Search Results (228)

Background: The waist–calf circumference ratio (WCR) is an index that combines waist and calf circumference measurements, offering a potentially effective method for evaluating the imbalance between abdominal fat and leg muscle mass in older adults. Objective: To assess the association between WCR and indicators of body composition, muscle strength, and physical performance in community-dwelling older women. Methods: This was a cross-sectional study involving 133 older women (≥65 years) from an urban-marginal community in Guayaquil, Ecuador. The WCR was categorized into quartiles (Q1: 2.07–2.57; Q2: 2.58–2.75; Q3: 2.76–3.05; Q4: 3.06–4.76). Body indicators included fat-free mass (FFM), skeletal muscle mass (SMM), appendicular muscle mass (ASM), appendicular muscle mass index (ASMI), visceral fat (VF), fat mass (FM), and fat mass index (FMI). Handgrip strength (HGS) and the Short Physical Performance Battery test (SPPB) score were used to assess muscle strength and function, respectively. Results: The median age of the participants was 75 [IQR: 65–82] years. The mean WCR was 2.92 ± 0.93. Statistically significant associations were found between WCR and VF (p < 0.001), WCR and SMM (p = 0.039), and WCR and ASM (p = 0.016). Regarding muscle function, WCR was associated with HGS (p = 0.025) and SPPB score (p = 0.029). Conclusions: A significant association was observed between WCR and body composition, and muscle strength and function in older women. Full article

Introduction and Aim: Sarcopenia has emerged as a key prognostic factor in patients with chronic limb-threatening ischemia (CLTI), with potential implications for clinical decision-making. This study aimed to assess the association between sarcopenia and clinical outcomes, mortality, and amputation, using simple, accessible screening tools in a CLTI population. Methods: In this prospective, single-center study conducted between December 2023 and December 2024, 170 patients with CTLI were enrolled. Sarcopenia screening was performed using the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaires, handgrip strength measurement, and calf circumference, adjusted for body mass index and sex. The primary outcome was 6-month all-cause mortality and/or major amputation. Results: Sarcopenia was identified in 77 patients (45.3%). Compared to non-sarcopenic individuals, sarcopenic patients were significantly older. They exhibited greater functional impairment, as well as poorer nutritional and muscle status. They also had significantly higher in-hospital mortality (16.9% vs. 3.2%, p = 0.002), 30-day mortality (24.7% vs. 4.3%, p = 0.001), and 6-month mortality (50.6% vs. 15.1%, p = 0.001). Sarcopenia was significantly associated with the primary outcome in univariate analysis (HR: 2.05; 95% CI: 1.31–3.20; p = 0.002) and remained an independent predictor after multivariate adjustment (HR: 1.95; 95% CI: 1.01–3.79; p = 0.048). Conclusions: Sarcopenia is a strong, independent predictor of poor outcome in patients with CLTI. Its detection through simple tools offers an easy and cost-effective strategy to improve risk stratification and guide early intervention through exercise-based therapy. Full article

Background: Sarcopenia is a progressive muscle disease that compromises mobility and quality of life in older adults. Although dual-energy X-ray absorptiometry (DXA) is the standard for assessing Appendicular Lean Mass Index (ALMI), it is costly and often inaccessible. This study aims to develop machine learning models using anthropometric measurements to predict low ALMI for the diagnosis of sarcopenia. Methods: A cross-sectional study was conducted on 183 Mexican adults (67.2% women and 32.8% men, ≥60 years old). ALMI was measured using DXA, and anthropometric data were collected following the International Society for the Advancement of Kinanthropometry (ISAK) protocols. Predictive models were developed using Logistic Regression (LR), Decision Trees (DTs), Random Forests (RFs), Artificial Neural Networks (ANNs), and LASSO regression. The dataset was split into training (70%) and testing (30%) sets. Model performance was evaluated using classification performance metrics and the area under the ROC curve (AUC). Results: ALMI indicated strong correlations with BMI, corrected calf girth, and arm relaxed girth. Among models, DT achieved the best performance in females (AUC = 0.84), and ANN indicated the highest AUC in males (0.92). Regarding the prediction of low ALMI, specificity values were highest in DT for females (100%), while RF performed best in males (92%). The key predictive variables varied depending on sex, with BMI and calf girth being the most relevant for females and arm girth for males. Conclusions: Anthropometry combined with machine learning provides an accurate, low-cost approach for identifying low ALMI in older adults. This method could facilitate sarcopenia screening in clinical settings with limited access to advanced diagnostic tools. Full article

Background and Clinical Significance: Neurofibromatosis type 1 (NF1) predisposes individuals to various peripheral nerve sheath tumors (PNSTs), including benign neurofibromas, malignant peripheral nerve sheath tumors (MPNSTs), and intermediate lesions known as atypical neurofibromatous neoplasms of uncertain biologic potential (ANNUBP), previously often termed atypical neurofibroma. These atypical lesions are considered premalignant precursors to MPNST. Case Presentation: We present the case of a 33-year-old male with NF1 who developed a rapidly growing, painful mass in his right calf. Clinical examination revealed signs consistent with NF1. Magnetic resonance imaging showed a large, heterogeneous mass in the lateral compartment. Biopsy revealed a neurofibroma with hypercellularity, moderate atypia, scarce S100 positivity, focal CD34 positivity, and an elevated Ki-67 proliferation index of 10–12%, consistent with ANNUBP. The patient underwent wide surgical resection, including the fibula and peroneal muscles. At the 30-month follow-up, there was no local recurrence, though the patient had a mild residual limp. Discussion: This case highlights the clinical presentation, diagnostic features, and management considerations for ANNUBP in NF1, emphasizing the importance of recognizing warning signs and the role of pathology in guiding treatment for these high-risk precursor lesions. Full article

Despite the benefits of resistance training in mitigating sarcopenia, adherence among frail older adults is often limited by osteoarticular pain, comorbidities, and logistical barriers. Pulsed electromagnetic field (PEMF) therapy has emerged as a potential alternative. However, evidence regarding its effects on functional and psychological parameters remains scarce. Objectives: To assess the effects of 12 PEMF therapy sessions on knee extensor strength and functional performance (Timed Up and Go test—TUG) in older adults with sarcopenia. Secondary outcomes included changes in calf circumference (CC), SARC-F + CC scores, and depressive symptoms. Methods: A controlled, non-randomized experimental design was employed, with a pre-intervention control group serving as a baseline reference (PEMF group: n = 25; control group: n = 16). Participants received 12 PEMF therapy sessions (three times per week) targeting the quadriceps and gastrocnemius muscles. Outcomes were measured using knee-extension dynamometry, TUG, CC, SARC-F + CC, and the Yesavage Geriatric Depression Scale. Statistical analyses included ANCOVA, with baseline values as covariates. Results: Significant improvements were observed in knee-extension strength, which increased from 13.05 ± 4.8 kgf to 18.56 ± 8 kgf (p < 0.001); TUG test time improved from 23.1 ± 14.4 to 18.7 ± 10 s (p = 0.048); SARC-F + CC scores decreased from 11.6 ± 8.2 to 6.5 ± 7.6 (p < 0.001), though the interaction effect with time was not significant (p = 0.252). No statistically significant changes were observed in CC, which increased from 34.0 ± 4.0 cm to 36.0 ± 3.9 cm following the intervention (p = 0.548). Yesavage Geriatric Depression Scale scores improved significantly (7.9 ± 2.4 to 5.4 ± 1.7, p = 0.0013). Conclusions: PEMF therapy significantly improved lower-limb muscle strength and functional mobility in elderly individuals with sarcopenia. Additionally, depressive symptoms were significantly reduced. However, no significant changes were observed in CC or SARC-F + CC. Full article

Background and Objectives: Sarcopenia and lower urinary tract symptoms (LUTSs) are both prevalent among older adults and may share underlying pathophysiological mechanisms. However, their association has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the association between sarcopenia and LUTSs, including the pooled estimates of prevalence and odds ratios (ORs), and to explore the influence of diagnostic definitions and study-level factors. Materials and Methods: A comprehensive literature search was conducted using PubMed and Embase for studies published between 1 January 2000 and 26 April 2025. This study adhered to PRISMA and MOOSE guidelines and was registered in PROSPERO (CRD420251037459). Eligible observational studies reported LUTS prevalence or ORs in individuals with sarcopenia, low muscle strength (LMS), low lean mass (LLM), low gait speed (LGS), or sarcopenia risk identified by SARC-F (score ≥4). Pooled ORs and prevalence rates were calculated using a random-effects model. Subgroup analyses were performed based on sarcopenia definitions—Asian Working Group for Sarcopenia (AWGS) and European Working Group on Sarcopenia in Older People (EWGSOP)—as well as LUTS subtypes and diagnostic components. Univariate meta-regression assessed associations with age, BMI, sex distribution, WHO region, and risk of bias. Results: Twenty-five studies comprising 84,484 participants were included. Sarcopenia was significantly associated with LUTSs (pooled OR = 1.78; 95% CI: 1.29–2.45; p < 0.001), with a pooled LUTS prevalence of 43.2% (95% CI: 26.9–61.0%). Stronger associations were observed in studies using AWGS diagnostic criteria (OR = 2.24; 95% CI: 1.41–3.56; p = 0.001), in those evaluating severe sarcopenia (OR = 1.66; 95% CI: 1.03–2.68; p = 0.038), and in institutionalized populations (OR = 3.68; 95% CI: 2.18–6.24; p < 0.001) compared to community-dwelling populations (OR = 1.43; 95% CI: 1.06–1.92; p = 0.018). Sarcopenia risk identified by SARC-F (score ≥4) showed the strongest association with LUTSs (OR = 3.20; 95% CI: 1.92–5.33; p < 0.001). Significant associations were also found for LLM (OR = 1.52; 95% CI: 1.19–1.95; p = 0.001) and LGS (OR = 1.37; 95% CI: 1.06–1.76; p = 0.015), but not for LMS (OR = 0.94; 95% CI: 0.47–1.89; p = 0.871). Exploratory analyses comparing LLM diagnostic modalities—including standardized criteria (ASMI, ASM/BMI), imaging-based methods (SMI, PMA), and surrogate measures (calf circumference)—revealed no significant differences (all p > 0.05). Heterogeneity was high (I² > 90%). Egger’s test indicated no evidence of publication bias (p = 0.838), and trim-and-fill analysis did not affect the pooled estimates. Conclusions: Sarcopenia—particularly in its severe forms—is significantly associated with LUTSs. Additionally, individuals who screened positive for sarcopenia using the SARC-F tool demonstrated a heightened risk of LUTSs. Subgroup analyses revealed a stronger association in institutionalized populations, suggesting that care setting may modify risk. These findings underscore the importance of assessing muscle health in older adults with urinary symptoms. Standardization of diagnostic criteria and longitudinal studies are needed to clarify causality and guide targeted interventions. Full article

Background/Objectives: This study aimed to establish the potential osteotropic effect of pine pollen on bone metabolism in male rats during the development of osteopenia induced by orchidectomy (ORX). We also established the effect of gonadectomy and pine pollen on the characteristics of calf muscles. Methods: This study was conducted using 40 male Wistar rats divided into one sham-operated (SHO) and four ORX groups. The SHO rats and one ORX group (negative control) were treated with physiological saline (PhS). The remaining ORX groups received exclusively testosterone (positive control) and two doses of pine pollen (50 and 150 mg/kg b.w.), respectively. The rats were killed 60 days later and their right tibia and left pelvic limbs were isolated. The tibia was analyzed using densitometry, computed tomography, and a bending machine to determine densitometry, structure, and mechanical properties, respectively. The left pelvic limb allowed for measurements of area, density, and fat tissue in the calf muscle. Results: The dose of 150 mg/kg b.w. inhibited the development of atrophic changes, both in the cortical and trabecular bone tissue. The dose of 50 mg/kg b.w. also has a protective effect on bones but is less pronounced and concerns only the trabecular bone tissue. The higher dose of pine pollen inhibited the catabolism of the calf muscles by maintaining the density and surface area as in the SHO group. It also limited the accumulation of intramuscular and subcutaneous adipose tissue. Conclusions: It is worth emphasizing the osteoprotective effectiveness of pine pollen, especially when administered in larger doses, which demonstrates the possibility of its use in the prevention of the development of osteoporosis in males. Full article

Background and Objectives: Negative-pressure wound therapy (NPWT) expedites tissue repair, yet functional recovery depends on adjunct rehabilitation. Evidence from high-resource settings is difficult to translate to Romanian county hospitals, where advanced devices are scarce. The objective of this study is to determine whether two tiers of low-technology, therapist-delivered exercise improve mobility, oedema resolution, pain and quality-of-life (QoL) beyond NPWT alone in adults with acute lower-limb wounds. Methods: A single-centre, prospective observational study (January 2021–June 2024) enrolled 92 patients and randomised them unevenly into: Group A, NPWT only (n = 39); Group B, NPWT + routine physiotherapy (n = 33); Group C, NPWT + enhanced manual programme (n = 20). All received −125 mmHg continuous suction; rehabilitation started 48 h post-operation. Primary outcomes were ankle dorsiflexion and knee flexion at 12 weeks. Secondary outcomes included calf circumference, ultrasound oedema depth, Manual Muscle Testing (MMT), pain (VAS), analgesic use and SF-36 domains through 24 weeks. Results: Baseline characteristics were similar (p > 0.40). At 12 weeks dorsiflexion reached 20.1 ± 1.8° in Group C, surpassing Group B (18.4 ± 2.1°; p = 0.004) and Group A (16.0 ± 2.3°; p < 0.001). Knee flexion followed the same gradient (140.8 ± 3.2°, 137.6 ± 3.4°, 133.4 ± 3.8° respectively). Oedema depth fell fastest in Group C (0.4 ± 0.2 mm by day 42) versus B (0.6 ± 0.2 mm) and A (0.8 ± 0.3 mm). Week-12 MMT grade ≥ 4.5 was attained by 95% of Group C, 85% of B and 72% of A (χ² = 10.9, p = 0.004). VAS pain fell more steeply with each rehabilitation layer, paralleled by a stepwise decline in daily tramadol. All SF-36 domains were highest in Group C at 24 weeks (Physical Function 88.7 ± 4.8 vs. 85.1 ± 5.4 vs. 78.2 ± 5.9; p < 0.001). Mobility correlated positively with QoL (r = 0.66) and inversely with pain and oedema. Conclusions: In a resource-constrained Romanian setting, adding structured manual physiotherapy to NPWT produced meaningful functional and patient-centred gains, while an “enhanced” programme incorporating daily PNF and elastic-band strengthening delivered the largest observed benefit. These findings justify prioritising therapist-led interventions even where sophisticated equipment is unavailable. Full article

This study examined the relationships between mid-arm circumference (MAC) and calf circumference (CC) with cognitive performance, considering the moderating effect of apolipoprotein E ε4 allele (APOE4) status. Data from 196 older adults (65–90 years) in the General Lifestyle and AD (GLAD) study were analyzed. Cognitive performance was assessed using the CERAD neuropsychological battery, with episodic memory score (EMS) and non-memory score (NMS) as primary outcomes. Multiple linear regression analyses examined associations between MAC, CC, and waist circumference (WC) with cognition, adjusting for key covariates. Interaction effects with APOE4 status were also explored. Higher MAC (or MAC/WC) significantly correlated with better EMS, while higher CC (or CC/WC) correlated with better NMS, even after Bonferroni correction (P_B < 0.0125). These associations were stronger in APOE4-negative individuals but not significant in APOE4-positive participants. WC was not associated with cognitive measures. The results suggest that Upper- and lower-limb musculature may play distinct roles in cognitive function, with MAC linked to episodic memory and CC to non-memory cognition, particularly in APOE4-negative individuals. These findings highlight the potential of muscle health maintenance as a strategy for preserving cognitive function in aging populations. Full article

Objectives: To evaluate the individual and combined impact of sarcopenia (SARC) and heart failure (HF) on functional performance, systemic biomarkers, and structural cardiac changes in hospitalized older adults. A total of 598 patients aged ≥65 years admitted to a geriatric unit between January 2023 and December 2024, stratified into four groups based on the presence or absence of sarcopenia and HF. Methods: Muscle strength (handgrip), gait speed, SPPB score, and calf circumference were assessed, along with inflammatory/nutritional markers and echocardiographic parameters. Sarcopenia was diagnosed according to EWGSOP2 criteria and HF was diagnosed according to ESC 2021 guidelines. Results: Functional impairment was the most severe in the SARC+/HF+ group, with significantly lower handgrip strength, gait speed, and SPPB scores (p < 0.001). Sarcopenia alone was associated with greater functional decline than HF alone. Serum hemoglobin and albumin levels were reduced in sarcopenic groups, while NT-proBNP and cardiac remodeling indices (IVS and LVEDD) were highest in patients with both conditions. Conclusions: Sarcopenia exerts a significant impact on physical performance in older adults, surpassing that of HF in isolation. The coexistence of sarcopenia and HF amplifies vulnerability and clinical decline, supporting the need for integrated assessment and early muscle-targeted interventions in geriatric cardiology. Full article

Setting up anthropometric profiles for elite athletes in each sport, sport discipline, or specific sport positions could be a key element of sport selection processes. The main purpose of this study was to determine the anthropometric characteristics, body composition, and somatotype profiles of elite international ILCA 7 class sailors and to determine the differences contributing to different levels of competitive success. The subject sample included 97 elite ILCA 7 class sailors. A set of 25 anthropometric variables was applied. The sailors were divided into three groups according to their level of general competitive success according to the World Sailing Rankings. Differences between elite ILCA 7 sailors, separated into Higher, Medium, and Lower groups based on their success, were found in terms of age, body mass, muscle mass, trunk muscle mass, leg muscle mass, biepicondilar humerus width, sum of skinfolds, triceps skinfold, supraspinale skinfold, medial calf skinfold, and endomorphy rating. The most successful group of sailors was, on average, 4.9 years older than the least successful group. More highly successful sailors were also found to have an average of 2.73 kg more muscle mass but an 8.81 mm lower sum of skinfolds than those in the lower success group. Considering the average values of somatotype categories, ILCA 7 sailors fit the endomorphic–mesomorph somatotype category (3.23 ± 0.99–4.81 ± 0.90–2.25 ± 0.86). This research clearly identifies the anthropometric profile of elite ILCA 7 sailors, which can significantly contribute to a more informed choice of sailing class. Given the results of this research, current ILCA 7 sailors can easily compare their own anthropometric parameters with elite ILCA 7 sailors and eventually adjust their training process to obtain a more desirable anthropometric profile. Full article

Background: Oral frailty is a state between normal oral function and oral hypofunction. Oral frailty progresses to oral hypofunction and dysphagia, which leads to malnutrition, and then to physical frailty and sarcopenia. Oral frailty is reported to be associated with physical frailty and malnutrition in hemodialysis patients, but there have been no reports on peritoneal dialysis (PD) patients. Methods: This prospective cohort study investigated the associations of oral frailty with physical frailty, sarcopenia, and malnutrition in patients on PD. Patients were divided into an oral frailty group and a non-oral frailty group according to the Oral Frailty Index-8. Patients were assessed for physical frailty, sarcopenia, and malnutrition at baseline and 1 year later, and changes in each measure were compared between the two groups. Physical frailty was assessed using the Revised Japanese version of the Cardiovascular Health Study Criteria (Revised J-CHS) and the FRAIL scale. Sarcopenia was assessed using the diagnostic criteria reported by the Asian Working Group for Sarcopenia in 2019 (AWGS2019 criteria) and the Screening Tool for Sarcopenia Combined with Calf Circumference (SARC-CalF), skeletal muscle index (SMI), calf circumference (CC), grip strength, and gait speed. Nutritional status was assessed with the Short-Form Mini-Nutritional Assessment (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Global Leadership Initiative on Malnutrition (GLIM) criteria, weight, and body mass index (BMI). Results: Of the 58 eligible patients, 51 completed the study. The oral frailty group was significantly older and had slower gait speed, fewer teeth, higher intact parathyroid hormone, higher C-reactive protein, higher frequency of cardiovascular disease, and lower employment at baseline. The oral frailty group had significantly worse physical frailty (Revised J-CHS, p = 0.047; FRAIL scale, p = 0.012), sarcopenia (SMI, p = 0.018; CC, p = 0.002), and nutritional status (MNA-SF, p = 0.029; MUST, p = 0.005; GLIM criteria, p = 0.022; weight, p < 0.001; BMI, p < 0.001). However, there were no significant differences in the worsening of sarcopenia (AWGS2019 criteria, SARC-CalF, grip strength, and gait speed). Conclusions: Oral frailty in patients on PD was associated with the development and progression of physical frailty and malnutrition, and may be associated with the development and progression of sarcopenia. Full article

Background/Objectives: Possible sarcopenia and malnutrition are critical public health concerns among older adults, particularly in vulnerable populations such as those with a history of homelessness. However, limited evidence exists on the nutritional status and muscle health of this group in Thailand. Methods: This study aimed to assess the nutritional status of formerly homeless older adults residing in supportive housing in Thailand and examine its association with possible sarcopenia. A cross-sectional study was conducted among 116 participants aged 50 years and older. Sociodemographic information was collected using a structured questionnaire. Nutritional status was then assessed using the Mini Nutritional Assessment short form (MNA-SF) and body mass index (BMI). Possible sarcopenia was determined based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, including low calf circumference, reduced handgrip strength, and/or low gait speed. Data were analyzed using descriptive statistics and logistic regression. Results: Of all participants, 66.4% were male, with a mean age of 59.14 years (SD = 7.791). A total of 78.4% were identified as having possible sarcopenia. Univariate analysis revealed significant associations between possible sarcopenia and malnutrition (OR = 6.111, 95% CI = 2.104–17.750), low BMI (OR = 16.784, 95% CI = 3.729–75.535), and waist circumference (OR = 0.129, 95% CI = 0.049–0.342). Multivariate logistic regression indicated that malnutrition (OR = 3.429, 95% CI = 1.093–10.763) and low BMI (OR = 11.732, 95% CI = 2.523–54.567) were significant predictors of possible sarcopenia, collectively explaining 33.8% of the variance. Conclusions: The findings underscore a high prevalence of possible sarcopenia among formerly homeless older adults in supportive housing in Thailand and highlight poor nutritional status, particularly low BMI and malnutrition, as a key contributing factor. These results emphasize the importance of early nutritional screening and interventions to prevent or delay sarcopenia in this vulnerable population. Full article

Passive Dynamic Ankle–Foot Orthoses (PD-AFOs) are medical devices prescribed to individuals with foot drop, a condition characterized by weakness of the ankle dorsiflexor muscles. PD-AFOs can store and release energy during the stance phase of the gait cycle, while supporting the foot in the swing phase. This study aimed at estimating the energetics of a novel fiberglass-reinforced polyamide custom PD-AFO in a population of mild foot drop patients. Eight PD-AFOs were designed and 3D-printed via selective laser sintering for eight participants with a unilateral foot drop condition. Lower limb kinematics and AFO flexion/extension were recorded during comfortable walking speed via skin marker-based stereophotogrammetry. The stiffness of each AFO was measured via an ad hoc experimental setup. The elastic work performed by the PD-AFO during gait was calculated as the dot product of the calf-shell resisting moment and the rotation angle. The average maximum energy stored by the calf-shell across all PD-AFOs was 0.013 ± 0.005 J/kg. According to this study, 3D-printed custom PD-AFOs made with fiberglass-reinforced polyamide can store some elastic energy, which is released to the ankle during push-off. Further studies should be conducted to assess the effect of this energy return mechanism in improving the gait of individuals with deficits of the ankle plantarflexor muscles. Full article

This study investigates ferroptosis in the context of peripheral artery disease (PAD), a vascular disease characterized by atherosclerosis of the lower extremities. Muscle atrophy and increased oxidative stress are hallmarks of PAD and correlate with worse clinical outcomes. Given ferroptosis’ association with oxidative stress, we explored its role in PAD myopathy by examining gene and protein markers related to metabolic pathways implicated in ferroptosis using both human PAD patients and cultured myotubes. Intermittent claudication (IC) PAD patients, critical limb ischemia (CLI) PAD patients, and non-PAD controls were recruited for this study. Calf muscle biopsies were analyzed for gene expression using qPCR, and protein levels were determined by Western blotting. Cultured myotubes treated with the ferroptosis inducer erastin provided an in vitro comparison. Results demonstrated upregulation of ferroptosis markers such as lipid peroxidation and PTGS2 gene expression in the muscle of CLI PAD patients compared to controls. Increased expression of ferroptosis-related genes HMOX1, ACSL4, ELAVL1, and Beclin-1 was also observed. Protein analysis showed trends consistent with gene expression in some ferroptosis markers. The increase in ferroptosis markers in CLI PAD patients, particularly in iron metabolism and autophagy pathways, suggests ferroptosis contributes to PAD myopathy. Full article