High Myostatin Serum Related with High Prevalence of Sarcopenia Among Elderly Population in Pedawa Village, Bali, Indonesia

BACKGROUND: Sarcopenia is defined as a decrease in muscle mass accompanied by a decrease in muscle strength and performance. Sarcopenia arises from the disruption of the complex balance between anabolic and catabolic factors. Myostatin strongly influences muscle growth inhibition. Deletion and function loss of myostatin causes hyperplasia and skeletal muscle hypertrophy.METHODS: This study was an analytical cross-sectional study. Seventy respondents aged ≥60 years in Pedawa Village, Bali, Indonesia were selected by using the stratified random sampling technique. Sarcopenia status was assessed according to Asian Working Group for Sarcopenia (AWGS) criteria, including muscle mass, grip strength, and walking speed. While the myostatin serum levels was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS: The incidence of sarcopenia in the elderly was 45 people (64.3%). Based on the analysis, there was a significant difference between myostatin levels in sarcopenia subjects (47.59 ng/mL) and non-sarcopenia subjects (39.7 ng/mL). Based on the statistical calculations, it was determined that the cut-off range of myostatin levels was 48.91 ng/mL. The prevalence ratio of sarcopenia incidence based on the myostatin levels in the elderly was 3.84, while based on the combination of age risk and myostatin levels was 9.75.CONCLUSION: Based of the data, there are significant differences of myostatin level between elderly people with and without sarcopenia. The prevalence of high myostatin levels in elderly is almost 4 times higher than low myostatin levels in the elderly.KEYWORDS: myostatin, sarcopenia, elderl

The The relationship between IL-6 and CRP with Sarcopenia in indigenous elderly population at Pedawa Village, Buleleng, Bali, Indonesia

Abstrak Latar belakang: Sarkopenia adalah sindrom yang ditandai dengan penurunan massa otot disertai penurunan kekuatan otot dan atau fungsi otot. Stres oksidatif dan proses inflamasi dikenal sebagai faktor pemicu untuk sarkopenia dengan melepaskan rangsangan katabolik interleukin-6 (IL-6) dan protein C-reaktif (CRP). Penelitian ini bertujuan untuk menentukan hubungan antara IL-6 dan kadar CRP terhadap parameter sarkopenia seperti massa otot, kekuatan pegangan, dan kecepatan berjalan. Metode: Penelitian ini menggunakan desain cross-sectional analitik yang dilakukan di Desa Pedawa, Kabupaten Buleleng, Bali pada bulan Agustus 2016. Sekitar 79 responden berusia ≥ 60 tahun menggunakan teknik sampling acak stratifikasi. Variabel yang dinilai yaitu parameter sarkopenia (massa otot, kekuatan pegangan, dan kecepatan berjalan) termasuk IMT, serta IL-6 dan pemeriksaan tingkat CRP. Uji korelasi spearman dan parsial digunakan untuk menilai korelasi antara parameter IL-6, CRP, dan sarkopenia. Hasil: Kadar IL-6 dan CRP tidak berkorelasi signifikan dengan tiga parameter sarkopenia. Kadar CRP berkorelasi dengan IL-6 (r = 0.37; p = 0.001) dan IMT (r = 0.29; p = 0.009). Pada kelompok pria, IL-6  hanya berkorelasi dengan CRP (r = 0.40; p = 0.011). Sedangkan pada kelompok wanita, IL-6 berkolerasi dengan CRP (r = 0.38; p = 0.017), kecepatan berjalan (r = 0.33; p = 0.037) serta CRP berkorelasi dengan IMT (r = 0.32; p = 0.049) dan massa otot total (r = -0.32; p = 0.043).  Setelah penyesuaian untuk variabel IMT, IL-6 berkorelasi dengan CRP (r = 0.43; p = 0,001) dan massa otot total (r = -0.25; p = 0.026) serta secara signifikan berkorelasi pada kelompok kurus (IMT<18.5 kg/m2) (r = -0.50; p = 0.026). CRP tidak berkorelasi secara signifikan dengan tiga parameter sarkopenia pada uji spearman, korelasi parsial, dan uji korelasi spesifik spearman berdasarkan pada kelompok IMT. Kesimpulan: Kadar IL-6 berhubungan dengan penurunan massa otot total pada keseluruhan lansia desa Pedawa setelah penyesuaian variabel IMT. Kata kunci: IL-6, Protein C-Reaktif (CRP), Sarkopenia, Lanjut usia, Desa Pedawa.   Abstract  Background: Sarcopenia is a syndrome characterized by decreased muscle mass with decreased muscle strength and or muscle function. Oxidative stress and inflammatory processes are known as triggering factors for sarcopenia by releasing catabolic stimuli of interleukin-6 (IL-6) and C-reactive protein (CRP).This study aims to determine the relationship between IL-6 and CRP levels to sarcopenia parameter such as muscle mass, grip strength, and walking speed. Methods: This study was an analytic cross-sectional design conducted at Pedawa Village, Buleleng District, Bali in August 2016. About 79 respondents aged ≥ 60 years using stratified random sampling technique. The assessed variables were sarcopenia parameter (muscle mass, grip strength, and walking speed) including BMI, as well as IL-6 and CRP levels examination. Spearman and partial correlation test were used to assess the correlation among IL-6, CRP, and sarcopenia parameters. Results: IL-6 levels and CRP were not significantly correlated with the three parameters of sarcopenia. CRP levels correlated with IL-6 (r = 0.37; p = 0.001) and BMI (r = 0.29; p = 0.009). In the male group, IL-6 was only correlated with CRP (r = 0.40; p = 0.011). While in the women group, IL-6 correlated with CRP (r = 0.38; p = 0.017), walking speed (r = 0.33; p = 0.037) and CRP correlated with BMI (r = 0.32; p = 0.049) and total muscle mass (r = -0.32; p = 0.043).  After adjustment to BMI variable, IL-6 was correlated with CRP (r = 0,43; p = 0,001) and total muscle mass (r = -0.25; p = 0.026) and significantly correlated in underweight groups (BMI<18.5 kg/m2) (r=-0.50; p=0.026). CRP was not significantly correlated with the three parameters of sarcopenia on Spearman, partial correlation, and Spearman's specific correlation test based on BMI group. Conclusion: IL-6 levels were associated with total muscle mass loss after BMI adjustmentin Pedawa village’s elderly as a whole. Keywords: IL-6, C-Reactive Protein (CRP), Sarcopenia, Elderly, Pedawa village. &nbsp