Abstract:Objective To explore the correlation of muscle mass and strength with diabetes mellitus in community-dwelling middle-aged and older Chinese population. Methods Based on the baseline data of the China Health and Retirement Longitudinal Study (CHARLS) in 2011,8680 eligible subjects aged ≥45 years with complete data were enrolled, including 1461 subjects diagnosed with diabetes mellitus. The general data and laboratory indicators of all participants were collected. Their muscle mass is represented by appendicular skeletal muscle mass (ASM), and hand grip strength (HGS) is measured using a grip meter. The skeletal muscle mass adjusted by body weight (ASM/BM) and hand grip strength adjusted by body mass (HGS/BM) were both categorized into tertiles (Q1, Q2 and Q3), and were assigned 2, 1 and 0 points, respectively. The composite score was calculated as the sum of ASM/BM and HGS/BM scores. The effect of ASM/BM and HGS/BM on risk for diabetes was investigated by logistic regression analysis, and the dose-response relationship of ASM/BM and HGS/BM with diabetes risk was fitted by restricted cubic spline curve. SPSS statistics 22.0, R 4.2 were used for statistical analysis. Data comparison between two groups was performed using student′s t test, Mann-Whitney U test or Chi-square test depending on data type. Results The ASM/BM and HGS/BM were significantly lower in the diabetic patients than the non-diabetic subjects [(27.49±3.90)% vs (29.30±4.51)%, (0.52±0.16) vs (0.57±0.16); P<0.05]. Multivariate logistic regression analysis showed that compared with the individuals from the Q3 group of ASM/BM and HGS/BM, those in Q1 group had 1.260-time (95%CI 1.025~1.548; P<0.05) and 1.496-times (95%CI 1.270-1.763; P<0.05) higher risk of diabetes, respectively. Moreover, the participants in the highest composite score group had a 1.743-times (95%CI 1.333-2.279; P<0.05) higher risk of diabetes than those in the lowest score group. Restricted cubic spline curve revealed that both ASM/BM and HGS/BM had a linear dose-response relationship with the risk of diabetes (non-linear P=0.138,0.570). Subgroup analysis showed that higher composite score significantly increased the risk of diabetes in the non-obese population (P<0.05), but not in the obese population. Conclusion In community-dwelling middle-aged and older Chinese population, muscle mass and strength are influencing factors for diabetes. The higher the composite score is, the higher risk of diabetes will be, especially in the non-obese people.

Abstract:Objective To analyze the correlation of serum high-sensitivity C-reactive protein (hs-CRP) level with metabolic syndrome (MS) and related metabolic diseases in the longevous people based on the Guangxi Natural longevity cohort. Methods A total of 265 longevous people aged 90 years and above living in Dongxing City and Shanglin County, Guangxi were enrolled during July to November 2019. Their demographic data, height, body mass, waist circumference, blood pressure, fasting blood glucose, blood lipids and hs-CRP levels were collected by house-to-house survey. The participants were divided into MS group (n=68) and non-MS group (n=197) according to whether they had MS or not, and also into hs-CRP ≥3 mg/L group (n=160) and hs-CRP <3 mg/L group (n=105) according to their hs-CRP levels. SPSS statistics 21.0 was used for data analysis. Student′s t test, Mann-Whitney U test, Chi-square test or Fisher exact test was employed for intergroup comparison, and multivariate logistic regression analysis was performed to analyze the relationship of hs-CRP with MS and its related metabolic diseases. Results The level of hs-CRP was significantly higher in the MS group than the non-MS group (P<0.05). The elderly with hs-CRP ≥3mg/L had higher ratios of hyper-low-density lipoprotein cholesterolemia, dyslipidemia and MS (P<0.05), and lower prevalence of hypertension than those from the non-MS group (P<0.05). They were also at risks of MS (OR=2.173,95%CI 1.151-4.106), dyslipidemia (OR=2.003,95%CI 1.128-3.555), hypertriglyceridemia (OR=2.139,95%CI 1.013-4.518), and hyper-low-density lipoprotein cholesterolemia (OR=3.821,95%CI 1.319-11.072), but at reduced risk of hypertension (OR=0.282,95%CI 0.087-0.908). Conclusion Serum hs-CRP level in longevous people are associated with MS, dyslipidemia, hypertriglyceridemia, hyper-low-density lipoprotein cholesterolemia and hypertension, and those with elevated hs-CRP are at increased risk of MS.

Abstract:Objective To explore the clinical features of left atrial spontaneous echo contrast (LASEC) in patients with persistent atrial fibrillation (AF) and to analyze its correlation with left atrial sphericity index (LASI). Methods Clinical data of 96 patients with nonvalvular persistent AF admitted to our hospital from August 2021 to December 2022 were collected and retrospectively analyzed. These patients were divided into LASEC group (n=54) and control group (n=42) according to the results of echocardiography. Their comorbidities, results of laboratory tests, cardiac ultrasound parameters and LASI were compared between the two groups. SPSS statistics 22.0 was used to perform the statistical analysis. Student′s t test, Mann-Whitney U test or Chi-square test was employed for intergroup comparison depending on data type. Pearson correlation analysis was applied to explore the correlation of LASI with comorbidity and echocardiographic parameters. Logistic regression analysis was conducted to investigate the risk factors of LASEC. Results The proportion of female patients, CHA2DS2-VASc score, D-dimer level, N-terminal pro-B-type natriuretic peptide (NT-proBNP), LA anteroposterior diameter and transverse diameter, and LASI were significantly higher in LASEC group than the control group (P<0.05). LASI was positively correlated with body mass index (BMI) , heart failure and left ventricular end-diastolic diameter (r=0.236,0.727,0.212; P<0.05), and negatively with left ventricular ejection fraction (r=-0.225, P<0.05). Higher CHA2DS2-VASc score (OR=1.637,95%CI 1.117-2.400), elevated D-dimer level (OR=1.006,95%CI 1.002-1.010), and increased mean LASI (OR=3.556,95%CI 1.704-7.424) were risk factors for LASEC. Conclusion LA sphericity is an causal risk factor for LASEC in patients with persistent AF. The mean LASI can well indicate LASEC, with a promised prospect for clinical application.

Abstract:Objective To investigate the predictive value of vasoactive inotropic score (VIS) for the clinical outcome of septic shock in the elderly. Methods Clinical data of 93 elderly patients with septic shock admitted in our hospital from January 2018 to December 2019 were collected and retrospectively analyzed. Based on the vital signs and laboratory results for diagnosing sepsis and septic shock, Acute Physiology and Chronic Health EvaluationⅡ score (APACHE Ⅱ) and sequential organ failure assessment score (SOFA) were calculated during sepsis, and the highest VIS in the first 48 h diagnosed with septic shock was also calculated. According to clinical outcome in 28 d after septic shock, the patients were divided into the death group and the survival group. Age, gender, smoking and drinking history, biochemical indicators, APACHE Ⅱ score, SOFA score, VIS, use of vasoactive drugs, and involved organ dysfunction were compared among different groups. Univariate and multivariate logistic regression analyses were used to analyze the risk factors of death in elderly patients with septic shock within 28 d. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of SOFA score, APACHE Ⅱ score and VIS for death in 28 d. SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was performed using student′s t test, nonparametric test, Fisher exact probability test or Chi-square test depending on data type. Results Within 28 d of follow-up, 55 patients (59.14%) died and assigned into the death group, and 38 (40.86%) survived and served as the survival group. The death group had significantly higher APACHE Ⅱ score, SOFA score, VIS, proportion of patients using vasoactive drugs and IL-6 level than the survival group (P<0.05). Multivariate logistic regression analysis showed APACHE Ⅱ score (OR=1.228,95%CI 1.051-1.436), SOFA score (OR=1.505,95%CI 1.084-2.091), VIS (as continuous variable, OR=1.027,95%CI 1.002-1.054), and VIS ≥17.06 (as categorical variable, OR=7.523,95%CI 1.445-39.154) were independent risk factors of 28 d death in elderly patients with septic shock (P<0.05). The AUC value of APACHE Ⅱ score, SOFA score and VIS in predicting 28 d death was 0.911 (95%CI 0.852-0.969), 0.895 (95%CI 0.825-0.964) and 0.763 (95%CI 0.663-0.862) respectively in elderly patients with septic shock. The combined detection of multiple indicators had better accuracy in the prediction for the short-term outcome. The AUC value of VIS combined with APACHE Ⅱ score was 0.926, with a sensitivity of 0.836 and a specificity of 0.947, and the value of VIS combined with SOFA score was 0.911, with a sensitivity of 0.945 and a specificity of 0.763. The cut-off point of VIS was 17.06 points, with a sensitivity of 0.691 and a specificity of 0.789. Conclusion The highest VIS in the first 48 h diagnosed with septic shock is related to the clinical outcome in the elderly, and is an independent risk factor to predict 28 d death in them. VIS can be used as an indicator to evaluate the prognosis of elderly patients with septic shock.

Abstract:Objective To explore the influencing factors of hypertension associated with obstructive sleep apnea syndrome (OSAS) in the elderly males and to construct an integral assessment system to predict the risk of hypertension in the OSAS population. Methods We selected 798 elderly males OSAS patients as the research subjects from six tertiary hospitals (Beijing, Gansu Province, Shandong Province, etc.) from January 2015 to October 2017. According to the presence of hypertension, they were divided into hypertension group (n=538) and non-hypertension group (n=260). Their general information and biochemical indicators were collected. SPSS 25.0 was used for data analysis. Spearman correlation analysis was used to evaluate the correlation between various indicators and hypertension grading, and logistic regression analysis to analyze the factors affecting hypertension. A risk prediction model was constructed for hypertension in elderly male OSAS population. Receiver operating characteristic (ROC) curve was used to evaluate the rick prediction model.Results The body mass index (BMI), oxygen desaturation index (ODI), time with pulse oxygen saturation (SpO₂)<90%, proportion of the cumulative sleep time with SpO₂<90％ in total sleep time (T90), creatinine, fasting blood glucose, proportion of patients with a drinking history, and prevalence of diabetes mellitus, coronary heart disease, carotid atherosclerosis and hyperlipidemia were significantly higher in the hypertensive patients than in non-hypertensive patients, and the differences were statistically significant (P<0.05). Correlation analysis showed that the age, BMI, apnea hypopnea index (AHI), ODI, time of SpO₂<90%, T90, low-density lipoprotein cholesterol, fasting blood glucose and creatinine levels were significantly positively correlated with hypertension grading (r=0.107,0.160,0.072,0.079,0.089,0.087,0.080,0.112,0.154; P<0.05 for all), and that the lowest oxygen saturation and high-density lipoprotein cholesterol were negatively correlated with hypertension grading (r=-0.082, -0.087; P<0.05 for both). Multivariate logistic regression analysis showed that BMI (OR=1.098,95%CI 1.053-1.145), fasting blood glucose (OR=1.144,95%CI 1.028-1.274), creatinine (OR=1.008,95%CI 1.002-1.014) and hyperlipidemia (OR=1.543,95%CI 1.070-2.224) were risk factors, and the treatment with continuous positive airway pressure (CPAP) (OR=0.612,95%CI 0.387-0.967) was a protective factor of hypertension in elderly male OSAS patients. The calculation formula for the risk prediction model was logit (P)=-3.263+0.093×BMI+0.135×fasting blood glucose+0.008×creatinine+0.434× hyperlipidemia-0.491×CPAP, with an area under ROC curve of 0.654 (95%CI 0.614-0.694), a sensitivity of 0.701 and a specificity of 0.542. Theoretically, the integral range of the individual patients to be evaluated was from -2 to 11 after values were assigned to all the variables in the model. Using the formula, the corresponding probability of hypertension was P=1/[1+exp(0.2277-0.217S)], where S representod the corresponding integral. Conclusion The BMI, fasting blood glucose, creatinine, hyperlipidemia, and CPAP are influencing factors of hypertension in the elderly male OSAS patients. The risk prediction model established in this study has some ability to detect hypertension in the elderly male OSAS patients, and the designed integral assessment system can predict the risk of hypertension simply and intuitively.

Abstract:Objective To analyze the factors associated with severe conduction injury after transcatheter aortic valve implantation (TAVR) with domestic self-expanding valves and assess their predictive efficacy. Methods A retrospective trial was conducted on the patients undergoing TAVR with domestic self-expanding aortic valves in the First Medical Center of Chinese PLA General Hospital from December 2016 to October 2022. According to their postoperative outcomes, they were divided into normal and conduction injury groups. Logistic regression analysis was used to screen the relevant factors. Receiver operating characteristic (ROC) curve was plotted to calculate their predicted efficacy and evaluate the difference in efficacy. SPSS statistics 26.0 was used for statistical analysis. Data comparison between two groups was performed using student′s t test, U test or Chi-square test depending on data type. Results There were 84 patients being enrolled, including 60 patients in the normal group and 24 patients in the conduction injury group. Significant differences were observed in following indicators between the two groups (P=0.005), including left ventricular outflow tract (LVOT) area, LVOT area/annular area, septal length, and difference between septal length and implantation depth (membranous septum minus implantation depth, ΔMSID). Multivariate logistic regression analysis showed that LVOT area/annular area (OR=0.874,95%CI 0.797-0.959, P=0.004) and ΔMSID (OR=0.660,95%CI 0.515-0.846, P=0.001) were independent risk factors for severe conduction injury after TAVR. ROC curve analysis indicated that the area under the curve of LVOT area/annular area and ΔMSID was 0.792 and 0.768, respectively, and was 0.908 for their combination. DeLong test revealed that statistical significance was seen in the predictive efficacy of the single indicator vs their combination (P<0.05). Conclusion LVOT area/annular area and ΔMSID are independent risk factors for incidence of severe conduction injury after TAVR, and can be used to predict the occurrence of new conduction injury after surgery. The two indicators combination shows better predictive efficacy than the single one.

Abstract:Objective To investigate the status quo and influencing factors of participation in cardiac rehabilitation (CR) in the elderly patients with coronary heart disease. Methods A total of 246 elderly patients with coronary heart disease (CHD) were selected as the research subjects, who were referred to the CR center from the outpatient and inpatient departments of Qionghai Hospital of Traditional Chinese Medicine from June 2019 to June 2021. Their participation rate in CR activities was counted according to the sign-in data. SPSS statistics 19.0 was used for data analysis. According to the data type, t-test orχ² test was used for comparison between groups. Logistic regression model was used to analyze the influencing factors of CR participation in the elderly CHD patients. Results Among the 246 elderly CHD patients, 42 (17.07%) had high CR participation, and 204 (82.93%) had poor CR participation. Of 246 questionnaires distributed, 233 were recovered with a recovery rate of 94.72%, including 41 (17.60%) with high participation and 192 (82.40%) with poor participation. Binary logistic regression analysis showed that married status (OR=0.598,95%CI 0.385-0.927), junior college or above (OR=0.635,95%CI 0.505-0.799), understanding of cardiac rehabilitation (OR=0.641,95%CI 0.416-0.988), needs for cardiac rehabilitation (OR=0.600,95%CI 0.374-0.962), and cardiac rehabilitation cognition (OR=0.665,95%CI 0.459-0.963) were the protective factors for CR participation in the elderly CHD patients, while difficulty in payment (OR=1.766,95%CI 1.043-2.993) and long one-way time from the residence to the hospital (OR=1.404,95%CI 1.105-1.783) were the risk factors. Conclusion The participation of the elderly CHD patients in in-hospital CR activities is low. Marital status, education level, medical payment burden, one-way time from the residence to the hospital, understanding of CR, needs for CR and cognition are the associating factors of CR participation.

Abstract:Objective To verify whether grip strength and muscle mass are both associated with all-cause mortality in the patients receiving peritoneal dialysis (PD). Methods A retrospective analysis was made of all followed-up patients at the PD Center of Beijing Luhe Hospital Affiliated to Capital Medical University from February to July 2019. Their clinical data were collected, hand grip strength were measured, and appendicular skeletal muscle mass index (ASMI) was measured using the body composition analyzer. All the patients were followed up until May 2022. With death as the endpoint, the patients were divided into the survival group and death group. Multivariate Cox regression was used to screen the risk factors for all-cause mortality and evaluate the association of grip strength and ASMI with all-cause mortality in PD patients. SPSS 26.0 was used for data analysis. Comparison between two groups was performed using t-test, Mann-Whitney U test or χ²test, depending on data type. Results A total of 76 PD patients were enrolled, with an average age of (57.43±13.01) years and an average follow-up period of (941.49±312.32) d. Among them, 27 (35.52%) died. The results of univariate analysis for all-cause mortality using Kaplan-Meier test showed that the patients in death group were older, had a higher incidence of diabetes mellitus, a higher proportion of those with decreased grip strength, and lower levels of serum creatinine and serum albumin than those in the survival group (P<0.05). Uultivariate Cox regression analysis with age, years of dialysis, diabetes mellitus, ASMI, grip strength, serum creatinine, albumin and C-reactive protein showed that lower hand grip strength (HR=3.182, 95% 1.114-9.089; P=0.031), diabetes mellitus (HR=4.053, 95% 1.320-12.446; P=0.014) and age (HR=4.191, 95% 1.281-13.711; P=0.018) were independent predictors of all-cause mortality in PD patients and that ASMI had no statistical difference. Conclusion Grip strength instead of muscle mass is associated with all-cause mortality of PD patients.

Abstract:Objective To determine the effects of thunder-fire moxibustion combined with cardiac rehabilitation therapy on myocardial perfusion, exercise tolerance and quality of life in elderly patients with coronary heart disease (CHD). Methods A total of 86 elderly patients with CHD admitted to Qionghai Hospital of Traditional Chinese Medicine from January 2021 to January 2022 were recruited as the research subjects, and randomly divided into study group and control group, with 43 cases in each group. The control group was given conventional cardiac rehabilitation therapy, while the study group was treated with thunder-fire moxibustion additionally. Myocardial perfusion status, exercise tolerance, therapeutic efficacy and quality of life were compared between two groups after treatment. SPSS statistics 19.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test orχ² test depending on data type. Results After intervention, the number of involved ischemic myocardial segments was reduced in both study group and control group [(7.45±2.15) vs (3.15±0.75), (7.51±2.17) vs (5.69±1.16); both P<0.001], and the number in the study group was significantly less than that in the control group (P<0.001). The study group had obviously higher peak oxygen uptake [(25.36±4.16) vs (21.16±3.79) and (17.63±2.83) ml/(min·kg)] and anaerobic threshold [(16.98±3.69) vs (14.07±2.83) and (11.47±2.66) ml/(min·kg)], when compared with the control group after intervention and the baseline values before treatment (P<0.05). The control group had obviously higher peak oxygen uptake [(21.16±3.79)vs(17.71±3.15) ml/(min·kg)] and anaerobic threshold [(14.07±2.83) vs(11.53±2.74) ml/(min·kg)] when compared with the baseline values before treatment (P<0.05). The total efficiency rate was statistically higher in the study group than the control group [38 (88.37%) vs 30 (69.77%), P<0.05]. The score of Seattle Angina Questionnaire after intervention was increased in both groups [(76.69±13.87) vs (61.15±12.16) points, (66.16±14.05) vs (61.43±11.47) points; both P<0.05], and that of the study group was notably higher than that of the control group (P<0.05). Conclusion On the basis of cardiac rehabilitation therapy, thunder-fire moxibustion can effectively improve the therapeutic efficacy for CHD and improve the exercise tolerance and quality of life in the patients.

Abstract:Objective To investigate the value and safety of different lung biopsy methods in the diagnosis of peripheral lung masses. Methods A total of 286 elderly patients with peripheral lung lesions diagnosed by radiology in our hospital from June 2019 to June 2021 were enrolled as the study subjects. According to the methods of lung biopsy, they were divided into transthoracic needle lung biopsy group (TNLB group, n=165) and transbronchial lung biopsy group (TBLB group, n=121). McNemar test was used to calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TNLB and TBLB in the diagnosis of properties of peripheral lung masses by taking pathological examination and follow-up result as the "gold standard". SPSS statistics 19.0 was used for data analysis. Student′s t test or Chi-square test was used for intergroup comparison depending on different data type. Results For the 165 patients from the TNLB group, 51 cases had positive and 114 cases had negative results after TNLB, and 9 negative cases were confirmed to be malignant by follow-up and surgical pathology. Among 121 patients receiving TBLB, 23 cases got positive and 98 cases negative results, and among the negative cases, 16 cases were confirmed to be malignant by follow-up examination. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in the diagnosis of peripheral lung masses were 85.00%, 100.00%, 94.55%, 100.00% and 92.11% for TNLB, and 58.97%, 100.00%, 86.78%, 100.00% and 83.67% for TBLB. The biopsyaccuracy rate was significantly higher in TNLB than TBLB (94.55% vs 86.78%,P<0.05). TNLB had higher incidence rate of complications than TBLB (24.85% vs 11.57%, P<0.05). TBLB had obviously higher positive detection rate for lesions ≥4 cm in diameter than those with diameter <4 cm (24.69% vs 7.50%, P<0.05). With regard to lesions <4 cm in diameter, the positive detection rate of TNLB was higher than that of TBLB (26.67% vs 7.50%, P<0.05). Conclusion TLNB has the advantages of accurate localization and high biopsy accuracy rate, but has more postoperative complications. TBLB can be used as a preferred biopsy method to improve the safety of biopsy for the elderly patients with peripheral lung masses, who has poor lung tolerance but large lesion diameter and lesion close to the central airway.

Abstract:Pyroptosis is a new type of programmed apoptosis of cells. During pyroptosis, the cell membrane bursts due to the stimulation of external factors, the cell begins to expand, cellular fluid flows out through the pores, inflammatory factors are generated to trigger inflammation, and the cell collapses in the later stage. Pyroptosis has been studied in the fields of neurosystemic diseases, infectious diseases, autoimmune diseases, and cardiovascular diseases. This article reviews the latest research findings of pyroptosis based on its mechanism, its role in cerebral hemorrhage and some key factors, to further explore the pathological mechanism of cerebral hemorrhage, hoping to provide a new approach to the research and treatment of cerebral hemorrhage.

Abstract:Epidemiology has found that diabetes mellitus is related to the occurrence and development of autoimmune diseases, tumors and other diseases, and that diabetic people are more prone to such diseases as tumors, and have more severe symptoms and worse prognosis than non-diabetic people. Colorectal cancer (CRC) is a common malignant tumor in the digestive system and one of the main cancers that threaten the life and health of Chinese and cause a decline in their quality of life. Relationship between diabetes, type 2 diabetes mellitus (T2DM) in particular, and CRC has drew increasing attention in recent years. The biggest concern by scholars is that T2DM can be an independent influencing factor of CRC, and this may be related to insulin resistance, hyperglycemia, inflammation, and exogenous insulin. This article reviews the correlation between T2DM and colorectal cancer and the potential mechanisms.

Abstract:Heat stroke is a clinical syndrome with an imbalance of heat production and heat dissipation due to exposure to a thermal environment and/or intense exercise, characterized by increasing core body temperature ＞40 ℃ and central nervous system abnormalities(such as delirium, convulsion, coma), accompanied by a life-threatening clinical syndrome of multiple organ damage. According to the different causes and susceptible populations, heat stroke is categorized into classic heat stoke and exertional heat stroke. Heat stroke can cause changes in function and morphology of multiple organs, resulting in multiple organ dysfunction syndrome, which is the leading cause of patient′s death. Currently, no treatment is proven effective other than symptomatic treatment. Understanding the multiple organ injury features caused by heat stroke has a profound significance for its clinical treatment and mortality decrease.

Abstract:As society ages, cognitive impairment is widespread, seriously affecting patients in their work, study, and social activities and becoming a serious public health problem. Previous studies have found that cognitive impairment is common in patients with primary headache. The shared anatomical basis, regulation of serotonin system, inflammation, neuroendocrine disorders, intestinal dysbacteriosis and involvement of depression, may be the pathophysiological basis of the comorbidity. Different types of primary headaches are also associated with different cognitive domains, resulting in different treatment options. This article reviews the pathophysiological mechanism and research progression in cognitive impairment associated with primary headache, aiming to provide patients with more reasonable treatments.

Abstract:The fatality rate and the total burden of chronic diseases are increasing day by day, and thus its prevention and control is particularly important. The key to the prevention and control of the chronic diseases lies in good patients′ self-management, and the premise of effective self-management is to have a good self-efficacy in chronic disease management. This article introduced the concept, significance and state quo of self-efficacy in chronic disease management, summarized the types, reliability and validity of the assessment tools, compared and analyzed the advantages and disadvantages of the current assessment tools, and discussed issues to be focused on, with a view to providing a reference for the introduction, development, and construction of specific assessment tools and their scientific choice.

Abstract:Sarcopenia is a progressive and generalized skeletal muscle disease that causes accelerated loss of skeletal muscle mass and function. The prevalence of sarcopenia in the community is about 10% globally but about 12% in China. Sarcopenia is associated with the decreased numbers of motor neurons and satellite cells,and muscle loss resulting from factors including aging, hormonal deficiencies, chronic inflammation, mitochondrial dysfunction,nutritional deficiencies, and physical inactivity. The diagnosis of sarcopenia is made based on the lower muscle mass and decreased muscle strength with or without reduced physical performance. Its treatment includes non-pharmaceutical and pharmaceutical options. The former includes resistance exercise, blood flow restriction training, and nutritional supplementation, but effects of medications lack evidence. Early diagnosis and intervention of sarcopenia can reduce the occurrence of adverse outcomes. This review focuses on the epidemiology, pathophysiology, diagnosis, and treatment of sarcopenia.