title: Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults.
abstract: With considerable variation including potential sex-specific differential rate of skeletal muscle loss, identifying modifiable factors for sarcopenia will be pivotal to guide targeted interventions. This study seeks to identify clinical and biological correlates of sarcopenia in community-dwelling older adults, with emphasis on the role of anabolic and catabolic stimuli, and special reference to gender specificity. In this cross-sectional study involving 200 community-dwelling and functionally independent older adults aged ≥50 years, sarcopenia was defined using the Asian Working Group for Sarcopenia criteria. Comorbidities, cognitive and functional performance, physical activity and nutritional status were routinely assessed. Biochemical parameters included haematological indices, lipid panel, vitamin D level, anabolic hormones [insulin-like growth factor-1 (IGF-1), free testosterone (males only)] and catabolic markers [inflammatory markers (interleukin-6, C-reactive protein) and myostatin]. Multiple logistic regression was performed to identify independent predictors for sarcopenia. Age was associated with sarcopenia in both genders. Malnutrition conferred significantly higher odds for sarcopenia in women (OR = 5.71, 95% CI 1.13-28.84.44, p = 0.035) while higher but acceptable range serum triglyceride was protective in men (OR = 0.05, 95% CI 0.00-0.52, p = 0.012). Higher serum myostatin independently associated with higher odds for sarcopenia in men (OR = 1.11, 95% CI 1.00-1.24, p = 0.041). Serum IGF-1 was significantly lower amongst female sarcopenic subjects, with demonstrable trend for protective effect against sarcopenia in multiple regression models, such that each 1 ng/ml increase in IGF-1 was associated with 1% decline in odds of sarcopenia in women (p = 0.095). Our findings support differential pathophysiological mechanisms for sarcopenia that, if corroborated, may have clinical utility in guiding sex-specific targeted interventions for community-dwelling older adults.
authors.affiliation: Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. Laura_Tay@ttsh.com.sg.|Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore. Laura_Tay@ttsh.com.sg.
authors.forename: L
authors.initials: L
authors.lastname: Tay
authors.affiliation: Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.|Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Ding
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.|Department of Physiology, National University of Singapore, Singapore, Singapore.
authors.forename: B P
authors.initials: BP
authors.lastname: Leung
authors.affiliation: Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.|Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: N H
authors.initials: NH
authors.lastname: Ismail
authors.affiliation: Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Yeo
authors.affiliation: Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: S
authors.initials: S
authors.lastname: Yew
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: K S
authors.initials: KS
authors.lastname: Tay
authors.affiliation: Department of Pharmacology, National University of Singapore, Singapore, Singapore.
authors.forename: C H
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.|Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: M S
authors.initials: MS
authors.lastname: Chong
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000209:etiology*; D012737:Sex Factors
chemical_list: D015415:Biomarkers
keywords: Insulin-like growth factor-1; Myostatin; Nutrition; Sarcopenia