Associations Between Oxidative Stress, Inflammation, Muscle Mass, and Sarcopenia Phenotypes in Older Adults with End-Stage Knee and Hip Osteoarthritis: A Cross-Sectional Study.
6 affiliations
- 1Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece.
- 2Department of Food Science and Nutrition, School of Environment, University of Aegean, Myrina, 81400 Lemnos, Greece.
- 3First Orthopedic Clinic, 424 Military Hospital, 56429 Thessaloniki, Greece.
- 4Department of Nutritional Sciences and Dietetics, School of Health Sciences, Hellenic Mediterranean University, 72300 Crete, Greece.
- 5Department of Nursing, School of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece.
- 6School of Physical Education and Sports Science, Faculty of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 62122 Serres, Greece.
Abstract
Background: Skeletal muscle impairment is common in older adults with end-stage knee and hip osteoarthritis (OA) and contributes to disability and functional decline. Τhe relative contributions of muscle mass, muscle strength, systemic inflammation and oxidative stress to sarcopenia phenotypes in this population remain incompletely understood. This study investigated the associations between muscle-related parameters, inflammatory and oxidative stress biomarkers, and sarcopenia phenotypes in older adults with end-stage OA. Methods: This cross-sectional study included 88 older adults scheduled for primary total knee (n = 56) or total hip arthroplasty (n = 32). Body composition, muscle strength, physical performance, and biochemical markers were assessed using standardized procedures. Systemic inflammation was evaluated using C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR), whereas oxidative stress was assessed by urinary F₂-isoprostanes. Sarcopenia status was categorized according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Results: Overall, 29.5% of participants were classified as having probable/confirmed sarcopenia phenotypes, with similar prevalence in knee and hip OA. Sarcopenic participants exhibited significantly lower appendicular skeletal muscle mass (ASMM), reduced handgrip strength, slower gait speed, poorer physical performance and higher body fat percentage than those without sarcopenia. Muscle strength demonstrated stronger associations with physical performance than muscle mass and remained an independent predictor of Short Physical Performance Battery (SPPB) score after adjustment for age, gender and muscle mass. Higher urinary F₂-isoprostane concentrations were independently associated with lower ASMM after adjustment for demographic characteristics and inflammatory biomarkers, whereas CRP and NLR were not independently associated with muscle-related outcomes in the fully adjusted models. Conclusions: Nearly one-third (29.5%) of older adults with end-stage knee and hip OA were classified as having probable or confirmed sarcopenia according to the EWGSOP2 criteria. Oxidative stress was independently associated with skeletal muscle mass, whereas CRP and NLR were not independently associated with muscle-related outcomes. These findings highlight the relevance of muscle strength and oxidative stress in older adults with end-stage OA and warrant further longitudinal investigation.
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BibTeX
@article{spanoudaki2026associations,
title = {{Associations Between Oxidative Stress, Inflammation, Muscle Mass, and Sarcopenia Phenotypes in Older Adults with End-Stage Knee and Hip Osteoarthritis: A Cross-Sectional Study.}},
author = {Maria Spanoudaki and Constantinos Giaginis and Antonios Cheimaras and Stavros Pellios and Dafni Sela and Agathi Pritsa and Ioannis Moschos and Eirini Koidou and Sousana K Papadopoulou},
journal = {Geriatrics (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/geriatrics11050142},
url = {https://europepmc.org/article/MED/42930021},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associations Between Oxidative Stress, Inflammation, Muscle Mass, and Sarcopenia Phenotypes in Older Adults with End-Stage Knee and Hip Osteoarthritis: A Cross-Sectional Study.
AU - Maria Spanoudaki
AU - Constantinos Giaginis
AU - Antonios Cheimaras
AU - Stavros Pellios
AU - Dafni Sela
AU - Agathi Pritsa
AU - Ioannis Moschos
AU - Eirini Koidou
AU - Sousana K Papadopoulou
PY - 2026
DA - 2026/10/07
JO - Geriatrics (Basel, Switzerland)
DO - 10.3390/geriatrics11050142
UR - https://europepmc.org/article/MED/42930021
AB - Background: Skeletal muscle impairment is common in older adults with end-stage knee and hip osteoarthritis (OA) and contributes to disability and functional decline. Τhe relative contributions of muscle mass, muscle strength, systemic inflammation and oxidative stress to sarcopenia phenotypes in this population remain incompletely understood. This study investigated the associations between muscle-related parameters, inflammatory and oxidative stress biomarkers, and sarcopenia phenotypes in older adults with end-stage OA. Methods: This cross-sectional study included 88 older adults scheduled for primary total knee (n = 56) or total hip arthroplasty (n = 32). Body composition, muscle strength, physical performance, and biochemical markers were assessed using standardized procedures. Systemic inflammation was evaluated using C-reactive protein (CRP) and the neutrophil-to-lymphocyte ratio (NLR), whereas oxidative stress was assessed by urinary F₂-isoprostanes. Sarcopenia status was categorized according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Results: Overall, 29.5% of participants were classified as having probable/confirmed sarcopenia phenotypes, with similar prevalence in knee and hip OA. Sarcopenic participants exhibited significantly lower appendicular skeletal muscle mass (ASMM), reduced handgrip strength, slower gait speed, poorer physical performance and higher body fat percentage than those without sarcopenia. Muscle strength demonstrated stronger associations with physical performance than muscle mass and remained an independent predictor of Short Physical Performance Battery (SPPB) score after adjustment for age, gender and muscle mass. Higher urinary F₂-isoprostane concentrations were independently associated with lower ASMM after adjustment for demographic characteristics and inflammatory biomarkers, whereas CRP and NLR were not independently associated with muscle-related outcomes in the fully adjusted models. Conclusions: Nearly one-third (29.5%) of older adults with end-stage knee and hip OA were classified as having probable or confirmed sarcopenia according to the EWGSOP2 criteria. Oxidative stress was independently associated with skeletal muscle mass, whereas CRP and NLR were not independently associated with muscle-related outcomes. These findings highlight the relevance of muscle strength and oxidative stress in older adults with end-stage OA and warrant further longitudinal investigation.
SN - 2308-3417
ER -