THE EFFECT OF TARGETED INTERVENTIONS ON C- TERMINAL AGRIN FRAGMENT CONCENTRATION IN SARCOPENIC OLDER ADULTS: A SCOPING REVIEW

P. Kumar¹, N. Girish¹, K. Nayak², S. Umakanth³

¹Manipal College of Health Professions, Manipal Academy of Higher Education, Department of Physiotherapy, Manipal, India, ²Manipal College of Health Professions, Manipal Academy of Higher Education, Department of Medical Laboratory Technology, Manipal, India, ³Dr. TMA Pai Hospital, Manipal Academy of Higher Education, Department of Medicine, Udupi, India

Background: Studies on the effects of interventions for sarcopenia are limited to changes in muscle mass, muscle strength, and physical performance. Considering the degradation of the neuromuscular junction (NMJ) with subsequent release of C-terminal Agrin Fragment (CAF) in blood as one of the possible mechanisms resulting in sarcopenia, CAF has emerged as a potent biomarker for identifying sarcopenia. However, the effect of interventions (exercises/ nutritional/ hormonal) on the level of CAF concentration is not clearly understood.

Purpose: To synthesize the effect of interventions (exercise/ nutrition/ hormonal) on the change in the level of CAF concentration.

Methods: A systematic literature search was conducted in seven electronic and studies were included if they met all of the following criteria:
(a) original study,
(b) on older adults,
(c) diagnosed with sarcopenia.
(d) looking at the effect of different intervention (exercise/ hormonal/ nutrition) on CAF level.
The studies were excluded if they fail to meet the inclusion criteria and/or:
(a) full text was not available,
(b) language was other than English,
(c) studies providing no extractable data,
(d) studies not included CAF biomarker, and
(e) animal studies.
The data extraction sheet was prepared, validated and relevant data were extracted.

Results: A total of 5,158 records were identified and 6 records were included. Exercise-based intervention has been used in five (n=5) of the studies. However, the mode of exercise varied between the studies, with two (n=2) have used resistance training, one (n=1) each have used aerobic as dual-task training, physical activity, and power training. In two studies (n=2) which have delivered 6 weeks of resistance exercise, a significant decrease in serum CAF levels was observed in the resistance exercise group compared to the control (F (2,26) =7.12, p= 0.003, ηP 2 =0.35), while other showing increase in CAF by 10.4% (3.59±1.45 to 4.00±1.20 pg/mL) in older adults. One (n=1) study, which compared strength and power training, significant reduction in CAF concentration in the group who underwent power training for 12 weeks. Nutrition as a treatment has not been provided as a single intervention rather it was administered to the participants prior to the strength and power training. Hormonal therapy has been utilized in only one (n=1) study, despite improvements in muscle strength and stair climbing power, no significant difference in the change in serum CAF concentration between testosterone and placebo group (effect size= -50.3 pM; 95% CI= -162.1 to 61.5 pM; p=0.374).

Conclusions: This review has scoped the scientific information about the effects of treatments on CAF concentration, which will aid practitioners and researchers in designing a therapeutic exercise program.

Implications: The selection of training mode/parameters/exercises is critical in reversing the impaired NMJ status and, eventually, managing sarcopenia.

Funding acknowledgements: None

Keywords:
Sarcopenia
Exercise
C-terminal Agrin Fragment

Topics:
Older people

Did this work require ethics approval? No

Reason: N/A