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Title [sv]
Sarkopeni hos äldre och kroniskt sjuka - epidemiologi, mekanismer och behandling
Title [en]
Sarcopenia in old age and chronic disease - epidemiology, mechanisms and interventions
Abstract [en]
This research project focuses the emerging concept of sarcopenia, i.e. the combined reduction of muscle mass and function, which is a major threat of an independent life style at old age and chronic disease. The overall objective is to illuminate prevalence, consequences, mechanisms and potential treatment of sarcopenia in old populations and geriatric patients. The project plan involves the collaboration of top national and international research groups, and the major global food companies, combining first class competence in body composition measurements, food registrations, muscle metabolism, genetics and intervention study knowledge. For the epidemiological studies the two Uppsala population-based cohorts ULSAM and PIVUS, comprising 2500 (ULSAM) and 1000 (PIVUS) subjects, that prospectively have examined the participants into old age (up to 93 years of age), will be utilized. The very well characterized cohorts contain muscle mass examinations (DXA) and muscle function tests feasible for the determination of prevalence as well as consequences of sarcopenia. Cooperation via the International Sarcopenia Initiative will compile population and clinical cohorts in order to test the most clinically relevant cut-offs for the criteria of sarcopenia. The SIGVARD study evaluates the relevance of sarcopenia in a group of geriatric patients for clinical outcomes, like 2-year mortality. Pathogenic mechanisms underlying sarcopenia is assessed by data from the ULSAM and PIVUS cohorts. Food intake, dietary patterns, serum fatty acid profiles and vitamin D concentrations at the age of 70 will be related to the subsequent development of sarcopenia 10-20 years later. Muscle biopsies were obtained from about 1000 ULSAM participants at the age of 70, when also muscle fibre type and capillary density were characterised. Such data will be related to subsequent sarcopenia. From freezer stored muscle samples mRNA extractions are performed in order to test the hypothesis that sarcopenia at old age may be related to specific gene expression signatures at the age of 70. Fifty-five 89-year old ULSAM participants volunteered to give a repeated muscle biopsy in order to evaluate changes over time from 70 years of age in muscle histology (e.g. fibre type) and molecular characteristics like satellite cell activity, muscle ubiquitine-proteolytic activity and gene expression in relation to changes in muscle mass, function and development of sarcopenia. The project plan is concluded by three studies on potentiall treatment options for sarcopenia in community-dwelling subjects as well as in post hip fracture patients. The Provide Study, an 18 site multi-centre 3-month randomized study, tests the hypothesis that a leucine rich and vitamin D fortified protein supplementation will improve muscle function and muscle mass. The VIVE2 (Uppsala/Stockholm and Boston) randomized controlled study provides resistance exercise 2-3 times/week to all 150 community-dwelling participants over 6 months, whereas half receive a leucine rich and vitamin D enriched formula. A third study target 89 hip fracture patients who are randomized to bisphosphonate treatment alone or combined with a protein supplementation, and controls, in a 12-month study. These studies are performed in collaboration with the three major medical nutrition industries, i.e. Nutricia, Nestle and Fresenius-Kabi. Altogether support is requested for four senior researchers and five PhD students that are involved in the performance of the project plan. There are strong indications that nutrition plays a major role for keeping the integrity of muscle function. The importance of the project lies in its capability to create knowledge and break-throughs on nutritional and related factors of significance for health, independence and well-being at old age, with potential economic benefit for the ageing societies.
Principal InvestigatorCederholm, Tommy
Coordinating organisation
Uppsala University
Funder
Period
2016-01-01 - 2019-12-31
National Category
Nutrition and Dietetics
Identifiers
DiVA, id: project:5445Project, id: 2015-02338_VR

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