 and TNF-α positively correlated with CTx (IL-6 and TNF-α turned out to be independent predictors of CTx, IL-1β of OPG while IL-6, TNF-α, and IL-1β were independent predictors of sRANKL and the OPG/sRANKL ratio). Conclusions: The relationship between the nutritional status and IL-1β, IL-6, and TNF-α concentrations as well as bone status indicators seems to indicate that abnormalities observed regarding the concentrations of pro-inflammatory cytokines and bone remodelling in girls with AN might result from malnutrition. Correlations between IL-1β, IL-6, TNF-α, bone markers, OPG, its ligand sRANKL, and/or the OPG/sRANKL ratio suggest potential involvement of these cytokines in the mechanism underlying the lack of the expected bone mineral density increase in adolescent girls. (Endokrynol Pol 2015; 66 (4): 313-321)

https://journals.viamedica.pl/endokrynologia_polska/article/download/EP.2015.0040/29609

Selected pro-inflammatory cytokines, bone metabolism, osteoprotegerin, and receptor activator of nuclear factor-kB ligand in girls with anorexia nervosa Wybrane cytokiny prozapalne, metabolizm kostny, osteoprotegeryna i ligand receptora aktywatora czynnika jądrowego-kB u dziewcząt z jadłowstrętem psychicznym

Introduction: In vitro studies indicate that vaspin may act as a regulator of bone metabolism. The aim of the study was to evaluate the relationship between vaspin and bone metabolism in girls with anorexia nervosa (AN), as well as the potential involvement of OPG and RANKL in this relationship. Material and methods: Serum vaspin, OC, CTx, OPG, and sRANKL were determined by ELISA in 50 girls with AN and in 30 healthy controls aged 13 to 17 years. Results: Girls with AN exhibited significant reduction in body weight, BMI, and Cole index as well as a significant increase in serum level of vaspin compared to healthy participants. These changes were associated with a significant decrease in serum OC and CTx levels and a significant increase in OPG and sRANKL, while the OPG/sRANKL ratio was significantly decreased. BMI and Cole index correlated negatively and significantly with CTx levels in the control group (C), girls with AN, and all study participants (C+AN). Girls with AN showed a significant negative correlation between BMI, the Cole index, and OPG levels. The combination group (C+AN) showed a significant positive correlation between BMI, Cole index, and the OPG/sRANKL ratio. In this group of girls vaspin levels correlated positively and significantly with sRANKL and negatively with body weight, BMI, Cole index, and OPG/sRANKL ratio. Girls with AN showed a significant negative correlation between vaspin levels and the OPG/sRANKL ratio. Conclusions: Undernourishment and associated deficit of adipose tissue may result in inadequate vaspin production and bone metabolism disorders in girls with AN. Vaspin acts as a coordinator of the dynamic balance between bone formation and resorption processes; its action is affected by the cytokines of the RANKL/RANK/OPG system. Changes in the relationships between vaspin, bone markers, OPG, and RANKL might contribute to the development of osteoporosis in girls with AN. (Endokrynol Pol 2016; 67 (6): 599–606)

/pdf/vaspin-and-selected-indices-of-bone-status-in-girls-with-4umkphouie.pdf

Vaspin and selected indices of bone status in girls with anorexia nervosa.

Serum leptin and adiponectin levels in children with type 1 diabetes mellitus – Relation to body fat mass and disease course

Bioelectrical Impedance Analysis (BIA) is a reliable, non-invasive, safe and effective method of determining body composition in healthy individuals as well as in patients with diabetes, hypertension, obesity and other diseases. BIA is about measuring the overall electrical resistance of the body, which is related to both passive and active resistance (reactance) using a set of surface electrodes connected to a computer analyser and by means of known intensity and frequency of electrical current. The parameters assessed are: total body water (TBW), intra-cellular body water (ICW), extra-cellular body water (ECW), body cell mass (BCM) and thus body fat mass (FM) and lean, fat-free body mass (FFM). BIA allows for following body composition changes during dietary programs and helps tune the diet adequately to them. BIA test results are influenced by variable factors dependent on correct usage of the measuring device and appropriate preparation of the individual to be examined.

/pdf/podstawy-teoretyczne-i-zastosowania-analizy-impedancji-ly1qo3apw6.pdf

Podstawy teoretyczne i zastosowania analizy impedancji bioelektrycznej (BIA)

Leczenie anoreksji wymaga wspolpracy wielodyscyplinarnego zespolu
specjalistow zarowno psychiatry, internisty, psychoterapeuty,
wykwalifikowanego w leczeniu zaburzen odzywiania dietetyka,
jak i personelu pielegniarskiego oraz fizjoterapeuty. Przy wspolwystepowaniu
zaburzen hormonalnych, kardiologicznych czy tez
metabolicznych niezbedne moze okazac sie wlączenie do zespolu
terapeutycznego innych specjalistow. Najwazniejszą cześcią
procesu leczenia anoreksji jest - bez wątpienia - terapia zywieniowa.
Ma ona na celu normalizacje masy ciala i poprawe stanu
odzywienia, a jej planowanie powinna poprzedzac ocena sposobu
zywienia, stanu odzywienia oraz zapotrzebowania na energie
i podstawowe skladniki pokarmowe. Ścisla wspolpraca dietetyka
i lekarza dotyczy zaplanowania indywidualnie dobranej diety zlozonej
z odpowiedniej ilości wody, elektrolitow, pierwiastkow śladowych,
bialka, weglowodanow, tluszczow oraz wyboru drogi
dostarczania pozywienia (zywienie fizjologiczne, dojelitowe lub pozajelitowe).

/pdf/interwencje-zywieniowe-w-leczeniu-anoreksji-wskazowki-3vrl4bvbyp.pdf

Interwencje żywieniowe w leczeniu anoreksji - wskazówki dietetyczne

Podręcznik Dietetyka w chorobach nowotworowych to kompendium wiedzy poruszające cały kompleks zagadnień związanych z szeroko pojętą problematyką dieta-nowotwory. Stanowi niezbędne w codziennej praktyce wytyczne dotyczące dietoterapii u chorych na nowotwory, będąc zbiorem przydatnych wskazówek do udzielania porad dietetycznych, które z jednej strony pozwolą zminimalizować ryzyko wystąpienia nowotworu (dietoprofilaktyka pierwotna), a z drugiej strony pozwolą na udzielenie porad dotyczących właściwego odżywiania po leczeniu onkologicznym (dietoprofilaktyka wtórna) . Książkę kierujemy do wszystkich lekarzy różnych specjalizacji, oraz dietetyków i pielęgniarek, a więc personelu wchodzącego w skład zespołów leczniczych pacjentów chorych na nowotwory. <UL> <LI><a href = "https://images.iformat.pl/B18BB4AEEB/E15FB2D1-72A8-4FAD-8028-E173F72579BF.epub" download="fragment">Fragment (epub)</a></LI> <LI><a href = "https://images.iformat.pl/B18BB4AEEB/7029E082-8B80-4F0C-9D3F-7E6EACD8009B.mobi" download="fragment">Fragment (mobi)</a></LI> </UL> 

Anna Lewitt

Papers

Podstawy teoretyczne i zastosowania analizy impedancji bioelektrycznej (BIA)

Interwencje żywieniowe w leczeniu anoreksji - wskazówki dietetyczne

Dietetyka w chorobach nowotworowych. Poradnik dla lekarzy