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Scientific Reports Nov 2023The causal roles of muscle weakness in cardiometabolic diseases and osteoporosis remain elusive. This two-sample Mendelian randomization (MR) study aims to explore the...
The causal roles of muscle weakness in cardiometabolic diseases and osteoporosis remain elusive. This two-sample Mendelian randomization (MR) study aims to explore the causal roles of muscle weakness in the risk of cardiometabolic diseases and osteoporosis. 15 single nucleotide polymorphisms (SNPs, P < 5 × 10) associated with muscle weakness were used as instrumental variables. Genetic predisposition to muscle weakness led to increased risk of coronary artery disease (inverse variance weighted [IVW] analysis, beta-estimate: 0.095, 95% confidence interval [CI]: 0.023 to 0.166, standard error [SE]:0.036, P-value = 0.009) and reduced risk of heart failure (weight median analysis, beta-estimate: - 0.137, 95% CI - 0.264 to - 0.009, SE:0.065, P-value = 0.036). In addition, muscle weakness may reduce the estimated bone mineral density (eBMD, weight median analysis, beta-estimate: - 0.059, 95% CI - 0.110 to - 0.008, SE:0.026, P-value = 0.023). We found no MR associations between muscle weakness and atrial fibrillation, type 2 diabetes or fracture. This study provides robust evidence that muscle weakness is causally associated with the incidence of coronary artery disease and heart failure, which may provide new insight to prevent and treat these two cardiometabolic diseases.
Topics: Humans; Diabetes Mellitus, Type 2; Coronary Artery Disease; Osteoporosis; Muscle Weakness; Paresis; Heart Failure; Polymorphism, Single Nucleotide; Genome-Wide Association Study; Mendelian Randomization Analysis
PubMed: 37968290
DOI: 10.1038/s41598-023-46837-y -
Journal of Cachexia, Sarcopenia and... Dec 2020
Review
Topics: Critical Illness; Female; Humans; Intensive Care Units; Male; Muscle Weakness; Muscles; Muscular Diseases; Polyneuropathies
PubMed: 32893974
DOI: 10.1002/jcsm.12620 -
The Medical Clinics of North America Jan 2024Pediatric adolescent muscle weakness can be from a variety of causes. Methodical diagnostic evaluation can lead to the category of diseases whereby phenotypic overlap... (Review)
Review
Pediatric adolescent muscle weakness can be from a variety of causes. Methodical diagnostic evaluation can lead to the category of diseases whereby phenotypic overlap requires either specialized care or broad testing patterns. However, having the ultimate diagnosis is important for prognostication.
Topics: Humans; Child; Adolescent; Muscle Weakness; Diagnosis, Differential
PubMed: 37951649
DOI: 10.1016/j.mcna.2023.06.015 -
Expert Review of Neurotherapeutics Dec 2016Weakness is one of the predominant clinical manifestations of neuromuscular disorders (NMDs), which strongly influences daily life, prognosis, and outcome of affected... (Review)
Review
Weakness is one of the predominant clinical manifestations of neuromuscular disorders (NMDs), which strongly influences daily life, prognosis, and outcome of affected patients. One of the major therapeutic goals in NMD-patients is to completely resolve muscle weakness. Various treatment options are available and include physical therapy, electrotherapy, diet, drugs, avoidance or withdrawal of muscle-toxic and weakness-inducing agents, detoxification, stem-cell-therapy, plasma-exchange, respiratory therapy, or surgery. Most accessible to treatment is weakness from immune-mediated neuropathies, immune-mediated transmission-disorders, and idiopathic immune myopathies. Areas covered: This manuscript aims to summarize and discuss recent findings and future perspectives concerning the treatment of muscle weakness in NMDs. Data were obtained by a literature search in databases such as PubMed and Current-Contents. Expert commentary: Weakness is most easily treatable in acquired NMDs and in hereditary myopathies and neuropathies beneficial treatment options are also available. Research needs to be encouraged and intensified to further expand the spectrum of treatment options for weakness.
Topics: Humans; Muscle Weakness; Neuromuscular Diseases; Paresis; Physical Therapy Modalities
PubMed: 27376189
DOI: 10.1080/14737175.2016.1206471 -
Current Opinion in Clinical Nutrition... Mar 2015Muscle wasting is common in severe critical illness. ICU-acquired weakness (ICU-AW) contributes to acute and long-term morbidity and mortality. The question remains... (Review)
Review
PURPOSE OF REVIEW
Muscle wasting is common in severe critical illness. ICU-acquired weakness (ICU-AW) contributes to acute and long-term morbidity and mortality. The question remains whether nutrition therapy in ICU can prevent or attenuate these complications. This review aims at integrating the most recent clinical data in order to answer this important clinical and research question. Clinical evidence was obtained from randomized controlled trials (RCTs). Results from animal experiments and observational studies are referred to when - respectively - providing possible explanatory mechanisms or new hypotheses.
RECENT FINDINGS
Although muscle wasting has been reproducibly quantified early in ICU, its relationship with ICU-AW has not yet been convincingly established. All recent RCTs evaluating increased energy/protein intake during ICU week 1 failed to demonstrate a protective effect against ICU-AW or physical function limitations. In one RCT, early parenteral nutrition increased the incidence of ICU-AW. The latter finding might be explained by suppressed autophagy.
SUMMARY
Current evidence does not support improved physical function with increased energy/protein provision in the first ICU week. Future RCTs aimed at reducing the burden of ICU-AW and improving long-term function should particularly focus on nutrition beyond the acute phase of critical illness and on non-nutritional interventions such as early mobilization.
Topics: Animals; Critical Illness; Dietary Proteins; Humans; Intensive Care Units; Muscle Weakness; Parenteral Nutrition; Randomized Controlled Trials as Topic
PubMed: 25603227
DOI: 10.1097/MCO.0000000000000150 -
Practical Neurology Dec 2022A man in his 20s gave a 9-year history of recurrent muscle pain and weakness, occurring mostly after exercise, and lasting for up to 2 days. There had been one episode...
A man in his 20s gave a 9-year history of recurrent muscle pain and weakness, occurring mostly after exercise, and lasting for up to 2 days. There had been one episode of severe rhabdomyolysis after cold exposure. He also had longstanding hypokalaemia, which was key to his correct diagnosis but was not followed. This case highlights the importance of an appropriately methodical investigation of weak hypokalaemic patients, and the relevance of hypokalaemia as a cause of neuromuscular symptoms not related to muscular channelopathies.
Topics: Male; Humans; Hypokalemia; Muscle Weakness; Rhabdomyolysis; Paresis
PubMed: 35907633
DOI: 10.1136/pn-2022-003433 -
Respiratory Care Sep 2006Neuromuscular abnormalities culminating in skeletal-muscle weakness occur very commonly in critically ill patients. Intensive-care-unit (ICU) acquired neuromuscular... (Review)
Review
Neuromuscular abnormalities culminating in skeletal-muscle weakness occur very commonly in critically ill patients. Intensive-care-unit (ICU) acquired neuromuscular abnormalities are typically divided into 2 discrete classes: polyneuropathy and myopathy. However, it is likely that these 2 entities commonly coexist, with myopathy being the most common cause of weakness. Major risk factors for ICU-acquired neuromuscular abnormalities include sepsis, corticosteroid administration, and hyperglycemia, with other associated factors including neuromuscular blockade and increasing severity of illness. The pathogenesis of these disorders is not well defined, but probably involves inflammatory injury of nerve and/or muscle that is potentiated by functional denervation and corticosteroids. ICU-acquired neuromuscular abnormalities are associated with multiple adverse outcomes, including higher mortality, prolonged duration of mechanical ventilation, and increased length of stay. The only intervention proven to reduce the incidence of ICU-acquired neuromuscular abnormalities is intensive insulin therapy. Additional research is necessary to better delineate the causes and pathogenesis of these disorders and to identify potential preventive and therapeutic strategies. In addition, consensus guidelines for its classification and diagnosis are needed.
Topics: Humans; Incidence; Intensive Care Units; Muscle Weakness; Paresis; Risk Factors
PubMed: 16934167
DOI: No ID Found -
Ageing Research Reviews Sep 2015This essay begins by proposing that muscle weakness of old age from sarcopenia is due in large part to reduced capillary density in the muscles, as documented in 9... (Review)
Review
This essay begins by proposing that muscle weakness of old age from sarcopenia is due in large part to reduced capillary density in the muscles, as documented in 9 reports of aged persons and animals. Capillary density (CD) is determined by local levels of various angiogenic factors, which also decline in muscles with aging, as reported in 7 studies of old persons and animals. There are also numerous reports of reduced CD in the aged brain and other studies showing reduced CD in the kidney and heart of aged animals. Thus a waning angiogenesis throughout the body may be a natural occurrence in later years and may account significantly for the lesser ailments (physical and cognitive) of elderly people. Old age is regarded here as a deficiency state which may be corrected by therapeutic angiogenesis, much as a hormonal deficiency can be relieved by the appropriate hormone therapy. Such therapy could employ recombinant angiogenic factors which are now commercially available.
Topics: Aging; Angiogenesis Inducing Agents; Animals; Humans; Muscle Weakness; Muscle, Skeletal; Neovascularization, Physiologic; Sarcopenia
PubMed: 26093038
DOI: 10.1016/j.arr.2015.03.005 -
Anesthesiology Jan 2016Muscle weakness is common in the surgical intensive care unit (ICU). Low muscle mass at ICU admission is a significant predictor of adverse outcomes. The consequences of... (Review)
Review
Muscle weakness is common in the surgical intensive care unit (ICU). Low muscle mass at ICU admission is a significant predictor of adverse outcomes. The consequences of ICU-acquired muscle weakness depend on the underlying mechanism. Temporary drug-induced weakness when properly managed may not affect outcome. Severe perioperative acquired weakness that is associated with adverse outcomes (prolonged mechanical ventilation, increases in ICU length of stay, and mortality) occurs with persistent (time frame: days) activation of protein degradation pathways, decreases in the drive to the skeletal muscle, and impaired muscular homeostasis. ICU-acquired muscle weakness can be prevented by early treatment of the underlying disease, goal-directed therapy, restrictive use of immobilizing medications, optimal nutrition, activating ventilatory modes, early rehabilitation, and preventive drug therapy. In this article, the authors review the nosology, epidemiology, diagnosis, and prevention of ICU-acquired weakness in surgical ICU patients.
Topics: Critical Care; Critical Illness; Humans; Iatrogenic Disease; Intensive Care Units; Length of Stay; Muscle Weakness; Respiration, Artificial
PubMed: 26445385
DOI: 10.1097/ALN.0000000000000874 -
Acta Bio-medica : Atenei Parmensis Nov 2020Several inherited disorders involve chronic fatigue, muscle weakness and pain. These conditions can depend on muscle, nerve, brain, metabolic and mitochondrial defects.... (Review)
Review
Several inherited disorders involve chronic fatigue, muscle weakness and pain. These conditions can depend on muscle, nerve, brain, metabolic and mitochondrial defects. A major trigger of muscle weakness and fatigue is exercise. The amount of exercise that triggers symptoms and the frequency of symptoms are highly variable. In this review, the genetic causes and molecular pathways involved in these disorders are discussed along with the diagnostic and treatment options available, with the aim of fostering understanding of the disease and exploring therapeutic options.
Topics: Exercise; Genetic Testing; Humans; Muscle Weakness; Syndrome
PubMed: 33170160
DOI: 10.23750/abm.v91i13-S.10642