Improvement of Skeletal and Muscle Health in Patients With Sarcopenia by Protein Powder With Resistance Exercise

ASM was measured using BIA, ASMI=ASM/height (m)^2.

Maximum force grip was held for 3 seconds, the right and left hands were measured alternately, 3 measurements were taken in each hand, and the maximum value was taken.

Let the tester start from the starting point, walk 6 meters at normal walking speed, stop when reaching the end point, record the time used, and calculate the 6m walking speed according to the time used and the distance of 6 meters.

The subject sat in the center of the chair, crossed his/her arms in front of his/her chest, and after hearing the command "start", he/she completed 5 consecutive times of standing up and sitting down, and recorded the total time in seconds.

The SPPB consists of 3 test items, each item is scored out of 4 points, and the total score is 12.

Using a questionnaire designed by the research team and validated by the previous study, the survey covered the age, gender, ethnicity, marital status, occupation, education level, place of residence, household income, living status (living alone and with family), dietary habits and application of nutritional supplements, lifestyle (smoking, drinking, and physical activity), family history, and chronic diseases (hypertension, diabetes, etc.) of the study participants, Hyperlipidemia, etc.)

Measure the height of the subjects

Measure the weight of the subjects

Calculate BMI using height and weight , BMI=weight/(height)^2

Measure the waist and hip circumference of the subjects and calculate the waist to hip ratio (waist circumference/hip circumference).

Using a human body composition analyzer to detect indicators such as total score, visceral fat area, body segment fat and basal metabolic rate, body cell mass, and limb skeletal muscle mass index.

The ADL was assessed using the Activity of Daily Living Scale (ADL), which consists of 10 items, including eating, bathing, grooming, dressing, bowel control, urination control, toileting, bed and chair transfers, walking, and walking up and down stairs.

The total score is 100, with a score of more than 60 indicating mild functional impairment but basic self-care in daily life; a score of 60-41 indicating moderate functional impairment and need for some assistance in daily life; a score of 40-21 indicating severe functional impairment and obvious need for dependence on others in daily life; and a score of less than 20 indicating complete disability and total dependence on others in daily life.

The PSQI (Pittsburgh Sleep Quality Index) questionnaire was used to assess the quality of the subjects' sleep during the last 1 month. It consists of 19 self-assessment and 5 other-assessment entries, of which the 19th self-assessment and 5 other-assessment entries are not involved in scoring. The cumulative score of each component is the total PSQI score, which ranges from 0 to 21, with higher scores indicating poorer sleep quality.

The 3-day, 24-hour dietary recall method was used to investigate the subjects' dietary intake. The survey process was supplemented with tools such as the "Retrospective Dietary Survey Auxiliary Chart" to help the subjects accurately recall their dietary intake. Based on the Standardized Version of the Chinese Food Composition Table (6th Edition), the energy and various types of protein, fat and carbohydrate intake of the population were calculated, and for the missing data in the Chinese Food Composition Table, the United States Department of Agriculture Food Composition Table was used to supplement the data, so as to build up a comprehensive database of dietary intake. The analysis of dietary intake included the intake of total fat, total protein, total carbohydrates and energy and its percentage in the total energy intake.

Subjects were assessed for overall cognitive functioning using the Montreal cognitive assessment (MoCA) scale out of 30, which contains cognitive functioning tests in multiple dimensions of visuospatial and executive functioning, naming, memory, attention, language, abstraction, delayed recall, and orientation.The normal threshold is usually ≥ 26 points, 21-25 points indicate mild cognitive impairment, and ≤ 20 points may indicate dementia risk

Bone density, lumbar spine bone density (lumbar 2 - lumbar 4) and left femoral neck bone density are examined using the dualenergy X-ray absorptiometry (DXA) method.

Ultrasound was used to examine the knee joint cavity for fluid or synovial hyperplasia and the tendon ligaments and muscles around the knee joint for damage.

The KOOS rating includes five independent evaluation dimensions, each calculated separately and converted into a percentage scale (0-100 points, with higher scores indicating better functionality)

Detect serum calcium (Ca), phosphorus (P), serum hydroxyvitamin D (25(OH)D), serum parathyroid hormone (PTH), P-alkaline phosphatase (ALP), serum osteocalcin (OC), serum type 1 pro-collagen N-terminal pre-peptide, serum type 1 collagen cross-linking N-terminal peptide (NTX), and serum anti-tartrate acid phosphatase 5b (TRACP-5b), estradiol (E2), leptin (LP), and so on.

Determine the serum levels of blood lipid concentration in the population. Lipid tests include total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).

Blood glucose tests are fasting blood glucose.

Measurement of insulin secretion level.

Detecting inflammatory cytokine concentration: including TNF-α, IL-1 α, IL-1 β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10 and other inflammatory factors.

The collected feces were subjected to 16S rRNA sequencing technology to detect the diversity of gut microbiota.