{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:59:59Z","timestamp":1794005999734,"version":"4.8.0"},"reference-count":64,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Abbott Nutrition"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The prevalence of sarcopenia (loss of muscle strength, mass and function) in individuals with heart failure (HF) stands at a considerable level (approximately 20%), contributing to heightened mortality rates and diminished quality of life. The underlying pathophysiological mechanisms involve the presence of low-grade inflammation and a disturbance of the anabolic\u2013catabolic protein balance. The nutritional assessment of patients with HF is a key aspect, and diverse diagnostic tools are employed based on patient profiles (outpatient, inpatient and nursing home). The Global Leadership Initiative on Malnutrition (GLIM) criteria serves as a consensus for diagnosing malnutrition. Given that edema can impact body mass index (BMI) in patients with HF, alternative body assessment technical methods, such as bioelectrical vector impedance (BiVA), BIA (without vector mode), computer tomography (CT) or clinical ultrasound (US), are useful. Scientific evidence supports the efficacy of both aerobic and resistance physical exercises in ameliorating and preventing muscle wasting associated with HF. Dietary strategies emphasize the importance of protein intake, while certain micronutrients like coenzyme Q10 or intravenous iron may offer benefits. This narrative review aims to present the current understanding of the pathogenesis, diagnosis and treatment of muscle loss in individuals with heart failure and its consequential impact on prognosis.<\/jats:p>","DOI":"10.3390\/nu16162717","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T09:29:41Z","timestamp":1723714181000},"page":"2717","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["A Narrative Review of the Diagnosis and Treatment of Sarcopenia and Malnutrition in Patients with Heart Failure"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1904-1107","authenticated-orcid":false,"given":"Luc\u00eda","family":"de Jorge-Huerta","sequence":"first","affiliation":[{"name":"Hospital Universitario 12 de Octubre, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Marco-Alacid","sequence":"additional","affiliation":[{"name":"Hospital Virgen de los Lirios, 03804 Alcoy, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Grande","sequence":"additional","affiliation":[{"name":"Medical Scientific Liaison, Abbott Nutrici\u00f3n, 28050 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Velardo Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Hospital Virgen del Puerto, 10600 Plasencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"L24","DOI":"10.1093\/eurheartj\/suz241","article-title":"Cardiac cachexia","volume":"21","author":"Lena","year":"2019","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.cardfail.2019.03.007","article-title":"Nutrition, Obesity, and Cachexia in Patients With Heart Failure: A Consensus Statement from the Heart Failure Society of America Scientific Statements Committee","volume":"25","author":"Vest","year":"2019","journal-title":"J. Card. Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/ehf2.12237","article-title":"Muscle wasting and sarcopenia in heart failure and beyond: Update 2017","volume":"4","author":"Springer","year":"2017","journal-title":"ESC Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100417","DOI":"10.1016\/j.cpcardiol.2019.03.006","article-title":"Lean Mass Abnormalities in Heart Failure: The Role of Sarcopenia, Sarcopenic Obesity, and Cachexia","volume":"45","author":"Carbone","year":"2020","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_7","first-page":"207","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"10","author":"Cederholm","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5141","DOI":"10.1016\/j.clnu.2021.07.027","article-title":"Relevance of nutritional assessment and treatment to counteract cardiac cachexia and sarcopenia in chronic heart failure","volume":"40","author":"Castro","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Curcio, F., Testa, G., Liguori, I., Papillo, M., Flocco, V., Panicara, V., Galizia, G., Della-Morte, D., Gargiulo, G., and Cacciatore, F. (2020). Sarcopenia and Heart Failure. Nutrients, 12.","DOI":"10.3390\/nu12010211"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Salom Vendrell, C., Garc\u00eda Tercero, E., Moro Hern\u00e1ndez, J.B., and Cedeno-Veloz, B.A. (2023). Sarcopenia as a Little-Recognized Comorbidity of Type II Diabetes Mellitus: A Review of the Diagnosis and Treatment. Nutrients, 15.","DOI":"10.3390\/nu15194149"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.jjcc.2021.10.013","article-title":"Sarcopenia as a comorbidity of cardiovascular disease","volume":"79","author":"Sasaki","year":"2022","journal-title":"J. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nrendo.2012.49","article-title":"Muscles, exercise and obesity: Skeletal muscle as a secretory organ","volume":"8","author":"Pedersen","year":"2012","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1210\/endrev\/bnaa016","article-title":"Muscle\u2013Organ Crosstalk: The Emerging Roles of Myokines","volume":"41","author":"Severinsen","year":"2020","journal-title":"Endocr. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Barbalho, S.M., Flato, U.A.P., Tofano, R.J., Goulart, R.D.A., Guiguer, E.L., Detregiachi, C.R.P., Buchaim, D.V., Ara\u00fajo, A.C., Buchaim, R.L., and Reina, F.T.R. (2020). Physical Exercise and Myokines: Relationships with Sarcopenia and Cardiovascular Complications. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21103607"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1113\/jphysiol.2007.139618","article-title":"Expression of interleukin-15 in human skeletal muscle\u2014Effect of exercise and muscle fibre type composition","volume":"584","author":"Nielsen","year":"2007","journal-title":"J. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6644631","DOI":"10.1155\/2021\/6644631","article-title":"Myokines and Heart Failure: Challenging Role in Adverse Cardiac Remodeling, Myopathy, and Clinical Outcomes","volume":"2021","author":"Berezin","year":"2021","journal-title":"Dis. Markers"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ijcard.2017.03.155","article-title":"Sarcopenia, cachexia, and muscle performance in heart failure: Review update 2016","volume":"238","author":"Saitoh","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1093\/eurjpc\/zwaa117","article-title":"Impact of sarcopenia on prognosis in patients with heart failure with reduced and preserved ejection fraction","volume":"28","author":"Konishi","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1002\/ejhf.1304","article-title":"Comparison of sarcopenia and cachexia in men with chronic heart failure: Results from the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF)","volume":"20","author":"Emami","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Esteban-Fern\u00e1ndez, A., Villar-Taibo, R., Alejo, M., Arroyo, D., Bonilla Palomas, J.L., Cachero, M., Joaquin, C., M\u00e9ndez Bail\u00f3n, M., P\u00e9rez-Rivera, J.\u00c1., and Romero-Vigara, J.C. (2023). Diagnosis and Management of Malnutrition in Patients with Heart Failure. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093320"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/S0735-1097(01)01448-6","article-title":"The relationship between obesity and mortality in patients with heart failure","volume":"38","author":"Horwich","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/ehf2.12545","article-title":"Discriminating sarcopenia in overweight\/obese male patients with heart failure: The influence of body mass index","volume":"7","author":"Fonseca","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1089\/met.2012.0057","article-title":"Influence of Severe Sarcopenia on Cardiovascular Risk Factors in Nonobese Men","volume":"10","author":"Abe","year":"2012","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lena, A., Anker, M.S., and Springer, J. (2020). Muscle Wasting and Sarcopenia in Heart Failure\u2014The Current State of Science. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21186549"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1111\/ggi.13756","article-title":"Impact of edema on length of calf circumference in older adults","volume":"19","author":"Ishida","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1016\/j.clnu.2022.07.041","article-title":"Advances in muscle health and nutrition: A toolkit for healthcare professionals","volume":"41","author":"Prado","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1016\/j.clnu.2022.02.001","article-title":"Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition","volume":"41","author":"Barazzoni","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1177\/0148607116633823","article-title":"Safety of Bioelectrical Impedance Analysis in Patients Equipped With Implantable Cardioverter Defibrillators","volume":"41","author":"Meyer","year":"2017","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_29","first-page":"169","article-title":"Safety and Results of Bioelectrical Impedance Analysis in Patients with Cardiac Implantable Electronic Devices","volume":"35","author":"Garlini","year":"2020","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101911","DOI":"10.1016\/j.cpcardiol.2023.101911","article-title":"Bioelectrical Impedance Analysis and Body Composition in Cardiovascular Diseases","volume":"48","author":"Szczygiel","year":"2023","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/HPC.0000000000000105","article-title":"Noninvasive Bioelectrical Impedance for Predicting Clinical Outcomes in Outpatients With Heart Failure","volume":"16","author":"Lyons","year":"2017","journal-title":"Crit. Pathw. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis? part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1111\/ggi.13241","article-title":"Phase angle measured by electrical bioimpedance and global cardiovascular risk in older adults","volume":"18","author":"Saad","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/10998004221132838","article-title":"A Current Review of the Uses of Bioelectrical Impedance Analysis and Bioelectrical Impedance Vector Analysis in Acute and Chronic Heart Failure Patients: An Under-valued Resource?","volume":"25","author":"Thanapholsart","year":"2023","journal-title":"Biol. Res. Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"de Luis Roman, D., Garc\u00eda Almeida, J.M., Bellido Guerrero, D., Guzm\u00e1n Rolo, G., Mart\u00edn, A., Primo Mart\u00edn, D., Garc\u00eda-Delgado, Y., Guirado-Pel\u00e1ez, P., Palmas, F., and Tejera P\u00e9rez, C. (2024). Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk. Nutrients, 16.","DOI":"10.3390\/nu16111552"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Aminuddin, A., Noor Hashim, M.F., Mohd Zaberi, N.A.S., Zheng Wei, L., Ching Chu, B., Jamaludin, N.A., Salamt, N., Che Roos, N.A., and Ugusman, A. (2021). The Association Between Arterial Stiffness and Muscle Indices Among Healthy Subjects and Subjects With Cardiovascular Risk Factors: An Evidence-Based Review. Front. Physiol., 12.","DOI":"10.3389\/fphys.2021.742338"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1016\/j.jacc.2022.02.025","article-title":"Nutrition Assessment and Dietary Interventions in Heart Failure","volume":"79","author":"Driggin","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_38","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_39","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s12603-017-0921-4","article-title":"Assessing the risk of sarcopenia in the elderly: The Mini Sarcopenia Risk Assessment (MSRA) questionnaire","volume":"21","author":"Rossi","year":"2017","journal-title":"J. Nutr. Health Aging."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/jcsm.12048","article-title":"SARC-F: A symptom score to predict persons with sarcopenia at risk for poor functional outcomes: SARC-F","volume":"7","author":"Malmstrom","year":"2016","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s41043-024-00500-y","article-title":"Hand grip strength as a proposed new vital sign of health: A narrative review of evidences","volume":"43","author":"Vaishya","year":"2024","journal-title":"J. Health Popul. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"104463","DOI":"10.1016\/j.archger.2021.104463","article-title":"Chair sit-to-stand performance is associated with diagnostic features of sarcopenia in older men and women","volume":"96","author":"Yoshiko","year":"2021","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.ijcard.2016.07.167","article-title":"Sarcopenia and physical activity in older male cardiac patients","volume":"222","author":"Izawa","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_44","first-page":"615","article-title":"Sarcopenia in heart failure: Mechanisms and therapeutic strategies","volume":"13","author":"Collamati","year":"2016","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_45","unstructured":"(2024, May 31). Gu\u00eda ESC 2020 Sobre Cardiolog\u00eda Del Deporte Y El Ejercicio En Pacientes Con Enfermedad Cardiovascular. Available online: https:\/\/www.revespcardiol.org\/es-pdf-S0300893221000750."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1002\/ehf2.12387","article-title":"Skeletal muscle wasting in chronic heart failure","volume":"5","author":"Suzuki","year":"2018","journal-title":"ESC Heart Fail."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ijcard.2016.07.135","article-title":"Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life","volume":"222","author":"Bekfani","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1016\/j.jacc.2021.03.232","article-title":"Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure","volume":"77","author":"Hersberger","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.arcmed.2016.11.005","article-title":"Nutritional Intervention in Malnourished Hospitalized Patients with Heart Failure","volume":"47","year":"2016","journal-title":"Arch. Med. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.clnu.2015.12.010","article-title":"Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial","volume":"35","author":"Deutz","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1002\/jcsm.12973","article-title":"Clinical implications of low estimated protein intake in patients with heart failure","volume":"13","author":"Streng","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2116","DOI":"10.1016\/j.clnu.2023.09.004","article-title":"Impact of a specialized oral nutritional supplement on quality of life in older adults following hospitalization: Post-hoc analysis of the NOURISH trial","volume":"42","author":"Baggs","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/ajcn\/nqy373","article-title":"\u03b2-Hydroxy-\u03b2-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: A systematic review and meta-analysis","volume":"109","author":"Bear","year":"2019","journal-title":"Am. J Clin Nutr."},{"key":"ref_54","first-page":"e47027","article-title":"Improving the Outcome of Patients With Heart Failure: Assessment of Iron Deficiency and Intravenous Iron Replacement","volume":"15","author":"Yera","year":"2023","journal-title":"Cureus"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.pcad.2020.08.004","article-title":"The role of diet and nutrition in heart failure: A state-of-the-art narrative review","volume":"63","author":"Billingsley","year":"2020","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Cvetinovic, N., Loncar, G., Isakovic, A.M., von Haehling, S., Doehner, W., Lainscak, M., and Farkas, J. (2019). Micronutrient Depletion in Heart Failure: Common, Clinically Relevant and Treatable. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20225627"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1053\/j.ajkd.2015.09.005","article-title":"Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones","volume":"67","author":"Ferraro","year":"2016","journal-title":"Am. J. Kidney Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.tem.2021.08.006","article-title":"Vitamin D toxicity related to its physiological and unphysiological supply","volume":"32","author":"Fraser","year":"2021","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1001\/jama.2011.1437","article-title":"Vitamin E and the Risk of Prostate Cancer: The Selenium and Vitamin E Cancer Prevention Trial (SELECT)","volume":"306","author":"Klein","year":"2011","journal-title":"JAMA"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1001\/archinternmed.2009.495","article-title":"Acute Selenium Toxicity Associated With a Dietary Supplement","volume":"170","author":"MacFarquhar","year":"2010","journal-title":"Arch. Intern. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1001\/jamaneurol.2018.1669","article-title":"Selenium Toxicity Associated With Reversible Leukoencephalopathy and Cortical Blindness","volume":"75","author":"Rae","year":"2018","journal-title":"JAMA Neurol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0002-9149(01)02261-5","article-title":"Relation of aldosterone \u201cescape\u201d despite angiotensin-converting enzyme inhibitor administration to impaired exercise capacity in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy","volume":"89","author":"Cicoira","year":"2002","journal-title":"Am. J. Cardiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/j.1365-2265.2011.04148.x","article-title":"Mineralocorticoid antagonism: A novel way to treat sarcopenia and physical impairment in older people? Mineralocorticoid antagonism","volume":"75","author":"Burton","year":"2011","journal-title":"Clin. Endocrinol."},{"key":"ref_64","first-page":"59","article-title":"Decreased muscle mass in type-2 diabetes. A hidden comorbidity to consider","volume":"40","year":"2023","journal-title":"Nutr. Hosp."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/16\/2717\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:37:08Z","timestamp":1760110628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/16\/2717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,15]]},"references-count":64,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["nu16162717"],"URL":"https:\/\/doi.org\/10.3390\/nu16162717","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,15]]}}}