{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:27:14Z","timestamp":1788560834488,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004319","name":"Shin Kong Wu Ho-Su Memorial Hospital","doi-asserted-by":"publisher","award":["SKH-8302-106-NDR-01"],"award-info":[{"award-number":["SKH-8302-106-NDR-01"]}],"id":[{"id":"10.13039\/501100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Sarcopenia and obesity can negatively impact quality of life and cause chronic fragility, and are associated with neuromuscular diseases, including myasthenia gravis (MG). The long-term consequences of body composition changes in chronic MG remain unknown; we therefore evaluated changes in body composition, including sarcopenia, obesity, lean body mass, and the prevalence of sarcopenic obesity in patients. In this cross-sectional study, 35 patients with MG (mean age: 56.1 years) and 175 matched controls were enrolled. Body fat mass and skeletal muscle mass were measured using whole body dual-energy X-ray absorptiometry. Patients with MG exhibited a higher prevalence of obesity and higher android adiposity and total body fat percentage than those of controls. Although the prevalence of sarcopenia and sarcopenic obesity did not increase with age, there was a decrease in arm and android muscle mass in patients with MG compared with controls. Lower muscle mass percentages were correlated with increased age and MG severity, but not with corticosteroid use. Thus, MG is associated with increased risk for obesity and decreased muscle mass with aging, regardless of corticosteroid use. Therefore, accurate diagnosis of body composition changes in MG could facilitate the application of appropriate therapies to promote health, improve quality of life, and prevent fragility.<\/jats:p>","DOI":"10.3390\/jpm11111139","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T17:59:38Z","timestamp":1635962378000},"page":"1139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Che-Cheng","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Neurology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan"},{"name":"Ph.D. Program in Nutrition and Food Sciences, Human Ecology College, Fu Jen Catholic University, New Taipei City 24205, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7259-9735","authenticated-orcid":false,"given":"Yen-Kung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan"},{"name":"School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan"},{"name":"School of Medicine, Taipei Medical University, Taipei 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2712-8533","authenticated-orcid":false,"given":"Hou-Chang","family":"Chiu","sequence":"additional","affiliation":[{"name":"School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan"},{"name":"Department of Neurology, Taipei Medical University, Shuang-Ho Hospital, New Taipei City 23561, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiann-Horng","family":"Yeh","sequence":"additional","affiliation":[{"name":"School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan"},{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan"},{"name":"Department of Neurology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1056\/NEJMra1602678","article-title":"Myasthenia Gravis","volume":"375","author":"Gilhus","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S1474-4422(18)30392-2","article-title":"Long-term effect of thymectomy plus prednisone versus prednisone alone in patients with non-thymomatous myasthenia gravis: 2-year extension of the MGTX randomised trial","volume":"18","author":"Wolfe","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1056\/NEJMoa1602489","article-title":"Randomized Trial of Thymectomy in Myasthenia Gravis","volume":"375","author":"Wolfe","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Meinen, S., Lin, S., R\u00fcegg, M.A., and Punga, A.R. (2012). Fatigue and Muscle Atrophy in a Mouse Model of Myasthenia Gravis Is Paralleled by Loss of Sarcolemmal nNOS. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0044148"},{"key":"ref_6","first-page":"M214","article-title":"Body fat and skeletal muscle mass in relation to physical disability in very old men and women of the Framingham Heart Study","volume":"53","author":"Visser","year":"1998","journal-title":"J. Gerontol. Ser. A Boil. Sci. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/ageing\/afu115","article-title":"Prevalence of and interventions for sarcopenia in ageing adults: A systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)","volume":"43","author":"Landi","year":"2014","journal-title":"Age Ageing"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12933-018-0700-5","article-title":"Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: A retrospective observational study","volume":"17","author":"Fukuda","year":"2018","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1038\/oby.2004.250","article-title":"Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly","volume":"12","author":"Baumgartner","year":"2004","journal-title":"Obes. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.clnu.2012.06.010","article-title":"Sarcopenic obesity: A Critical appraisal of the current evidence","volume":"31","author":"Prado","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jocd.2013.08.007","article-title":"The Official Positions of the International Society for Clinical Densitometry: Acquisition of Dual-Energy X-Ray Absorptiometry Body Composition and Considerations Regarding Analysis and Repeatability of Measures","volume":"16","author":"Hangartner","year":"2013","journal-title":"J. Clin. Densitom."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1385\/JCD:6:2:75","article-title":"Clinical Applications of Body Composition Measurements Using DXA","volume":"6","author":"Albanese","year":"2003","journal-title":"J. Clin. Densitom."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jocd.2013.08.020","article-title":"The Official Positions of the International Society for Clinical Densitometry: Indications of Use and Reporting of DXA for Body Composition","volume":"16","author":"Kendler","year":"2013","journal-title":"J. Clin. Densitom."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/BOR.0b013e328358d59b","article-title":"Sarcopenia in older adults","volume":"24","author":"Walston","year":"2012","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.7600\/jpfsm.3.111","article-title":"The important role of the neuromuscular junction in maintaining muscle mass and strength","volume":"3","author":"Mori","year":"2014","journal-title":"J. Phys. Fit. Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S137","DOI":"10.1111\/j.1447-0594.2010.00608.x","article-title":"Muscle weakness and neuromuscular junctions in aging and disease","volume":"10","author":"Shigemoto","year":"2010","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1212\/WNL.0000000000000804","article-title":"Increased risk of osteoporosis in patients with myasthenia gravis: A population-based cohort study","volume":"83","author":"Yeh","year":"2014","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America, Jaretzki, A., Barohn, R., Ernstoff, R., Kaminski, H., Keesey, J., Penn, A., and Sanders, D. (2000). Myasthenia gravis. Neurology, 55, 16\u201323.","DOI":"10.1212\/WNL.55.1.16"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1212\/01.WNL.0000163988.28892.79","article-title":"Quantitative myasthenia gravis score: Assessment of responsiveness and longitudinal validity","volume":"64","author":"Bedlack","year":"2005","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Suzuki, S., Murai, H., Imai, T., Nagane, Y., Masuda, M., Tsuda, E., Konno, S., Oji, S., Nakane, S., and Motomura, M. (2014). Quality of life in purely ocular myasthenia in Japan. BMC Neurol., 14.","DOI":"10.1186\/1471-2377-14-142"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: Consensus Report of the Asian Working Group for Sarcopenia","volume":"15","author":"Chen","year":"2014","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"The Examination Committee of Criteria for \u2018Obesity Disease\u2019 in Japan, Japan Society for the Study of Obesity (2002). New Criteria for \u2018Obesity Disease\u2019 in Japan. Circ. J., 66, 987\u2013992.","DOI":"10.1253\/circj.66.987"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1136\/jnnp.36.2.244","article-title":"Neurogenic muscle involvement in myasthenia gravis: A clinical and histopathological study","volume":"36","author":"Oosterhuis","year":"1973","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jns.2017.08.3250","article-title":"Body composition and adipokines plasma levels in patients with myasthenia gravis treated with high cumulative glucocorticoid dose","volume":"381","author":"Braz","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/ane.12374","article-title":"Risk of diabetes mellitus among patients with myasthenia gravis","volume":"132","author":"Yeh","year":"2015","journal-title":"Acta Neurol. Scand."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S1474-4422(09)70063-8","article-title":"Autoimmune myasthenia gravis: Emerging clinical and biological heterogeneity","volume":"8","author":"Meriggioli","year":"2009","journal-title":"Lancet Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1093\/brain\/awl095","article-title":"MRI and clinical studies of facial and bulbar muscle involvement in MuSK antibody-associated myasthenia gravis","volume":"129","author":"Farrugia","year":"2006","journal-title":"Brain"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1093\/brain\/awg223","article-title":"Clinical correlates with anti-MuSK antibodies in generalized seronegative myasthenia gravis","volume":"126","author":"Evoli","year":"2003","journal-title":"Brain"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2169\/internalmedicine.44.671","article-title":"Myasthenia Gravis with Anti-MuSK Antibody, Showing Progressive Muscular Atrophy without Blepharoptosis","volume":"44","author":"Ishii","year":"2005","journal-title":"Intern. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1212\/01.WNL.0000128048.23930.1D","article-title":"Are MuSK antibodies the primary cause of myasthenic symptoms?","volume":"62","author":"Selcen","year":"2004","journal-title":"Neurology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/qjmed\/hcn152","article-title":"Myasthenic crisis","volume":"102","author":"Chaudhuri","year":"2008","journal-title":"QJM Int. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1212\/01.wnl.0000254620.45529.97","article-title":"Clinical comparison of anti-MuSK- vs anti-AChR-positive and seronegative myasthenia gravis","volume":"68","author":"Deymeer","year":"2007","journal-title":"Neurology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.jocn.2011.09.022","article-title":"AchR-positive myasthenia gravis with MRI evidence of early muscle atrophy","volume":"19","author":"Zouvelou","year":"2012","journal-title":"J. Clin. Neurosci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.arr.2018.07.005","article-title":"The age-related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans","volume":"47","author":"Wilkinson","year":"2018","journal-title":"Ageing Res. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/01.mco.0000134362.76653.b2","article-title":"Muscle tissue changes with aging","volume":"7","author":"Volpi","year":"2004","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14910","DOI":"10.1523\/JNEUROSCI.3590-11.2011","article-title":"Changes in Aging Mouse Neuromuscular Junctions Are Explained by Degeneration and Regeneration of Muscle Fiber Segments at the Synapse","volume":"31","author":"Li","year":"2011","journal-title":"J. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.exger.2010.03.007","article-title":"Remodeling of the neuromuscular junction precedes sarcopenia related alterations in myofibers","volume":"45","author":"Deschenes","year":"2010","journal-title":"Exp. Gerontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.exger.2010.08.029","article-title":"Age-associated alterations of the neuromuscular junction","volume":"46","author":"Jang","year":"2011","journal-title":"Exp. Gerontol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/jnnp.35.3.311","article-title":"Neurogenic muscle atrophy in myasthenia gravis","volume":"35","author":"Brownell","year":"1972","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"536","DOI":"10.2169\/internalmedicine.44.536","article-title":"Seronegative Myasthenia Gravis and Muscle Atrophy of the Tongue","volume":"44","author":"Kurihara","year":"2005","journal-title":"Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/mus.20757","article-title":"Myasthenia gravis presenting with unusual neurogenic muscle atrophy","volume":"36","author":"Samuraki","year":"2007","journal-title":"Muscle Nerve"},{"key":"ref_43","first-page":"55","article-title":"From Sarcopenia to Frailty: The Pathophysiological Basis and Potential Target Molecules of Intervention","volume":"3","author":"Yu","year":"2017","journal-title":"Frailty Sarcopenia Onset Dev. Clin. Chall."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0385-8146(12)80083-6","article-title":"Atrophy of the Tongue with Persistent Articulation Disorder in Myasthenia Gravis: Report of 10 Patients","volume":"21","author":"Marchiori","year":"1994","journal-title":"Auris Nasus Larynx"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/11\/1139\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:24:58Z","timestamp":1760167498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/11\/1139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,3]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jpm11111139"],"URL":"https:\/\/doi.org\/10.3390\/jpm11111139","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,3]]}}}