Inflammaging in the pathogenesis of chronic non­communicable diseases

See Krivoshapova K. E., Masenko V. L., Bazdyrev E. D., Barbarash O. L. Osteosarcopenic obesity in cardiovascular patients. Controversial and open issues in Review articles, pp. 92­98.

Osteosarcopenic obesity in cardiovascular patients. Controversial and open issues

See “Inflammaging in the pathogenesis of chronic non-communicable diseases”, Kim O. T. in Opinion of invited editor, pp. 54-55.The study of osteosarcopenic obesity (OSO) in patients with cardiovascular diseases (CVDs) in recent years has caused a dis-cussion on common pathogenesis of atherosclerosis, obesity, progressive loss of skeletal and muscle mass. Are these processes independent age-related conditions or comorbidities with common links of pathogenesis? The aim of this review was to analyze studies on OSO in patients with CVDs. We used following electronic databases: PubMed, Clinical Trials, Google Scholar, www.elibrary.ru. Based on this analysis, modern ideas on the etiology, epidemiology and pathogenesis of OSO in elderly and senile patients with atherosclerosis were described. The authors concluded that absence of standards for OSO diagnosis and inadequate clinical suspicion of specialists during routine examination is one of the main causes of its insufficient detection in elderly patients with CVDs. The results of analyzed studies allow us to consider the OSO and atherosclerotic changes as a single link of cardiovascular continuum. Eliminating the negative effect of chronic inflammation on human body should be considered as a key mechanism in the treatment of OSO and atherosclerosis. However, more research is needed in this area.

Metformin and tBHQ Treatment Combined with an Exercise Regime Prevents Osteosarcopenic Obesity in Middle-Aged Wistar Female Rats

Osteosarcopenic obesity (OSO) is characterized by bone density, mass, and muscle strength loss, in conjunction with adipose tissue increase. OSO impairs physical activity and mobility, provoking autonomy loss; also, it is known that augmenting body fat in the elderly decreases life expectancy. The main factors influencing this health deterioration are the inflammatory environment induced by adipose tissue and its infiltration into muscle tissue, which leads to oxidative stress generation. Currently, there are several treatments to delay OSO, among which exercise training stands out because it improves muscle fiber quality and quantity and decreases adipose tissue. We have recently demonstrated that the combined treatment between moderate exercise and metformin slows sarcopenia’s onset by a mechanism that includes adipose reduction and REDOX regulation. On the other hand, tert-butylhydroquinone (tBHQ) is a well-known antioxidant that counteracts oxidative stress. Therefore, to slow down obesity’s harmful effects on muscle mass and bone mineral density, we performed different interventions, including combining a Fartlek-type exercise routine with metformin and tBHQ administration, in a model of middle-aged female Wistar rats with obesity induced with a hypercaloric diet. Our results showed that the combined exercise-metformin-tBHQ treatment increased muscle mass and strength, decreased body weight, body mass index, and fat percentage, and improved redox status, thus increasing animal survival.

Effect of 12-weeks elastic band resistance training on MyomiRs and osteoporosis markers in elderly women with Osteosarcopenic obesity: a randomized controlled trial

Background Interorgan communication networks established during exercise in several different tissues can be mediated by several exercise-induced factors. Therefore, the present study aimed to investigate the effects of resistance-type training using elastic band-induced changes of myomiRs (i.e., miR-206 and miR-133), vitamin D, CTX-I, ALP, and FRAX® score in elderly women with osteosarcopenic obesity (OSO). Methods In this randomized controlled trial, 63 women (aged 65–80 years) with Osteosarcopenic Obesity were recruited and assessed, using a dual-energy X-ray absorptiometry instrument. The resistance-type training via elastic bands was further designed three times per week for 12-weeks. The main outcomes were Fracture Risk Assessment Tool score, bone mineral content, bone mineral density, vitamin D, alkaline phosphatase, C-terminal telopeptides of type I collagen, expression of miR-206 and miR-133. Results There was no significant difference between the study groups in terms of the Fracture Risk Assessment Tool score (p = 0.067), vitamin D (p = 0.566), alkaline phosphatase (p = 0.334), C-terminal telopeptides of type I collagen (p = 0.067), microR-133 (p = 0.093) and miR-206 (p = 0.723). Conclusion Overall, the results of this study illustrated 12-weeks of elastic band resistance training causes a slight and insignificant improvement in osteoporosis markers in women affected with Osteosarcopenic Obesity. Trial registration Randomized controlled trial (RCT) (Iranian Registry of Clinical Trials, trial registration number: IRCT20180627040260N1. Date of registration: 27/11/2018.

Low-Intensity Exercise Routine for a Long Period of Time Prevents Osteosarcopenic Obesity in Sedentary Old Female Rats, by Decreasing Inflammation and Oxidative Stress and Increasing GDF-11

The loss of skeletal muscle mass and strength is known as sarcopenia; it is characterized as a progressive and generalized muscle disorder associated with aging. This deterioration can seriously compromise the elderly’s health and reduce their quality of life. In addition to age, there are other factors that induce muscle mass loss, among which are sedentary lifestyle, chronic diseases, inflammation, and obesity. In recent years, a new clinical condition has been observed in older adults that affects their physical capacities and quality of life, which is known as osteosarcopenic obesity (OSO). Osteoporosis, sarcopenia, and obesity coexist in this condition. Physical exercise and nutritional management are the most widely used interventions for the treatment and prevention of sarcopenia. However, in older adults, physical exercise and protein intake do not have the same outcomes observed in younger people. Here, we used a low-intensity exercise routine for a long period of time (LIERLT) in order to delay the OSO appearance related to sedentarism and aging in female Wistar rats. The LIERLT routine consisted of walking at 15 m/min for 30 min, five days a week for 20 months. To evaluate the effects of the LIERLT routine, body composition was determined using DXA-scan, additionally, biochemical parameters, inflammatory profile, oxidative protein damage, redox state, and serum concentration of GDF-11 at different ages were evaluated (4, 8, 12, 18, 22, and 24 months). Our results show that the LIERLT routine delays OSO phenotype in old 24-month-old rats, in a mechanism involving the decrease in the inflammatory state and oxidative stress. GDF-11 was evaluated as a protein related to muscle repair and regeneration; interestingly, rats that perform the LIERLT increased their GDF-11 levels.

AB0176 PATHOLOGICAL PHENOTYPES OF BODY COMPOSITION IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:Inflammation, decreased physical activity, hormonal disorders, and the use of glucocorticoids lead to changes in the composition of the body in rheumatoid arthritis (RA). Various combinations of decreased muscle and bone mass and increased adipose tissue have led to the release of various pathological phenotypes of the composition of the body.Objectives:To determine the frequency of pathological phenotypes of body composition in patients with RA.Methods:The study included 79 women with RA, with a median age of 60 y.o. [55; 65]. 92% of the women were postmenopausal. The median duration of the disease was 9 years [3; 11]. Basic anti-inflammatory therapy was received by 81% of patients. Methotrexate was used most often as the basic therapy – in 52% of cases. 49% of patients were treated with glucocorticoid drugs. All patients underwent dual-energy X-ray absorptiometry. The mineral density of the tissues was determined in the standard measurement areas - the spine and the proximal thigh, and the content of muscle and adipose tissue was analyzed. We calculated appendicular muscle mass (AMM), which is the sum of upper and lower limb muscle mass and appendicular muscle index (AMI), the ratio of appendicular muscle mass to the square of height. AMM< 15 kg, AMI < 6 kg / m2 corresponds to sarcopenia.Results:The average AMM was 17.8±3.0 kg. 18% patients had AMM <15 kg / m2. The average AMI was 6.8±1.0 kg / m2. 25% patients had AMI < 6 kg/m2. The average body mass index (BMI) was 27.6±4.8 kg/m2. 37% patients were overweight (25≤ BMI <29.9 kg/m2), 28% of women had a BMI corresponding to obesity. The average fat content was 28.2 kg. 71% of women had an obesity, according to X-ray absorptiometry, which is 2.5 times higher than the number of cases of obesity detected by BMI. A decrease a bone mineral density (BMD) was found in 73% of women, including osteoporosis in 25%. The most frequent phenotype was osteopenic obesity (Table 1), which was detected in almost 40% of patients. Isolated osteoporosis (16.5%) and obesity (17.7%) and osteosarcopenic obesity (16.5%) were found with approximately the same frequency. Osteosarcopenia was found in 9% of patients. In 4%, no changes in the compositional composition of the human body were detected.Table 1.Pathological phenotypes of body compositionPathological phenotypes of body compositionn=79Osteoporosis, n (%)13 (16,5)Obesity, n (%)14 (17,7)Osteosarcopenia, n (%)7 (8,9)Osteopenic obesity, n (%)29 (36,7)Osteosarcopenic obesity, n (%)13 (16,5)Conclusion:The overall frequency of pathological phenotypes of body composition was high and amounted to 96.2% in women with RA. The most common pathological phenotype was an osteopenic obesity characterized by a decrease in BMD and an increase in fat mass.Disclosure of Interests:None declared