Authors :
Presenting Author: Chin-Wei Huang, MD, PhD, CSCN Diplomate (EEG) – National Cheng Kung University College of Medicine
Yu-Shiue Chen, MS – Neurology – National Cheng Kung University Hospital; Tzu-Hsin Huang, MD – Neurology – National Cheng Kung University Hospital; Ming-Chi Lai, MD – Pediatrics – Chi-Mei Medical Center
Rationale:
Epilepsy is a chronic neurological disorder, and there is limited information available regarding sarcopenia in patients with epilepsy. The objective of this study was to investigate the prevalence of sarcopenia and identify the associated risk factors in patients with epilepsy.
Methods:
This cross-sectional study recruited epilepsy patients from our epilepsy clinic and healthy controls from our hospital staff at the National Cheng Kung University Medical Center in Tainan, Taiwan, between March 2020 and July 2020. Sarcopenia was defined according to the algorithms provided by the 2019 Asian Working Group for Sarcopenia (AWGS) and the 2010 European Working Group on Sarcopenia in Older People (EWGSOP). Muscle mass, determined by skeletal mass index, was measured using bioelectrical impedance analysis. Muscle strength was assessed through hand grasping, and physical performance was evaluated using gait speed during a six meter walk. Hormone levels (testosterone, growth hormone, insulin-like growth factor-1 [IGF-1]) and vitamin D levels were also assessed. Descriptive statistics and logistic regression models were used to determine the prevalence and associations of sarcopenia in patients with epilepsy.
Results:
A total of 300 participants were recruited, with a mean age of 42.9 ± 14.7 years (ranging from 20 to 82 years), and 161 (53.7%) were women. The epilepsy group consisted of 200 participants (mean age: 43.5 ± 15.3 years), while the control group consisted of 100 participants (mean age: 41.8 ± 13.3 years). The prevalence of sarcopenia among all participants was 31.3%, with 10.6% in men and 20.7% in women, showing a significantly higher prevalence in females (p = 0.004). In the epilepsy group, the prevalence of sarcopenia was 36.0%, compared to 22.0% in the control group (p = 0.014). The logistic regression model revealed important factors associated with sarcopenia in epilepsy patients, including body mass index (BMI), protein levels in body composition, and calf circumference. Additionally, hormones (testosterone and IGF-1) were found to be associated with sarcopenia in men with epilepsy.
Conclusions:
The prevalence of sarcopenia was significantly higher in patients with epilepsy compared to healthy controls. BMI, protein levels, and calf circumference were positively associated with sarcopenia in patients with epilepsy. Further studies are needed to examine the interaction between hormone changes, the use of anti-epileptic drugs, and sarcopenia in epilepsy. Moreover, early and regular detection of associated factors is crucial in proposing early management strategies for sarcopenia, aiming to reduce its prevalence and severity.
Funding:
National Science and Technology Council (111-2314-B-006-103-MY2)