Startseite Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
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Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study

  • Xilin Peng , Ruihao Zhou , Congqi Liu , Xudong Chen , Tao Zhu EMAIL logo und Guo Chen EMAIL logo
Veröffentlicht/Copyright: 1. April 2024
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Open Medicine
Aus der Zeitschrift Open Medicine Band 19 Heft 1

Abstract

Aim

Abnormalities in sleep patterns are a common health problem for the older adults. The relationship between sarcopenia and sleep duration in older people is controversial. This research is to examine the association between sleep duration and sarcopenia.

Methods

We drew 21,095 adults from the China Health and Retirement Longitudinal Survey (CHARLS). Not only we explore the relationship between sleep duration and sarcopenia, but also compare sleep duration to three sarcopenia subcomponents. Moreover, the sensitivity analysis was conducted by the gender and residence area to ascertain the discrepancy, separately. Finally, using restricted cubic spline to find the non-linear association between them.

Results

Among 7,342 community older adults engaged by CHARLS in 2015, the incidence of possible sarcopenia and sarcopenia was 23.14 and 11.30%, separately. Sleep duration (≤6 h) [OR(95%CI) = 1.30(1.03–1.65), p < 0.05] and (≥8 h) [OR(95%CI) = 1.33(1.05–1.69), p < 0.05] were significantly linked with possible sarcopenia, while long sleep duration (≥8 h) [OR(95%CI) = 1.41(1.01–2.02), p < 0.05] was correlated strongly with sarcopenia. A non-linear relationship (U-shaped) between sarcopenia risk and sleep duration was found (p for non-linear = 0.009).

Conclusions

Our findings highlight the importance of sleep duration in the onset of sarcopenia and might assist older persons to maintain good sleeping habits.

Keywords: sarcopenia; sleep duration; possible sarcopenia; older Chinese people

1 Introduction

China, which has one-fifth of the world’s elderly and the world’s largest elderly population (≥60 years old), will further increase its aging burden in 2022 when the second baby boom generation (born between 1962 and 1975) begins to retire [1]. By 2050, it is anticipated that the prevalence of sarcopenia among the elderly in China would surpass 500 million [2]. Sarcopenia, defined by the Asian Working Group for Sarcopenia 2019 (AWGS2019), is an age-related illness [3]. Long-term clinical outcomes demonstrated that AWGS-defined sarcopenia was highly related to an elevated risk of physical limits at 4 years, sluggishness at 7 years, and death at 10 years [4]. AWGS2019 discourages the use of the phrase “possible sarcopenia” in medical or research settings. In clinical practice, possible sarcopenia is sufficient to trigger an examination of causes and prepare early intervention.

As a vital human requirement, adults should sleep for 7–8 h every night, according to the National Sleep Foundation’s recommendations. Typical changes in sleep patterns linked with aging include decreased total sleep time and sleep efficiency, which impacted up to 50% of the elderly population [5]. Sleep problems in the elderly not only affect their quality of life but also put them at greater risk of death, too little or too much sleep has been shown to lead to diabetes, metabolic syndrome, obesity, cardiovascular disease, and death [6,7]. In a longitudinal cohort research of sleep duration and muscle loss in Japan, long sleep length was associated with progression to sarcopenia after 4 years, whereas short sleep duration was not [8]. However, in a cross-sectional survey of 1,068 older adults, there was no correlation between sleep duration and sarcopenia [9]. The relationship between total sleep duration and sarcopenia remains debatable. The AWGS2019 definition of “possible sarcopenia” was validated, and its diagnostic accuracy for sarcopenia was found to be remarkable [10].

Based on our current search, there are few unanimous results regarding the association between sleep duration and sarcopenia, especially in community-dwelling older adults in China. To offset the potential economic and social effects of China’s aging population, this study investigated the association between sleep duration and sarcopenia and possible sarcopenia.

2 Methods

2.1 Study population

The CHARLS is a micro-database that is nationally representative. The preliminary survey yielded high-quality survey data. A face-to-face computer-assisted personal interview comprising physical measures, blood sample collection, and other evaluations were employed in the CHARLS. The Peking University Biomedical Ethics Review Committee (IRB00001052-11015) accepted the study design and methodology and all subjects provided informed consent. More information is available on the CHARLS project website (http://charls.pku.edu.cn/).

For this retrospective cross-sectional study, we selected 21,095 people from 2015, the inclusion criteria of participants must meet the requirements of true age (≥60 years), gender, and physical examination related data such as height, weight, grip strength, 5 chair standing times (5-TCS), sleep duration, etc.

2.2 Total sleep duration

The CHARLS study queried participants about their sleep durations throughout the previous month using a questionnaire and data collection. An earlier comprehensive review and meta-analysis identified a nonlinear U-shaped connection between sleep duration and the relative risk of developing sarcopenia, with nadirs between 6 and 8 h per night [11]. We classified total sleep duration into three groups: short (≤6 h), normal (6–8 h), or long (≥8 h).

2.3 Sarcopenia

The AWGS2019 agreement maintains a maximum age restriction of 60 or 65 years, depending on how each nation defines “elderly.” According to consensus recommendations, three measurements are required to diagnose sarcopenia: muscle strength, muscle mass, and physical performance [3].

The handgrip strength, which was assessed in kilograms (kg) by having the subject squeeze a dynamometer as firmly as possible, represents muscle strength. Everyone was tested twice with both hands, the dynamometer held at a right angle, and the handle squeezed for several seconds. The greatest value of a single measurement is taken, whether it is with the dominant hand, the left and right hands, or both. Normal minimum handgrip strength according to the AWGS2019 was 28 kg for males and 18 kg for females.

Muscle mass, using an algorithm previously verified in a Chinese population, the appendicular skeletal muscle mass (ASM) was used to measure muscle mass:

ASM = 0 .193 × Body Weight (Kilogram) + 0 .107 × Height (Centimeter) − 4 .157 ⁎ Sex (Men = 1; Women = 2) − 0 .037 × Age (Year) − 2 .63118

The skeletal muscle mass index (SMI) was determined by dividing the ASM by the square of the individual’s height in meters (SMI = ASM/height2). Numerous investigations have demonstrated that SMI and dual-energy X-ray absorptiometry (DXA) are in good agreement [12,13]. The cutoff for deficient muscle mass was based on the lowest 20% of SMI for the research population. In our study, the cutoff values were 4.93 kg/m2 for women and 6.78 kg/m2 for men.

Based on the recommendations of AWGS2019, meanwhile in combination with the physical examination items of CHARLS, 5-CST is used as the data of the physical fitness test. The participants were asked to maintain their arms crossed over their chest, stand up straight, and sit down as swiftly as possible five times, without hesitating or using their arms to propel themselves. If the participants used their arms or others during the recording of the time, the test would be considered unsuccessful. Low physical performance was characterized by a 5-CST of more than 12 s.

Possible sarcopenia is described by reduced muscular strength or poor physical performance. Sarcopenia is distinguished by reduced muscle mass and strength, or a combination of poor physical performance. In addition, people with severe sarcopenia have low muscular mass, limited muscle strength, and poor physical performance. Since there are only 165 (3.62%) people defined as having severe sarcopenia, they are placed in the sarcopenia group. All subjects were then split into three groups: non-sarcopenia, possibly sarcopenia, and sarcopenia.

2.4 Covariates

Demographic data such as age, gender, degree of education, marital status, and dwelling area, as well as socioeconomic groupings [14]. Behavioral characteristics include smoking status, number of days of alcohol consumption in the past year, activities of daily living (ADL), and instrumental activities of daily living (IADL). ADL and IADL were divided into have no difficulty group (did not need help in all ADL or IADL items) and have difficulty group (needed help in any ADL or IADL items) [15]. Physical examination including body mass index (BMI according to the WHO definition of China <18.5, 18.5–24.0, 24.0–28.0, and ≥28.0 kg/m2) [16], self-reported 14 physician-diagnosed comorbidities (hypertension, dyslipidemia, diabetes, cancers, chronic lung diseases, liver diseases, heart diseases, stroke, kidney diseases, digestive diseases, psychiatric diseases, memory-related disease, arthritis or rheumatism, and asthma) were divided into three groups: none of these, only one disease or have two or more diseases, hypertension (self-reported, medication, or systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) [17], diabetes (self-reported, medication, fasting plasma glucose ≥126 mg/dL, or non-fasting plasma glucose ≥200 mg/dL), chronic kidney disease (eGFR <90 mL/min is renal insufficiency, glomerular filtration rate estimated by Cockcroft-Gault equation) [18], cognitive function score (The total cognitive score was calculated by adding the scores for orienting [5 points], calculation [5 points], recollection [20 points], and drawing [1 point], for a total of 31 points.), depression symptoms assessments (depressed disorders were measured using the 10-item short form of the Center for Epidemiologic Studies Depression Scale [CES-D-10]), and knee height.

2.5 Statistical analysis

Continuous variables with normal distributions were represented by mean and standard deviation (SD), while those with abnormal distributions were represented by medians and interquartile ranges. For categorical variables, percentages were employed. To compare participant characteristics by total sleep time category, one-way ANOVA, the Kruskal–Wallis H-test, and the Chi-square test were utilized.

The relationship between sarcopenia and total sleep duration was examined using unadjusted and adjusted logistic regression models. Pre-set models were used to guarantee the reliability of the findings. Besides, the sensitivity analysis was run independently for gender and residential area to determine the disparity. Restricted cubic spline (RCS) with four knots and a logistic regression model were used to analyze the nonlinear association between sleep time (continuous variables) and sarcopenia (bicategorical variables) and to investigate the dose–response relationship. The model was adjusted to account for age, gender, marital status, drinking, ADL, IADL, co-morbidities, and CES-D-10 scores. R 4.2.2 was used to complete RCS and optimum cutoff points with the “ggrcs” package [19].

With 95% confidence intervals (95%CI), the outcomes of the regression analysis were presented as odds ratio (OR). The level of statistical significance was established at p-value <0.05 and two-sided tests. All statistical analysis was employed with Stata/MP 17.0 (Stata Corporation, College Station, USA).

3 Results

3.1 Description of the study population

We picked 7,342 individuals from 2015 in CHARLS (Figure S1). Table 1 depicts a variety of participant characteristics according to the duration of sleep. With a mean age of 67.89 ± 6.38 years, 50.04% of them were female, 74.17% of whom lived in rural areas. Possible sarcopenia accounted for 23.14% (1,699/7,342), whereas sarcopenia accounted for 11.30% (830/7,342) of the total participants.

Table 1

Characteristics of participants according to total sleep duration in CHARLS 2015

Characteristic Total N = 7,342 Short N = 2,844 Medium N = 1,560 Long N = 2,938 P-value
Age (years, M ± SD) 67.89(6.38) 68.36(6.63) 67.15(5.93) 67.81(6.33) <0.001
Female 50.04(3,674) 57.81(1,644) 46.09(719) 44.62(1,311) <0.001
Education degree
Illiteracy 31.88(2,119) 35.99(925) 24.27(341) 31.94(853) <0.001
Primary school 46.69(3,103) 45.60(1,172) 48.40(680) 46.84(1,251)
Middle school 19.88(1,321) 17.04(438) 25.20(354) 19.81(529)
University and above 1.55(103) 1.36(35) 2.14(30) 1.42(38)
Marital status
Married/cohabitation 77.88(5,718) 74.05(2,106) 81.41(1,270) 79.71(2,342) <0.001
Single/divorced/bereave 22.12(1,624) 25.95(738) 18.59(290) 20.29(596)
Residential area
Urban 25.83(1,892) 24.76(702) 33.80(526) 22.64(664) <0.001
Rural 74.17(5,432) 75.24(2,133) 66.20(1,030) 77.36(2,269)
Socioeconomic status (CNY)
0–4,283 2,392(1,164) 24.78(452) 20.63(215) 24.84(497) 0.002
4,284–9,550 33.86(1,648) 34.76(634) 32.44(338) 33.78(676)
9,551 or more 42.22(2,055) 40.46(738) 46.93(489) 41.38(828)
Smoke
Never 54.78(3,891) 59.29(1,640) 52.51(795) 51.58(1,456) <0.001
Current 32.44(2,304) 28.52(789) 33.69(510) 35.60(1,005)
Ever but quit 12.78(908） 12.18(337) 13.80(209) 12.82(362)
Drink
Never 25.90(1,901) 24.00(682) 21.19(360) 26.99(793) <0.001
Current 7.47(548) 6.86(195) 7.06(120) 7.35(216)
Ever but quit 66.63(4,890) 69.14(1,965) 71.15(1,219) 65.66(1,929)
Difficulty in daily activities 30.92(1,710) 27.48(308) 37.26(863) 25.74(539) <0.001
Difficulty in instrumental activities 36.80(2,702) 44.20(1,257) 29.49(460) 33.53(985) <0.001
BMI (kg/m 2 , M ± SD)
<18.5 7.75(569) 8.61(245) 6.86(107) 7.39(217) <0.001
18.5 ≤ BMI < 24.0 51.80(3,803) 54.40(1,547) 48.78(761) 50.88(1,495)
24.0 ≤ BMI < 28.0 29.86(2,192) 27.00(768) 32.63(509) 31.14(915)
≥28 10.60(778) 9.99(284) 11.73(183) 10.59(311)
Number of co-morbidities
0 49.02(3,599) 46.17(1,313) 53.21(830) 49.56(1,456) <0.001
1 6.96(511) 6.36(181) 6.35(99) 7.86(231)
≥2 4.02(3,232) 47.47(1,350) 40.45(631) 42.58(1,251)
Hypertension 27.84(2,044) 29.29(833) 25.00(390) 27.94(821) 0.010
Diabetes 11.65(855) 12.27(349) 10.71(167) 11.54(339) 0.293
Chronic kidney disease 47.67(3,500) 51.09(1,453) 43.27(675) 46.70(1,372) <0.001
Cognitive assessment (score, M ± SD) 12.06(5.98) 11.34(6.00) 13.59(5.81) 11.95(5.90) <0.001
CES-D-10 items (score, M ± SD) 8.28(6.49) 10.26(7.00) 7.25(5.93) 6.96(5.76) <0.001
Knee height (cm, M ± SD) 47.40(3.68) 46.96(3.52) 44.71(3.75) 47.66(3.74) <0.001
Sarcopenia defined on AWGS 2019
Without sarcopenia 65.55(4,831) 61.53(1,750) 71.96(1,121) 66.10(1,942) <0.001
Possible sarcopenia 23.14(1,699) 25.00(711) 19.94(311) 23.04(677)
Sarcopenia 11.30(830) 13.47(383) 8.21(128) 10.86(319)
Components of sarcopenia
Low muscle mass 44.24(3,248) 36.99(1,052) 49.68(775) 48.37(1,421) <0.001
Low muscle strength 17.46(1,282) 19.23(547) 14.17(221) 17.49(514) <0.001
Low physical performance 24.79(1,820) 28.62(814) 19.29(301) 24.00(705) <0.001

Abbreviations: AWGS 2019, Asian Working Group for Sarcopenia 2019; BMI, body mass index; CES-D-10, 10-item short form of the Center for Epidemiologic Studies Depression Scale; CNY, Chinese Yuan.

3.2 Association between total sleep duration and possible sarcopenia

In the overall research population, the crude model (Model 1) revealed a substantial connection between short or long total sleep time and the possibility of sarcopenia, for short total sleep duration (≤6 h) [OR(95%CI) = 1.46(1.26–1.71), p < 0.001] and for long total sleep duration (≥8 h) [OR(95%CI) = 1.26(1.08–1.46), p < 0.001]. Model 4 revealed that the short sleep duration group [OR(95%CI) = 1.30(1.03–1.65), p < 0.05] and the long sleep duration group [OR(95%CI) = 1.33(1.05–1.69), p < 0.05] were substantially related with a greater probability of sarcopenia compared to the typical sleep length groups (6–8 h) (Table 2).

Table 2

Associations between sarcopenia and total sleep duration by multinomial logistic regression model

Total sleep duration Possible sarcopenia Sarcopenia Possible sarcopenia Sarcopenia
OR (95%CI) OR (95%CI) OR (95%CI) OR (95%CI)
Model 1 a Model 2 b
Short 1.46(1.26–1.71)*** 1.92(1.55–2.37)*** 1.44(1.18–1.76)*** 1.46(1.08–1.96)**
Medium Ref. Ref. Ref. Ref.
Long 1.26(1.08–1.46)*** 1.44(1.16–1.79)*** 1.28(1.05–1.55)** 1.41(1.04–1.90)**
Model 3 c Model 4 d
Short 1.42(1.16–1.74)*** 1.43(1.06–1.93)** 1.30(1.03–1.65)** 1.13(0.80–1.62)
Medium Ref. Ref. Ref. Ref.
Long 1.24(1.02–1.52)** 1.39(1.03–1.88)** 1.33(1.05–1.69)** 1.41(1.01–2.02)**

***: p-value < 0.001, **: p-value < 0.05. aCrude model. bAdjusted for age, gender, marital status, residential area, socioeconomic status. cAdjusted for age, gender, marital status, residential area, socioeconomic status, smoke, drink. dAdjusted for age, gender, marital status, residential area, socioeconomic status, smoke, drink, difficulty in daily activities, difficulty in instrumental activities, BMI, co-morbidities, hypertension, diabetes, chronic kidney disease, cognitive assessment scores, CES-D-10 items scores.

Ref, reference; CI, confidence interval; OR, odds ratio.

3.3 Association between total sleep duration and sarcopenia

The outcomes of several models produced from multiple logistic regression studies are presented in Table 2. Compared with normal sleeping for 6–8 h, short total sleep duration (≤6 h) had a nearly two-fold increased likelihood of sarcopenia [OR(95%CI) = 1.92(1.55–2.37), p < 0.001], as for long total sleep duration (≥8 h) had an over one-fold increased likelihood of sarcopenia [OR(95%CI) = 1.44(1.16–1.79), p < 0.001]. After adjusting all relative factors (Model 4), the risk of the long group [OR(95%CI) = 1.41(1.01–2.02), p < 0.05] was higher than the control group, and no significant result was displayed in the short group [OR(95%CI) = 1.13(0.80–1.62)].

3.4 Association between the length of sleep and the specific sarcopenia components

The short group had a significant relationship with lower physical performance [OR(95%CI) = 1.32(1.05–1.67), p < 0.05], as same as the long group [OR(95%CI) = 1.35(1.06–1.71), p < 0.05]. Compared with the normal group, lower grip strength was associated with the long total sleep duration [OR(95%CI) = 1.36(1.03–1.79), p < 0.05], but not with the shorter total sleep duration. However, the link between total sleep duration and lower SMI was no longer significant (Table 3).

Table 3

Associations between development of sarcopenia subcomponents and total sleep duration by logistic regression model

Total sleep duration Low muscle mass Low physical performance Low muscle strength
OR (95%CI) OR (95%CI) OR (95%CI)
Short 1.12(0.73–1.71) 1.32(1.05–1.67)** 1.08(0.82–1.43)
Medium Ref. Ref. Ref.
Long 1.21(0.80–1.83) 1.35(1.06–1.71)** 1.36(1.03–1.79)**

***: p-value < 0.001, **: p-value < 0.05.

Ref, reference; CI, confidence interval; OR, odds ratio.

3.5 Differences in the sexual influence of sleep time on the incidence of sarcopenia

After adjusted factors (Model 4) (Table 4), the association between the short sleep group and possible sarcopenia [OR(95%CI) = 1.11(0.79–1.57), p = 0.542] or sarcopenia [OR(95%CI) = 1.36(0.67–2.84), p = 0.406] was no longer significant, the long sleep group [OR(95%CI) = 1.47(1.06–2.04), p < 0.05] increased the risk of possible sarcopenia, sarcopenia [OR(95%CI) = 1.72(0.83–3.57), p = 0.142] which was not significant for elderly male. As for the elderly female, the relationship between the short sleep group and possible sarcopenia [OR(95%CI) = 1.49(1.04–2.12), p < 0.05] was significant, sarcopenia [OR(95%CI) = 1.16(0.80–1.68), p = 0.446] was not obvious. The risk of possible sarcopenia [OR(95%CI) = 1.06(0.70–1.61), p = 0.791] and sarcopenia [OR(95%CI) = 1.32(0.86–2.03), p = 0.204] in the long sleep group were not significant.

Table 4

Associations between the sexual difference of sarcopenia and total sleep duration by logistic regression models

Outcome variable Analytic model Female Male
Short Medium Long Short Medium Long
OR (95%CI) OR (95%CI) OR (95%CI) OR (95%CI)
Possible sarcopenia Model 1a 1.52(1.21–1.90)*** Ref. 1.19(0.94–1.50) 1.42(1.15–1.76)*** Ref. 1.30(1.07–1.60)**
Model 2b 1.55(1.15–2.09)** Ref. 1.20(0.88–1.65) 1.34(1.02–1.76)** Ref. 1.31(1.02–1.69)**
Model 3c 1.57(1.16–2.12)** Ref. 1.18(0.86–1.63) 1.29(0.97–1.70) Ref. 1.28(0.98–1.66)
Model 4d 1.49(1.04–2.12)** Ref. 1.16(0.80–1.68) 1.11(0.79–1.57) Ref. 1.47(1.06–2.04)**
Sarcopenia Model 1a 1.62(1.25–2.10)*** Ref. 1.43(1.09–1.87)** 2.07(1.39–3.06)*** Ref. 1.54(1.04–2.27)**
Model 2b 1.43(1.00–2.04)** Ref. 1.48(1.03–2.13)** 1.55(0.90–2.65) Ref. 1.23(0.73–2.10)
Model 3c 1.43(1.00–2.04) Ref. 1.49(1.03–2.14)** 1.47(0.85–2.53) ref. 1.14(0.67–1.96)
Model 4d 1.06(0.70–1.61) Ref. 1.32(0.86–2.03) 1.36(0.66–2.84) Ref. 1.72(0.83–3.57)

***: p-value < 0.001, **: p-value < 0.05. aCrude model. bAdjusted for age, gender, marital status, residential area, socioeconomic status. cAdjusted for age, gender, marital status, residential area, socioeconomic status, smoke, drink. dAdjusted for age, gender, marital status, residential area, socioeconomic status, smoke, drink, difficulty in daily activities, difficulty in instrumental activities, BMI, co-morbidities, hypertension, diabetes, chronic kidney disease, cognitive assessment scores, CES-D-10 items scores.

Ref, reference; CI, confidence interval; OR, odds ratio.

3.6 Differences in the residential area difference of sleep time on the incidence of sarcopenia

The results showed that there were indeed urban–rural differences in the relationship between sarcopenia and sleep duration (Table S1). The elderly living in urban areas, the risk of possible sarcopenia (short sleep time [OR(95%CI) = 1.24 (0.08–1.92), p = 0.330] and long sleep time [OR(95%CI) = 1.25 (0.08–1.95), p = 0.334]) and sarcopenia (short sleep time [OR(95%CI) = 1.49(0.66–3.38), p = 0.335] and long sleep time [OR(95%CI) = 2.02 (0.85–4.79), p = 0.110]) did not show a statistically significant. However, the relatively long [OR(95%CI) = 1.42 (1.06–1.91), p < 0.05] or relatively short sleep duration [OR(95%CI) = 1.35(1.00–1.81), p < 0.05] of the elderly living in rural areas increased the risk of possible sarcopenia. Short [OR(95%CI) = 1.00(0.66–1.48), p = 0.959] and long sleep time [OR(95%CI) = 1.29(0.86–1.93), p = 0.214] compared to the normal sleep time prone to have the risk of sarcopenia but no significant.

3.7 Non-linear relationship between sleep duration and the risk of sarcopenia

Using RCS regression (p for non-linear = 0.009), Figure 1 illustrates a non-linear (U-shaped) relationship between sleep duration and the risk of sarcopenia. Participants who slept for an average of 7 h total each day had the lowest risk.

Figure 1 RCS between total sleep duration and the risk of sarcopenia.
Figure 1

RCS between total sleep duration and the risk of sarcopenia.

4 Discussion

In our present study, we found that sleep disturbance is a risk factor for developing sarcopenia in the Chinese elderly population. The incidence of possible sarcopenia and sarcopenia was 23.14 and 11.30%, respectively. This compares to prior findings indicating that the prevalence of skeletal sarcopenia as defined by the AWGS 2014 ranged from 5.5 to 25.7% [3]. The general frequency of 11–14% among elderly Chinese residents of the neighborhood was constant [20]. The risk factor for possible sarcopenia is an abnormal (≥6 h or ≤8 h) sleep pattern. Since the definition of “possible sarcopenia” is based on the newest recent AWGS2019 recommendations, there were still few recent studies that explored the overall risk factor. The mechanism by which sleep disturbances contribute to possible sarcopenia is reduced muscular strength or physical performance. Referring to restorative theory [21], sleep is necessary for the body’s repair and recovery processes. Many biological reactions develop during sleep including protein synthesis, muscle repairment, and hormone release, which influences muscular strength and physical performance indirectly. Sleep disturbances also have an impact on appetite and hunger [22]. One study stated that two consecutive nights of only 4 h of sleep resulted from leptin decreasing by 18% and growth hormone-releasing peptide increasing by 28%, leading to muscle loss and adipose tissue rising [23].

After additional adjustment for confounders, only long total sleep duration (≥8 h) was a danger factor for the progression of sarcopenia, irrespective of short sleep duration. The finding is in line with the results of other cross-sectional studies [9,24,25]. Furthermore, two longitudinal cohorts of 2 years [26] and 4 years [8] demonstrated that long total sleep duration also increased the incidence of sarcopenia in older adults. This result can be explained by the following mechanisms: prolonged sleep has been linked to the development of insulin resistance (IR), which induces anabolic resistance. Finally, sleep difficulties cause hormonal imbalances promoting the occurrence of sarcopenia [27]. According to the findings of a meta-analysis, high interleukin-6 and C-reactive protein levels were substantially related to longer rather than shorter sleep duration [28]. Some studies [29,30] have found an association between long and short sleep duration and the risk of sarcopenia. This disagreement may be related to discrepancies in research background, sarcopenia diagnostic criteria, and sleep disorder definitions.

We discovered that abnormal sleep duration was associated with poor physical performance and long sleep duration was associated with lower muscle strength, only lower muscle mass was not significantly associated with either sleep duration. These findings were consistent with those of other studies [31,32]. A Japanese study discovered that long sleep (>9 h) was associated with lower physical performance after 4 years of follow-up [8]. Long sleep (>9 h) was linked to poor physical performance (low gait speed) and poor grip strength, but not to low muscle mass. Instead, the results of a community survey [26] showed that it was related to lower muscle mass in addition to lower muscle strength. Various methods of assessing muscle mass can explain this difference. AWGS2019 advises utilizing either multifrequency bioelectrical impedance analysis or DXA both height-adjusted, to measure muscle mass for diagnosing sarcopenia [3]. In terms of gender disparities, the results of our gender stratification are in conflict with those of certain similar studies [24,33]. The elderly are more prone to sarcopenia if they sleep too much or too little. This may cause by the difference in sex hormone secretion, which not only controls muscle growth and development but also modulates sleep rhythm. It is indeed the same as the prior research after doing the RCS analysis [11,33]. Moreover, our findings revealed urban–rural disparities in the link between sarcopenia and sleep duration. This disparity could be attributed to the lifestyles of the elderly living in rural and urban areas. In China, the elderly living in rural areas typically engage in farming activities, and irregular schedules are more common than those living in urban areas. The sleep restorative theory [21] believes that sleep is essential for the process of body repair and rejuvenation. According to the original 2015 CHARLS data, 14,343 (68.42%) of the elderly in the community came from rural regions, while 6,620 (31.58%) were from urban areas. The high concentration of elderly persons in rural areas participating contributes to inequality.

The relationship between sleep and sarcopenia may operate in both directions. Circadian rhythms and molecular clocks play a significant role in the growth and development of skeletal muscle. The Bmal1 (brain and muscle ARNT-like1) gene is one of the key transcriptional activators of biological clock genes [34]. A study [35] discovered that Bmal1 deficiency is associated with aging and causes severe sarcopenia. Besides, abnormal sleep duration causes endocrine disruption (growth hormone, insulin-like growth factor-1, cortisol, testosterone, etc.), blocking myofibril reconstruction, and strengthening in cellular and molecular pathways [36]. Finally, lifestyle behaviors are influenced by sleep patterns. Sleep-deprived individuals are more likely to smoke, lack exercise, consume large amounts of alcohol, and increase sedentary time indirectly [37].

The first advantage of this study is that the sample data we gathered and analyzed were nationally representative. These conclusions may be applied to all of China’s elderly. According to our knowledge, this is the first study to evaluate the association between sleep duration and the risk of sarcopenia in the Chinese elderly using the CHARLS. With the most recent AWGS2019 diagnostic criteria, our findings indicate several potential risk variables for possible sarcopenia, which would help with its early diagnosis and prevention. This study has certain limitations. First, as a cross-sectional study, this research was unable to establish a causal connection between sleep duration and sarcopenia. Additionally, the data on sleep duration are self-reported, which may result in biased findings. The reliability of self-reported sleep duration is also confirmed by the results of several relevant studies based on CHARLS [38–40]. Future research may utilize polysomnography and actigraphy to measure sleep duration [41]. However, we did not investigate the effect of sleep quality in our study because CHARLS lacks this variable. Further studies are required to collect more detailed information to elucidate the association between sleep-related variables and the risk of possible sarcopenia and sarcopenia.

In conclusion, this study found that total sleep duration is non-linearly associated with the risk of developing sarcopenia in older Chinese community residents. Our findings advocate for a greater focus on sleep patterns in the elderly, further additional in-depth investigations to investigate the underlying molecular pathways connecting them.

Abbreviations

ADL

activities of daily living

ASM

appendicular skeletal muscle mass

AWGS2019

Asian Working Group for Sarcopenia in 2019

Bmal1

brain and muscle ARNT-like 1

BMI

body mass index

CES-D-10

10-item short form of the Center for Epidemiologic Studies Depression Scale

CHARLS

China Health and Retirement Longitudinal Study

DXA

dual-energy X-ray absorptiometry

IADL

instrumental activities of daily living

OR

odds ratio

RCS

restricted cubic spline

SD

standard deviations

SMI

skeletal muscle mass index

5-TCS

5-time chair stand

95%CI

95% confidence intervals

# These authors contributed equally to the article and should be considered as co-first authors.

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Acknowledgments

We appreciate all CHARLS survey participants and recorders, as well as the CHARLS team for supplying the data.

  1. Funding information: This study was supported by grant no. 2018YFC2001800 from the National Key R&D Program of China (Beijing, China).

  2. Author contributions: X.P., R.Z., and C.L. conceived the project and planned the investigation. X.P. and C.L. conducted statistical analyses and result interpretations. X.P. and X.C. drafted the first version of the manuscript. R.Z., G.C., and T.Z. revised it for significant intellectual substance.

  3. Conflict of interest: The authors declare no conflict of interest.

  4. Data availability statement: The China Longitudinal Study of Health and Retirement (CHARLS) (http://charls.pku.edu.cn) contains information on the findings of this investigation. Prior to access, approval from the Peking University CHARLS team is necessary.

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Received: 2023-11-22
Revised: 2024-02-24
Accepted: 2024-02-27
Published Online: 2024-04-01

© 2024 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
  227. Identification of signatures associated with microsatellite instability and immune characteristics to predict the prognostic risk of colon cancer
  228. Single-cell analysis identified key macrophage subpopulations associated with atherosclerosis
https://doi.org/10.1515/med-2024-0938
Schlagwörter für diesen Artikel
sarcopenia; sleep duration; possible sarcopenia; older Chinese people
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. EDNRB inhibits the growth and migration of prostate cancer cells by activating the cGMP-PKG pathway
  3. STK11 (LKB1) mutation suppresses ferroptosis in lung adenocarcinoma by facilitating monounsaturated fatty acid synthesis
  4. Association of SOX6 gene polymorphisms with Kashin-Beck disease risk in the Chinese Han population
  5. The pyroptosis-related signature predicts prognosis and influences the tumor immune microenvironment in dedifferentiated liposarcoma
  6. METTL3 attenuates ferroptosis sensitivity in lung cancer via modulating TFRC
  7. Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps
  8. Novel lumbar plexus block versus femoral nerve block for analgesia and motor recovery after total knee arthroplasty
  9. Correlation between ABCB1 and OLIG2 polymorphisms and the severity and prognosis of patients with cerebral infarction
  10. Study on the radiotherapy effect and serum neutral granulocyte lymphocyte ratio and inflammatory factor expression of nasopharyngeal carcinoma
  11. Transcriptome analysis of effects of Tecrl deficiency on cardiometabolic and calcium regulation in cardiac tissue
  12. Aflatoxin B1 induces infertility, fetal deformities, and potential therapies
  13. Serum levels of HMW adiponectin and its receptors are associated with cytokine levels and clinical characteristics in chronic obstructive pulmonary disease
  14. METTL3-mediated methylation of CYP2C19 mRNA may aggravate clopidogrel resistance in ischemic stroke patients
  15. Understand how machine learning impact lung cancer research from 2010 to 2021: A bibliometric analysis
  16. Pressure ulcers in German hospitals: Analysis of reimbursement and length of stay
  17. Metformin plus L-carnitine enhances brown/beige adipose tissue activity via Nrf2/HO-1 signaling to reduce lipid accumulation and inflammation in murine obesity
  18. Downregulation of carbonic anhydrase IX expression in mouse xenograft nasopharyngeal carcinoma model via doxorubicin nanobubble combined with ultrasound
  19. Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement
  20. miR-335-3p improves type II diabetes mellitus by IGF-1 regulating macrophage polarization
  21. The analyses of human MCPH1 DNA repair machinery and genetic variations
  22. Activation of Piezo1 increases the sensitivity of breast cancer to hyperthermia therapy
  23. Comprehensive analysis based on the disulfidptosis-related genes identifies hub genes and immune infiltration for pancreatic adenocarcinoma
  24. Changes of serum CA125 and PGE2 before and after high-intensity focused ultrasound combined with GnRH-a in treatment of patients with adenomyosis
  25. The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis
  26. Development and validation of a novel model to predict pulmonary embolism in cardiology suspected patients: A 10-year retrospective analysis
  27. Downregulation of lncRNA XLOC_032768 in diabetic patients predicts the occurrence of diabetic nephropathy
  28. Circ_0051428 targeting miR-885-3p/MMP2 axis enhances the malignancy of cervical cancer
  29. Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
  30. The construction of a novel prognostic prediction model for glioma based on GWAS-identified prognostic-related risk loci
  31. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study
  32. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database
  33. CD36-mediated podocyte lipotoxicity promotes foot process effacement
  34. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis
  35. FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage
  36. Challenges in treating primary immune thrombocytopenia patients undergoing COVID-19 vaccination: A retrospective study
  37. Let-7 family regulates HaCaT cell proliferation and apoptosis via the ΔNp63/PI3K/AKT pathway
  38. Phospholipid transfer protein ameliorates sepsis-induced cardiac dysfunction through NLRP3 inflammasome inhibition
  39. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy
  40. Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction
  41. High SEC61A1 expression predicts poor outcome of acute myeloid leukemia
  42. Comparison of polymerase chain reaction and next-generation sequencing with conventional urine culture for the diagnosis of urinary tract infections: A meta-analysis
  43. Secreted frizzled-related protein 5 protects against renal fibrosis by inhibiting Wnt/β-catenin pathway
  44. Pan-cancer and single-cell analysis of actin cytoskeleton genes related to disulfidptosis
  45. Overexpression of miR-532-5p restrains oxidative stress response of chondrocytes in nontraumatic osteonecrosis of the femoral head by inhibiting ABL1
  46. Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
  47. Clinical analysis of incomplete rupture of the uterus secondary to previous cesarean section
  48. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
  49. No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study
  50. Identification and validation of autophagy-related genes in SSc
  51. Long non-coding RNA SRA1 suppresses radiotherapy resistance in esophageal squamous cell carcinoma by modulating glycolytic reprogramming
  52. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study
  53. The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis
  54. Compilation of a self-management assessment scale for postoperative patients with aortic dissection
  55. Left atrial appendage closure in conjunction with radiofrequency ablation: Effects on left atrial functioning in patients with paroxysmal atrial fibrillation
  56. Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study
  57. Clinical characteristics and assessment of risk factors in patients with influenza A-induced severe pneumonia after the prevalence of SARS-CoV-2
  58. Analgesia nociception index is an indicator of laparoscopic trocar insertion-induced transient nociceptive stimuli
  59. High STAT4 expression correlates with poor prognosis in acute myeloid leukemia and facilitates disease progression by upregulating VEGFA expression
  60. Factors influencing cardiovascular system-related post-COVID-19 sequelae: A single-center cohort study
  61. HOXD10 regulates intestinal permeability and inhibits inflammation of dextran sulfate sodium-induced ulcerative colitis through the inactivation of the Rho/ROCK/MMPs axis
  62. Mesenchymal stem cell-derived exosomal miR-26a induces ferroptosis, suppresses hepatic stellate cell activation, and ameliorates liver fibrosis by modulating SLC7A11
  63. Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke
  64. ANO6 (TMEM16F) inhibits gastrointestinal stromal tumor growth and induces ferroptosis
  65. Prognostic value of EIF5A2 in solid tumors: A meta-analysis and bioinformatics analysis
  66. The role of enhanced expression of Cx43 in patients with ulcerative colitis
  67. Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance
  68. Role of ICAM-1 in triple-negative breast cancer
  69. Cost-effectiveness of ambroxol in the treatment of Gaucher disease type 2
  70. HLA-DRB5 promotes immune thrombocytopenia via activating CD8+ T cells
  71. Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome
  72. Efficacy of tacrolimus monotherapy in primary membranous nephropathy
  73. Mechanisms of Tripterygium wilfordii Hook F on treating rheumatoid arthritis explored by network pharmacology analysis and molecular docking
  74. FBXO45 levels regulated ferroptosis renal tubular epithelial cells in a model of diabetic nephropathy by PLK1
  75. Optimizing anesthesia strategies to NSCLC patients in VATS procedures: Insights from drug requirements and patient recovery patterns
  76. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss
  77. Correlation between fat-soluble vitamin levels and inflammatory factors in paediatric community-acquired pneumonia: A prospective study
  78. CD1d affects the proliferation, migration, and apoptosis of human papillary thyroid carcinoma TPC-1 cells via regulating MAPK/NF-κB signaling pathway
  79. miR-let-7a inhibits sympathetic nerve remodeling after myocardial infarction by downregulating the expression of nerve growth factor
  80. Immune response analysis of solid organ transplantation recipients inoculated with inactivated COVID-19 vaccine: A retrospective analysis
  81. The H2Valdien derivatives regulate the epithelial–mesenchymal transition of hepatoma carcinoma cells through the Hedgehog signaling pathway
  82. Clinical efficacy of dexamethasone combined with isoniazid in the treatment of tuberculous meningitis and its effect on peripheral blood T cell subsets
  83. Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis
  84. Lycopene inhibits pyroptosis of endothelial progenitor cells induced by ox-LDL through the AMPK/mTOR/NLRP3 pathway
  85. Methylation regulation for FUNDC1 stability in childhood leukemia was up-regulated and facilitates metastasis and reduces ferroptosis of leukemia through mitochondrial damage by FBXL2
  86. Correlation of single-fiber electromyography studies and functional status in patients with amyotrophic lateral sclerosis
  87. Risk factors of postoperative airway obstruction complications in children with oral floor mass
  88. Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction
  89. Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022
  90. Evaluating anemia in HIV-infected patients using chest CT
  91. Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court
  92. Causal association of circulating immune cells and lymphoma: A Mendelian randomization study
  93. Assessment of the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals on treating renal fibrosis: A systematic review and meta-analysis
  94. Comprehensive landscape of integrator complex subunits and their association with prognosis and tumor microenvironment in gastric cancer
  95. New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: A drug Mendelian randomization study
  96. Population pharmacokinetics of meropenem in critically ill patients
  97. Comparison of the ability of newly inflammatory markers to predict complicated appendicitis
  98. Comparative morphology of the cruciate ligaments: A radiological study
  99. Immune landscape of hepatocellular carcinoma: The central role of TP53-inducible glycolysis and apoptosis regulator
  100. Serum SIRT3 levels in epilepsy patients and its association with clinical outcomes and severity: A prospective observational study
  101. SHP-1 mediates cigarette smoke extract-induced epithelial–mesenchymal transformation and inflammation in 16HBE cells
  102. Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway
  103. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma
  104. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program
  105. Exploring anesthetic-induced gene expression changes and immune cell dynamics in atrial tissue post-coronary artery bypass graft surgery
  106. Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism
  107. Analysis of the risk factors of the radiation-induced encephalopathy in nasopharyngeal carcinoma: A retrospective cohort study
  108. Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review
  109. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population
  110. Prognostic and diagnostic value of circulating IGFBP2 in pancreatic cancer
  111. Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques
  112. Research trends related to emergence agitation in the post-anaesthesia care unit from 2001 to 2023: A bibliometric analysis
  113. Frequency and clinicopathological correlation of gastrointestinal polyps: A six-year single center experience
  114. ACSL4 mediates inflammatory bowel disease and contributes to LPS-induced intestinal epithelial cell dysfunction by activating ferroptosis and inflammation
  115. Affibody-based molecular probe 99mTc-(HE)3ZHER2:V2 for non-invasive HER2 detection in ovarian and breast cancer xenografts
  116. Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials
  117. The relationship between IFN-γ, IL-10, IL-6 cytokines, and severity of the condition with serum zinc and Fe in children infected with Mycoplasma pneumoniae
  118. Paraquat disrupts the blood–brain barrier by increasing IL-6 expression and oxidative stress through the activation of PI3K/AKT signaling pathway
  119. Sleep quality associate with the increased prevalence of cognitive impairment in coronary artery disease patients: A retrospective case–control study
  120. Dioscin protects against chronic prostatitis through the TLR4/NF-κB pathway
  121. Association of polymorphisms in FBN1, MYH11, and TGF-β signaling-related genes with susceptibility of sporadic thoracic aortic aneurysm and dissection in the Zhejiang Han population
  122. Application value of multi-parameter magnetic resonance image-transrectal ultrasound cognitive fusion in prostate biopsy
  123. Laboratory variables‐based artificial neural network models for predicting fatty liver disease: A retrospective study
  124. Decreased BIRC5-206 promotes epithelial–mesenchymal transition in nasopharyngeal carcinoma through sponging miR-145-5p
  125. Sepsis induces the cardiomyocyte apoptosis and cardiac dysfunction through activation of YAP1/Serpine1/caspase-3 pathway
  126. Assessment of iron metabolism and iron deficiency in incident patients on incident continuous ambulatory peritoneal dialysis
  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
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Heruntergeladen am 5.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2024-0938/html?lang=de
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