Objectives: Frailty among community-dwelling older adults increases the risk of adverse health outcomes. Sar copenic obesity (SO), characterized by low muscle mass combined with excess adiposity, may worsen frailty.Locomotive syndrome (LS) shares features with frailty and sarcopenia. This study examined whether LS modifies the association between body composition and frailty. Methods: We analyzed cross-sectional data of 481 adults aged ≥ 40 years from the DETECt-L cohort in Japan.Frailty was defined according to the Japanese Cardiovascular Health Study criteria. Body composition was measured using bioelectrical impedance, based on skeletal muscle mass and body fat, to categorize participants into normal, sarcopenia, obesity, or SO phenotypes. Logistic regression-estimated odds ratios for comparing prefrailty/frailty with robustness were calculated. Model 1 was unadjusted; Model 2 (fully adjusted) adjusted for age, sex, pain, fall history, and Timed Up-and-Go and single-leg standing tests; and Model 3 additionally included body mass index (BMI) (sensitivity). Results: Overall, 41.6% of participants were classified as prefrail or frail. The distribution of body composition phenotypes was as follows: normal (42.8%), sarcopenic (31.2%), obese (15.8%), and SO (10.2%). In Model 2, both sarcopenia (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.38–3.63) and SO (OR, 2.51; 95% CI, 1.21–5.24) were associated with increased odds of prefrailty/frailty. These associations remained robust after adjusting for BMI. However, LS did not significantly affect these associations. Conclusions Sarcopenia and SO were independently associated with prefrailty/frailty regardless of LS status.Integrating muscle function and adiposity metrics may support early risk detection in community settings.

BACKGROUND/AIMS: This study aimed to predict sustained viral response (SVR) to low-dose pegylated interferon (PEG-IFN) plus ribavirin of elderly and/or cirrhotic patients with genotype 2 hepatitis C virus (HCV) using viral response within 2 weeks. METHODS: Low-dose PEG-IFN-α-2b plus ribavirin was administered to 50 elderly and/or cirrhotic patients with genotype 2 HCV for 24 weeks. The dynamics of HCV RNA and HCV core antigen levels within 2 weeks were measured. RESULTS: The patients' median age was 66 years. There were 21 male and 29 female patients. The median baseline HCV RNA level was 5.7 log IU/mL. Rapid viral response was achieved in 17 patients (34%), SVR in 28 (56%), and two (4%) discontinued treatment. Univariate analysis of factors contributing to SVR showed significant differences for sex, baseline virus level, and response within 4 weeks. When 40 fmol/L was set as the cutoff value for the core antigen level at 1 week, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting SVR were 93%, 75%, 84%, 88%, and 85%, respectively. CONCLUSIONS: Low-dose PEG-IFN plus ribavirin was a safe and cost-effective treatment for elderly and/or cirrhotic patients with genotype 2 HCV, and the viral response within 2 weeks was a useful predictor of SVR.
Aged* ; Female ; Genotype* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Interferons* ; Liver Cirrhosis ; Male ; Ribavirin* ; RNA ; Sensitivity and Specificity

BACKGROUND/AIMS: The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon alpha-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C. METHODS: The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured. RESULTS: Significant differences between null responders and nonnull responders were noted for interleukin (IL)-28B genotype, amino acid 70 substitution, alpha-fetoprotein, low-density lipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operating characteristic curve of the hepatitis C virus (HCV) RNA level decline at 2 weeks (AUC=0.993) was the highest among the factors predicting the null response. When the cutoff value for the HCV RNA level decline at 2 weeks was set at 0.80 log, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting a null response were 82%, 96%, 82%, 96%, and 94%, respectively. In comparison, values for the non-TT and mutant type of amino acid 70 substitution were similar to those for HCV RNA level decline at 2 weeks. CONCLUSIONS: Virological response at 2 weeks or the combination of IL-28B and amino acid 70 substitution are accurate predictors of a null response.
Administration, Oral ; Adult ; Aged ; Antiviral Agents/*administration & dosage ; Area Under Curve ; Drug Therapy, Combination ; Female ; Genotype ; Hepatitis C, Chronic/*drug therapy/genetics ; Humans ; Injections, Subcutaneous ; Interferon-alpha/*administration & dosage ; Male ; Medication Adherence ; Polyethylene Glycols/*administration & dosage ; Prospective Studies ; RNA, Viral/metabolism ; Recombinant Proteins/administration & dosage ; Ribavirin/*administration & dosage ; Treatment Outcome ; Viral Load ; Young Adult