Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients
Background: Hospitalization in older adults often worsens sarcopenia due to prolonged bed rest, poor nutrition, and inactivity. This study examined how hospitalization impacts muscle mass, focusing on oxidative stress and gut-derived endotoxemia. Methods: Thirty-one hospitalized older adults were co...
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MDPI AG
2025-03-01
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| Series: | Antioxidants |
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| Online Access: | https://www.mdpi.com/2076-3921/14/3/304 |
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| author | Chiara Bagnato Arianna Magna Elena Mereu Sciaila Bernardini Simona Bartimoccia Roberta Marti Pietro Enea Lazzerini Alessandra D’Amico Evaristo Ettorre Giovambattista Desideri Pasquale Pignatelli Francesco Violi Roberto Carnevale Lorenzo Loffredo Neurodegenerative Study Group |
| author_facet | Chiara Bagnato Arianna Magna Elena Mereu Sciaila Bernardini Simona Bartimoccia Roberta Marti Pietro Enea Lazzerini Alessandra D’Amico Evaristo Ettorre Giovambattista Desideri Pasquale Pignatelli Francesco Violi Roberto Carnevale Lorenzo Loffredo Neurodegenerative Study Group |
| author_sort | Chiara Bagnato |
| collection | DOAJ |
| description | Background: Hospitalization in older adults often worsens sarcopenia due to prolonged bed rest, poor nutrition, and inactivity. This study examined how hospitalization impacts muscle mass, focusing on oxidative stress and gut-derived endotoxemia. Methods: Thirty-one hospitalized older adults were compared with 31 outpatients. Ultrasound was used to measure the thickness of the rectus femoris (RF), intercostal, and diaphragmatic muscles at admission and discharge. Serum levels of LPS, zonulin, sNOX2-dp, and H<sub>2</sub>O<sub>2</sub> were also assessed. Results: Hospitalized patients had higher serum levels of sNOX2-dp, H<sub>2</sub>O<sub>2</sub>, LPS, and zonulin than outpatients. In hospitalized patients, significant increases were observed at discharge compared to admission levels in sNOX2-dp (20.9 ± 6.5 to 23.8 ± 7.5 pg/mL; <i>p</i> = 0.004), H<sub>2</sub>O<sub>2</sub> (24.4 ± 9.8 to 32.8 ± 14.5 µM; <i>p</i> = 0.01), LPS (30.4 ± 12.6 to 43.3 ± 16.35 pg/mL; <i>p</i> < 0.001), and zonulin (2.06 ± 1.23 to 2.95 ± 1.33 ng/mL; <i>p</i> < 0.001). Ultrasound data revealed a reduction in RF muscle thickness (−35%) (0.58 ± 0.29 to 0.38 ± 0.31 cm, <i>p</i> < 0.001), intercostal muscle thickness (−28%) (0.22 ± 0.08 to 0.16 ± 0.06 cm, <i>p</i> < 0.001), and diaphragmatic muscle thickness (−26%) (0.19 ± 0.06 to 0.14 ± 0.04 cm, <i>p</i> < 0.001) at discharge compared to admission. Additionally, muscle strength, measured using the hand-grip test, showed a 25% reduction. Regression analysis revealed correlations between RF muscle loss and increases in sNOX2-dp and H<sub>2</sub>O<sub>2</sub>, as well as between NOX2, H<sub>2</sub>O<sub>2</sub>, and LPS with zonulin. Conclusions: Hospitalization in older adult patients elevates NOX2 blood levels, correlating with reduced muscle mass. Increased low-grade endotoxemia may trigger NOX2 activation, generating oxidative stress that accelerates muscle degeneration and can lead to sarcopenia. |
| format | Article |
| id | doaj-art-8fdc272918264ee58d707b5ea9f9520e |
| institution | DOAJ |
| issn | 2076-3921 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antioxidants |
| spelling | doaj-art-8fdc272918264ee58d707b5ea9f9520e2025-08-20T02:42:35ZengMDPI AGAntioxidants2076-39212025-03-0114330410.3390/antiox14030304Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly PatientsChiara Bagnato0Arianna Magna1Elena Mereu2Sciaila Bernardini3Simona Bartimoccia4Roberta Marti5Pietro Enea Lazzerini6Alessandra D’Amico7Evaristo Ettorre8Giovambattista Desideri9Pasquale Pignatelli10Francesco Violi11Roberto Carnevale12Lorenzo Loffredo13Neurodegenerative Study Group14Department of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyDepartment of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalySapienza University of Rome, 00185 Rome, ItalyIRCCS Neuromed, 86077 Pozzilli, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyDepartment of Clinical Internal, Anaesthesiologic and Cardiovascular Science, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, ItalyBackground: Hospitalization in older adults often worsens sarcopenia due to prolonged bed rest, poor nutrition, and inactivity. This study examined how hospitalization impacts muscle mass, focusing on oxidative stress and gut-derived endotoxemia. Methods: Thirty-one hospitalized older adults were compared with 31 outpatients. Ultrasound was used to measure the thickness of the rectus femoris (RF), intercostal, and diaphragmatic muscles at admission and discharge. Serum levels of LPS, zonulin, sNOX2-dp, and H<sub>2</sub>O<sub>2</sub> were also assessed. Results: Hospitalized patients had higher serum levels of sNOX2-dp, H<sub>2</sub>O<sub>2</sub>, LPS, and zonulin than outpatients. In hospitalized patients, significant increases were observed at discharge compared to admission levels in sNOX2-dp (20.9 ± 6.5 to 23.8 ± 7.5 pg/mL; <i>p</i> = 0.004), H<sub>2</sub>O<sub>2</sub> (24.4 ± 9.8 to 32.8 ± 14.5 µM; <i>p</i> = 0.01), LPS (30.4 ± 12.6 to 43.3 ± 16.35 pg/mL; <i>p</i> < 0.001), and zonulin (2.06 ± 1.23 to 2.95 ± 1.33 ng/mL; <i>p</i> < 0.001). Ultrasound data revealed a reduction in RF muscle thickness (−35%) (0.58 ± 0.29 to 0.38 ± 0.31 cm, <i>p</i> < 0.001), intercostal muscle thickness (−28%) (0.22 ± 0.08 to 0.16 ± 0.06 cm, <i>p</i> < 0.001), and diaphragmatic muscle thickness (−26%) (0.19 ± 0.06 to 0.14 ± 0.04 cm, <i>p</i> < 0.001) at discharge compared to admission. Additionally, muscle strength, measured using the hand-grip test, showed a 25% reduction. Regression analysis revealed correlations between RF muscle loss and increases in sNOX2-dp and H<sub>2</sub>O<sub>2</sub>, as well as between NOX2, H<sub>2</sub>O<sub>2</sub>, and LPS with zonulin. Conclusions: Hospitalization in older adult patients elevates NOX2 blood levels, correlating with reduced muscle mass. Increased low-grade endotoxemia may trigger NOX2 activation, generating oxidative stress that accelerates muscle degeneration and can lead to sarcopenia.https://www.mdpi.com/2076-3921/14/3/304sarcopeniaoxidative stressNADPH oxidaseNOX2NADPH oxidasemuscle ultrasound |
| spellingShingle | Chiara Bagnato Arianna Magna Elena Mereu Sciaila Bernardini Simona Bartimoccia Roberta Marti Pietro Enea Lazzerini Alessandra D’Amico Evaristo Ettorre Giovambattista Desideri Pasquale Pignatelli Francesco Violi Roberto Carnevale Lorenzo Loffredo Neurodegenerative Study Group Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients Antioxidants sarcopenia oxidative stress NADPH oxidase NOX2 NADPH oxidase muscle ultrasound |
| title | Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients |
| title_full | Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients |
| title_fullStr | Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients |
| title_full_unstemmed | Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients |
| title_short | Impact of Hospitalization on Sarcopenia, NADPH-Oxidase 2, Oxidative Stress, and Low-Grade Endotoxemia in Elderly Patients |
| title_sort | impact of hospitalization on sarcopenia nadph oxidase 2 oxidative stress and low grade endotoxemia in elderly patients |
| topic | sarcopenia oxidative stress NADPH oxidase NOX2 NADPH oxidase muscle ultrasound |
| url | https://www.mdpi.com/2076-3921/14/3/304 |
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