Sleep duration and disturbances were associated with testosterone level, muscle mass, and muscle strength - A cross-sectional study in 1274 older men

Background: Testosterone level follows a circadian rhythm. However, whether sleep duration and disturbances can affect testosterone level, muscle mass, and strength remains unknown. Objective: To examine the relationship of sleep duration and disturbances to testosterone level, muscle mass, muscle strength, and walking speed. Participants and methods: We recruited 1274 community-dwelling men older than 65 years of age. Their early morning testosterone level was assayed by mass spectrometry. A sleep questionnaire was administered to enquire about their reported sleep duration, prolonged sleep latency (>0.5 hour), and subjective insomnia complaint. Muscle mass was measured by dual-energy x-ray absorptiometry. Testosterone level, muscle mass, handgrip strength, and walking speed were tested against sleep duration and disturbances. Results: Testosterone increased with increasing sleep duration up to 9.9 hours, after which it decreased, giving rise to an inverted U-shaped relationship (P for quadratic trend <.05). A similar inverted U-shaped relationship occurred between sleep duration and muscle mass and function. Earlier go-to-bed time, despite being associated with a higher testosterone level (P < .05), was associated with weaker grip strength (P < .05). Earlier wake-up time was associated with higher muscle mass (P < .05) but neither grip strength nor walking speed. Neither prolonged sleep latency nor insomnia was associated with testosterone levels. However, prolonged sleep latency was associated with lower muscle mass (P < .05), weaker grip strength (P < .05), and slower walking speed (P < .001). Insomnia, on the other hand was associated with weaker grip strength (P < .05) and slower walking speed (P < .001) but not muscle mass. Conclusions: Sleep duration and disturbances can affect testosterone level, muscle mass, and its function. Whether optimization of sleep can ameliorate age-associated decline in sex hormone and muscle performance warrants further studies

Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: a cross-sectional study in 1489 older men

Objective: To examine the relationship between different measures of testosterone and estradiol (E2), muscle mass, muscle strength, and physical performance; and to test whether the association of sex hormone level with muscle strength and physical performance was independent of muscle mass. Design and methods: A cross-sectional survey on 1489 community-dwelling men older than 64 years of age. Serum levels of testosterone and E2 were measured by mass spectrometry, and sex hormone-binding globulin (SHBG) levels were measured by immunoradioassay. Muscle mass was examined by dual-energy X-ray absorptiometry and physical performance was assessed by hand-grip strength, gait speed, step length and chair-stand test. Results: Appendicular skeletal mass (ASM) was positively associated with total testosterone (TT; P<0.001), free testosterone (FT; P<0.001), and total E2 (P<0.001) but not with free E2 (P=0.102). After adjustment for age, serum SHBG and relative ASM, both TT and FT were significantly associated with grip strength, narrow-walk speed and the composite neuromuscular score. Higher total E2, but not free E2 was associated with lower grip strength (P<0.05) after adjustment for age, FT, SHBG and relative ASM. Conclusions: Testosterone level was related to both muscle mass, strength and physical performance. Total E2 level, though related to muscle mass positively, affected muscle strength adversely in older men

Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia

Abstract Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three‐round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (5 mg/L [0.5 mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3–6 month period and suggested a tentative cut‐off value of 21 kg/m 2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ‐5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient‐reported outcomes. The AWGC consensus offers a comprehensive definition and user‐friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co‐morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.Japan Society for the Promotion of Science https://doi.org/10.13039/50110000169

Sleep Duration and Disturbances Were Associated With Testosterone Level, Muscle Mass, and Muscle Strength—A Cross-Sectional Study in 1274 Older Men

Background: Testosterone level follows a circadian rhythm. However, whether sleep duration and disturbances can affect testosterone level, muscle mass, and strength remains unknown. Objective: To examine the relationship of sleep duration and disturbances to testosterone level, muscle mass, muscle strength, and walking speed. Participants and methods: We recruited 1274 community-dwelling men older than 65 years of age. Their early morning testosterone level was assayed by mass spectrometry. A sleep questionnaire was administered to enquire about their reported sleep duration, prolonged sleep latency (>0.5 hour), and subjective insomnia complaint. Muscle mass was measured by dual-energy x-ray absorptiometry. Testosterone level, muscle mass, handgrip strength, and walking speed were tested against sleep duration and disturbances. Results: Testosterone increased with increasing sleep duration up to 9.9 hours, after which it decreased, giving rise to an inverted U-shaped relationship (P for quadratic trend <.05). A similar inverted U-shaped relationship occurred between sleep duration and muscle mass and function. Earlier go-to-bed time, despite being associated with a higher testosterone level (P < .05), was associated with weaker grip strength (P < .05). Earlier wake-up time was associated with higher muscle mass (P < .05) but neither grip strength nor walking speed. Neither prolonged sleep latency nor insomnia was associated with testosterone levels. However, prolonged sleep latency was associated with lower muscle mass (P < .05), weaker grip strength (P < .05), and slower walking speed (P < .001). Insomnia, on the other hand was associated with weaker grip strength (P < .05) and slower walking speed (P < .001) but not muscle mass. Conclusions: Sleep duration and disturbances can affect testosterone level, muscle mass, and its function. Whether optimization of sleep can ameliorate age-associated decline in sex hormone and muscle performance warrants further studies