Impact of body composition on clinical outcomes in patients with active radiographic axial spondyloarthritis under biological therapy.

OBJECTIVE: To assess the association of body composition, evaluated by bioimpedance analysis (BIA), with disease activity, physical function, and mobility in patients with axSpA undergoing bDMARD treatment for one year. METHODS: Patients with AS (radiographic axSpA) were enrolled in an extension of the German Spondyloarthritis Inception Cohort (GESPIC). Patients were required to be candidates for bDMARD therapy at baseline presenting high disease activity despite previous treatment with nonsteroidal anti-inflammatory drugs. Outcomes (disease activity, function, and mobility) and body composition parameters were assessed at baseline and every 6 months thereafter. Body composition was assessed by BIA. The association between body composition parameters and outcomes over 1 year was analyzed using longitudinal generalized estimating equations. RESULTS: Seventy-four patients with radiographic axSpA were included in current analysis with a mean age of 36.5 years, disease duration of 6.2 years and ASDAS-CRP score of 3.4 at baseline. Fat mass value and fat mass index were positively associated with disease activity (ASDAS: ß = 0.01, 95% CI [-0.01, 0.03] and ß = 0.04, 95% CI [-0.01, 0.08], respectively) and functional disability (BASFI). Visceral adipose tissue (VAT) was associated with reduced spine mobility (BASMI: ß = 0.20, 95% CI [0.07, 0.33]). Additionally, increase in VAT and fat mass parameters was linked to worse disease activity and functional disability in women, while they were strongly associated with reduced spinal mobility in men. CONCLUSIONS: Higher levels of body fat and VAT were positively associated with increased disease activity, functional disability, and reduced spinal mobility in patients with radiographic axSpA treated with bDMARDs.

Longitudinal trends of body composition in Anorexia Nervosa: Cardiac functioning impacts the restoration of fat-free mass at three-months follow-up.

BACKGROUND AND AIMS: Predictors of outcomes are needed in order to improve the clinical management of patients with Anorexia Nervosa (AN). The present study evaluated whether cardiac dysfunction might be associated with different longitudinal outcomes of AN. METHODS AND RESULTS: A sample of 35 patients with AN (11 restricting, 24 binge-purging- age range 16-28 years old) and 42 healthy controls (18-29 years old) were evaluated in terms of psychometric variables, Body Mass Index (BMI), body composition (by bioimpedance analysis, namely: Fat-Free Mass - FFM, Fat Mass - FM, Body Cell Mass - BCM, Phase Angle - PhA) and cardiac functioning (left ventricular ejection fraction - LVEF; global longitudinal strain - LVGLS). FM was significantly and negatively associated with eating psychopathology (weight and shape concerns, b -0.523, p 0.029; and shape concerns b -0.578, p0.015), while cardiac dysfunction (LVGLS > -18%) was positively associated with dietary restraints (b 1.253, p 0.043). LVEF, in turn, was positively associated with BCM (b 0.721, p 0.008) and FFM (b 0.779, p 0.039). Cardiac dysfunction negatively impacted the effect of nutritional rehabilitation, as those patients reporting reduced LVGLS showed lower FFM (b -4.410, p 0.011), FM (b -1.495, p 0.003) and BCM (b -2.205, p 0.015) at follow-up after three months. CONCLUSION: These preliminary results showed that cardiac functioning might represent an early predictor of cachexia and chronicity, while body composition seems to be a more accurate measure for evaluating the recovery process of patients with AN.

Association between the Thickness or Area of the Temporal Muscle and Skeletal Muscle Mass in Bioimpedance Analysis.

INTRODUCTION: Sarcopenia associated with stroke can significantly impact patient prognosis; however, the current standard diagnostic methods for sarcopenia are rarely used in stroke patients. Therefore, the aim of the current study was to investigate whether the temporal muscle thickness (TMT) or area (TMA) could serve as a surrogate marker for measuring skeletal muscle mass. METHODS: This retrospective chart review study was conducted on 244 participants from March 2018 to February 2020. The TMT and TMA were measured at the supraorbital roof level using brain CT or T1-weighted MR imaging obtained from participants. The skeletal muscle mass and skeletal muscle index (SMI) and whole-body phase angle (WBPA) at 50 kHz were collected. Pearson correlation analysis was used to assess the relationship between the TMT or TMA and the results of the bioimpedance analysis. RESULTS: The mean TMT showed significant positive correlations with skeletal muscle mass (male, r = 0.520; female, r = 0.706), SMI (male, r = 0.426; female, r = 0.582), and WBPA (male, r = 0.295; female, r = 0.232). The mean TMA showed significant positive correlations with skeletal muscle mass (male, r = 0.490; female, r = 0.657), SMI (male, r = 0.289; female, r = 0.473), and WBPA (male, r = 0.232; female, r = 0.243). CONCLUSION: We observed moderate to strong positive correlations between body composition analysis measured by BIA and TMT or TMA, suggesting that TMT or TMA could serve as a reliable surrogate marker for identifying low skeletal muscle mass in cerebrovascular disease.

Quantitative analysis of the effect of docetaxel-induced edema on quality of life in patients with breast cancer and related factors: a prospective cohort study.

BACKGROUND: Systemic edema is an adverse effect of docetaxel chemotherapy and causes distress to patients, including those receiving this agent for breast cancer. However, its characteristics and factors related to its effect on quality of life (QoL) have not been adequately investigated. In this study, we assessed systemic edema quantitatively, explored related factors, and evaluated QoL in patients receiving docetaxel for breast cancer. METHODS: The study had a prospective cohort design and included 37 patients with no known history of swelling who were treated with docetaxel between September 2019 and April 2022. Patients were examined at the start, middle, and end of their course of treatment and 1 and 2 months later. Body water content, body mass, fat mass, and muscle mass were quantified using bioelectrical impedance analysis. Systemic edema was evaluated with reference to the Common Terminology Criteria for Adverse Events. The timing of development of systemic edema at any anatomical site that was grade 2 or worse was recorded. QoL was assessed using the Quality of Life-Anti Cancer Drug scale. Nutrition was evaluated using the Brief-type self-administered diet history questionnaire. Multivariable logistic regression analysis was performed to identify related factors. QoL was also compared between patients with edema and those without edema. RESULTS: Systemic edema developed in 67% of the study participants and was most prevalent at the end of treatment. Body fat mass (adjusted odds ratio [aOR] 0.802, 95% confidence interval [CI] 0.651-0.988, p = 0.038), disease stage (aOR 3.279, 95% CI 0.493-21.793, p = 0.219), and history of alcohol consumption (aOR 0.141, 95% CI 0.013-1.521, p = 0.106) were identified as risk factors for docetaxel-induced edema. Participants who developed systemic edema experienced more physical, vital, and emotional distress 1 month after treatment than those who did not. There was no association between systemic edema and nutrition. CONCLUSIONS: Systemic edema may develop after treatment with docetaxel and increase distress in patients with a high body fat mass. Patients at risk of systemic edema should be informed in advance about the potential frequency, location, and timing of its onset and encouraged to self-manage this condition.

Comparing body composition measures in children with end stage liver disease using noninvasive bioimpedance analysis.

BACKGROUND: Chronic liver disease (CLD) in children, often leads to cirrhosis and end-stage liver disease (ESLD). CLD poses significant challenges in management and prognosis. Assessing body composition, including sarcopenia, is increasingly recognized as important in understanding outcomes in this population. METHODS: We conducted a prospective observational study, involving children aged 2 to 18 years with ESLD awaiting liver transplantation. Socio-demographic, clinical, and laboratory data were collected, and body composition was assessed using Bioelectrical Impedance Analysis (BIA). Sarcopenia was defined using age-specific cut-off points for appendicular skeletal muscle mass (aSMM) and fat-free mass (FFM). RESULTS: The study included 57 children (42.1% girls, 57.9% boys; median age: 10.9 years) with liver cirrhosis. Of them 11 (19.3%) died during the study. The mean duration of living with end-stage liver disease prior to participation was 5.43 years [IQR: 3.32, 8.39]. The most common etiology was biliary atresia (24.6%), followed by cryptogenic (22.8%). Deceased children exhibited significantly higher sarcopenia prevalence, lower basal metabolic rate and growth scores compared to survivors (P < 0.05), (771.0 vs. 934.0, P = 0.166) (65.0 vs. 80.5, P = 0.005). Total body and limb-specified lean mass were lower in deceased children, although not statistically significant. Similarly, total mineral (90% normal) and bone mineral content were lower in deceased children, with a significant difference observed only in water-to-FFM percentage (72.5 vs. 73.1, P = 0.009). CONCLUSION: This study highlights the high prevalence of sarcopenia among children with ESLD and its association with adverse outcomes, including mortality. Bioimpedance analysis emerges as a promising, non-invasive method for assessing body composition in pediatric ESLD, warranting further investigation and integration into clinical practice.

The value of bioimpedance analysis in the assessment of hydration and nutritional status in children on chronic peritoneal dialysis.

Bioimpedance analysis (BIA)-body composition monitoring (BCM) has been used to evaluate the hydration and nutritional status of adults and children on dialysis. However, its clinical application still has challenges, so further exploration is valuable. We used BIA-BCM to evaluate the hydration and nutritional status of children undergoing chronic peritoneal dialysis from 1 July 2021 to 31 December 2022 in the Children's Hospital of Fudan University to explore the clinical value of this method. A total of 84 children on chronic peritoneal dialysis (PD) were included. In the PD group, 16 (19.05%) and 31 (36.90%) had mild and severe overhydration (OH), respectively; 41.27% (26/63) had a low lean tissue index (LTI). In the PD group, patients with relative OH (Re-OH) > 5.6% had significantly higher systolic blood pressure (SBP) and SBP z score (SBPz). Patients with LTI > 12% had significantly higher body mass index (BMI) and BMI z score (BMIz). Canonical correlation analysis indicated a linear relationship (ρ = 0.708) between BIA-BCM hydration and the clinical hydration indicator and a linear relationship (ρ = 0.995) between the BIA-BCM nutritional indicator and the clinical nutritional indicator. A total of 56% of children on chronic peritoneal dialysis had OH, and 41% had a low LTI. In PD patients, SBP and SBPz were correlated with BIA-BCM Re-OH, and BMI and BMIz were correlated with BIA-BCM LTI. BIA-BCM indicators have good clinical value in evaluating hydration and nutrition.

Assessment of changes in blood volume during lower body negative pressure-induced hypovolemia using bioelectrical impedance analysis.

BACKGROUND: Lower body negative Pressure (LBNP)-induced hypovolemia is simulating acute hemorrhage by sequestrating blood into lower extremities. Bioelectrical Impedance Analysis (BIA) is based on the electrical properties of biological tissues, as electrical current flows along highly conductive body tissues (such as blood). Changes in blood volume will lead to changes in bioimpedance. This study aims to study changes in upper (UL) and lower (LL) extremities bioimpedance during LBNP-induced hypovolemia. METHODS: This was a prospective observational study of healthy volunteers who underwent gradual LBNP protocol which consisted of 3-minute intervals: at baseline, -15, -30, -45, -60 mmHg, then recovery phases at -30 mmHg and baseline. The UL&LL extremities bioimpedance were measured and recorded at each phase of LBNP and the percentage changes of bioimpedance from baseline were calculated and compared using student's t-test. A P-value of < 0.05 was considered significant. Correlation between relative changes in UL&LL bioimpedance and estimated blood loss (EBL) from LBNP was calculated using Pearson correlation. RESULTS: 26 healthy volunteers were enrolled. As LBNP-induced hypovolemia progressed, there were a significant increase in UL bioimpedance and a significant decrease in LL bioimpedance. During recovery phases (where blood was shifted from the legs to the body), there were a significant increase in LL bioimpedance and a reduction in UL bioimpedance. There were significant correlations between estimated blood loss from LBNP model with UL (R = 0.97) and LL bioimpedance (R = - 0.97). CONCLUSION: During LBNP-induced hypovolemia, there were reciprocal changes in UL&LL bioimpedance. These changes reflected hemodynamic compensatory mechanisms to hypovolemia.

Relationship between the phase angle from bioelectrical impedance analysis and daily physical activity in patients with rheumatoid arthritis.

OBJECTIVES: This study aimed to examine the relationship between daily physical activity and the phase angle (PhA) obtained by bioelectrical impedance analysis in rheumatoid arthritis (RA) patients. METHODS: Data from a prospective cohort study of RA patients who were surveyed every year were analysed. The PhA was assessed by the bioelectrical impedance analysis method, and physical activity was assessed as the amount of time of exercise in metabolic equivalents (METs) per day using a triaxial accelerometer for 7 consecutive days. The association between physical activity and the PhA was evaluated using the isotemporal substitution model in multiple regression analysis. RESULTS: Seventy-six RA patients were included in the analysis (81% female and age 66.2 ± 13.1 years). On cross-sectional analysis, the isotemporal substitution model in multiple regression analysis showed that the PhA was 0.05 points higher every 10 minutes when activities with intensity of 1 ≤ METs < 2 were replaced by activities with intensity of ≥3 METs (P = .01). Over 1 year, the rate of change in the PhA was 0.69% higher every 10 minutes when activities with intensity of 1 ≤ METs < 2 were replaced by activities with intensity of ≥3 METs (P = .037). CONCLUSION: The PhA in RA patients may be related to physical activity level.

[Metabolic features of the inflammatory syndrome of chronic pelvic pain (category IIIA of chronic non-bacterial prostatitis) in young men, depending on the somatotype].

PURPOSE: dentification of bioimpedance and clinical features in young men with chronic pelvic pain inflammatory syndrome (CP/CPPS NIH IIIa) depending on the somatotype. METHOD: s. 150 men of the first period of adulthood from 22 to 35 years old with CP/CPPS NIH IIIa were examined from 2018 to 2022 years. The average age was 31 [28; 34] year. Somatotypes were computed according to Carter and Heath. Body composition was assessed anthropometry and bioimpedance analysis. RESULTS: Ectomorphs had the least clinical, laboratory and instrumental manifestations of CP/CPPS NIH IIIa, the levels of total and free testosterone were the highest. The active cell mass predominated in the component composition of the body. Manifestations in mesomorphs had a moderate degree of severity. Endomorphs had the most severe manifestations of CP/CPPS NIH IIIa, the largest amount of fat mass was noted in the body composition than in men of other somatotypes, the hormonal status was characterized by the lowest levels of free and total testosterone, and the highest level of estradiol. DISCUSSION: Based on the literature data and our own results, it can be assumed that the identified changes in the body component composition and hormonal status of men contribute to the maintenance of chronic inflammation in the prostate, organ ischemia, impaired intracranial metabolism, recurrent course of CP/CPPS NIH IIIa, which significantly reduces the patients quality of life and increases the risk of prostate inflammation with age. CONCLUSION: Determining the somatotype and conducting a component analysis of body composition allows patients to be divided into groups according to the severity of manifestations of CP/CPPS NIH IIIa. The revealed patterns allow us to classify male endomorphs into the group with the most severe manifestations of CP/CPPS NIH IIIa.

[Bioimpedance analysis of body composition and rest energy expenditure in highly trained cross-country skiers].

The body composition monitoring using bioimpedance analysis (BIA) is important in assessing the functional state of athletes in sports. Based on changes of body composition, it is possible to optimize the actual dietary intake, as well as successfully organize the training process. The purpose of this research was to conduct a comparative assessment of BIA parameters and rest energy expenditure (REE) in highly trained cross-country skiers and young non-athletes. Material and methods. The members of the national cross-country skiing team from the Komi Republic and Russian Federation (n=30; age - 22.3±2.7 years) were examined. Practically healthy medical students served as a control group for the present study (n=40; age - 20.2±2.4 years). The participants successively passed the following study steps: assessment of the body composition by BIA (ACCUNIQ BC380), REE determination by indirect non-fasting calorimetry and calculation technique. Results. The parameters of total body water, fat-free mass, lean tissue and body cell mass were higher in contrast to the fat mass percentage in the athletes (р<0.001). The calculated REE was lower than measured REE among all the participants. At the same time, the REE calculated by the Ketch-McArdle formula significantly differed between the groups, while no differences were found between the REE calculated by the Harris-Benedict prediction equation. The measured REE were significantly higher by 16% (p<0.001) i n athletes compared to those in the control group. Conclusion. The body composition of athletes was distinguished by a significantly higher amounts of total body water, fat-free mass, skeletal muscle, active cell mass, and lower percentage of fat mass compared to healthy untrained individuals. The results obtained among athletes coincided with the idea that the magnitude of REE is determined by the mass of metabolically active tissues and to a lesser extent depends on the fat mass. BIA results can be used to monitor athletes' body composition during the training process.

Longitudinal associations of bioelectrical phase angle and fatigue in breast cancer patients.

Cancer-related fatigue is commonly treated in an undifferentiated manner, because its pathophysiology is still not well understood. Therefore, we investigated if bioelectrical phase angle (PhA), a non-invasive marker of cell integrity, could help to single out specific fatigue subtypes. In a randomized controlled strength training intervention trial, PhA was measured by bioelectrical impedance analysis in 158 breast cancer patients. Fatigue was assessed with the multidimensional 20-item Fatigue Assessment Questionnaire. Multiple regression analyses considering changes in PhA and fatigue from baseline to post-intervention and ANCOVA models investigating the strength training effect on PhA were conducted. Further, explorative mediation and moderation analyses were performed. Decrease (=worsening) in PhA was significantly associated with increase in physical (P = .010) and emotional (P = .019) fatigue. These associations were markedly stronger in patients with normal BMI (interaction P = .059 and .097) and with low pre-diagnosis exercise level (interaction P = .058 and .19). Among patients with normal BMI strength training was associated with an increase in PhA (ANCOVA P = .059), but not among overweight/obese patients (interaction P = .035). Chemotherapy was a major determinant for low PhA, but PhA did not mediate the effect of chemotherapy on fatigue. In conclusion, PhA has a significant inverse association with physical and emotional fatigue. This association is moderated by BMI and previous exercise. Significant relationships of PhA were also observed with chemotherapy and strength training. Thus, PhA might be a marker that could help in the classification of subtypes of fatigue with different pathophysiology, which may require specifically tailored treatment. Further research on this is warranted.

Chronic kidney disease-related sarcopenia as a prognostic indicator in elderly haemodialysis patients.

BACKGROUND: The mortality of dialysis patients greatly exceeds that of the general population and identifying predictive factors for mortality may provide opportunities for earlier intervention. This study assessed the influence of sarcopenia on mortality in patients on haemodialysis. METHODS: This prospective, observational study enrolled 77 haemodialysis patients aged 60 years and over, of whom 33 (43%) were female, from two community dialysis centres. Baseline demographic and laboratory data were collected, and sarcopenia was diagnosed using grip strength, muscle mass by bioimpedance analysis (BIA) and muscle function by timed up-and-go according to European Working Group on Sarcopenia in Older People criteria. Nutritional status was assessed using a subjective nutritional assessment score, comprising functional changes in weight, appetite, gastrointestinal symptoms and energy.. A comorbidity score (maximum 7 points) was derived from the presence or absence of hypertension, ischaemic heart disease, vascular disease (cerebrovascular disease, peripheral vascular disease, and abdominal aortic aneurysm), diabetes mellitus, respiratory disease, a history of malignancy and psychiatric disease. Outcomes over six years were linked to the Australian and New Zealand Dialysis and Transplant Registry. RESULTS: The median participant age was 71 years (range 60-87). Probable and confirmed sarcopenia was present in 55.9% and severe sarcopenia with reduced functional testing in 11.7%. Over 6 years, overall mortality was 50 of the 77 patients (65%), principally from cardiovascular events, dialysis withdrawal and infection. There were no significant survival differences between patients with no, probable, confirmed, or severe sarcopenia, or between tertiles of the nutritional assessment score. After adjustment for age, dialysis vintage, mean arterial pressure (MAP) and the total comorbidity score, no sarcopenia category predicted mortality. However, the total comorbidity score [Hazard Ratio (HR) 1.27, Confidence Intervals (CI) 1.02, 1.58, p = 0.03] and MAP (HR 0.96, CI 0.94, 0.99, P = < 0.01) predicted mortality. CONCLUSION: Sarcopenia is highly prevalent in elderly haemodialysis patients but is not an independent predictor of mortality. Haemodialysis patients have multiple competing risks for mortality which, in this study, was predicted by a lower MAP and a higher total comorbidity score. TRIAL REGISTRATION: Recruitment commenced December 2011. The study was registered 10.01.2012 with the Australian New Zealand Clinical Trials Registry (ACTRN12612000048886).

Perioperative trends in neck and leg fluid volume in surgical patients: a prospective observational proof-of-concept study.

PURPOSE: The severity of obstructive sleep apnea (OSA) may increase postoperatively. The changes in segmental fluid volume, especially neck fluid volume, may be related to increasing airway collapsibility and thus worsening of OSA in the postoperative period. Our objective was to evaluate the feasibility of performing bioelectrical impedance analysis (BIA) and to describe the trend and predictors of changes in segmental fluid volumes in patients receiving general anesthesia for noncardiac surgery. METHODS: We conducted a prospective observational proof-of-concept cohort study of adult patients undergoing elective inpatient noncardiac surgery. Patients underwent a portable sleep study before surgery, and segmental fluid volumes (neck fluid volume [NFV], NFV phase angle, and leg fluid volume [LFV]) were measured using BIA at set time points: preoperative period (preop), in the postanesthesia care unit (PACU), the night following surgery at 10 pm (N 0), and the following day at 10 am (POD 1). Linear regression models were constructed to evaluate for significant predictors of overall segmental fluid changes. The variables included in the models were sex, preoperative apnea-hypopnea index (AHI), fluid balance, body mass index (BMI), cumulative opioids, and the timepoint of measurement. RESULTS: Thirty-five adult patients (20/35 females, 57%) were included. For the feasibility outcome, measure of recruitment was 50/66 (76%) and two measures of protocol adherence were fluid measurements (34/39, 87%) and preoperative sleep study (35/39, 90%). There was a significant increase in NFV from preop to N 0 and in LFV from preop to PACU. Neck fluid volume also increased from PACU to N 0 and PACU to POD 1, while LFV decreased during the same intervals. The overall changes in NFV were associated with the preop AHI, BMI, and opioids after adjusting for body position and pneumoperitoneum. CONCLUSIONS: This proof-of-concept study showed the feasibility and variability of segmental fluid volumes in the perioperative period using BIA. We found an increase in NFV and LFV in the immediate postoperative period in both males and females, followed by the continued rise in NFV and a simultaneous decrease in LFV, which suggest the occurrence of rostral fluid shift. Preoperative AHI, BMI, and opioids predicted the NFV changes. STUDY REGISTRATION: ClinicalTrials.gov; NCT02666781, registered 25 January 2016; NCT03850041, registered 20 February 2019.

RéSUMé: OBJECTIF: La gravité de l'apnée obstructive du sommeil (AOS) peut augmenter en période postopératoire. Les changements dans le volume segmentaire de fluides, en particulier le volume liquidien du cou, peuvent être liés à l'augmentation de la collapsibilité des voies aériennes et donc à l'aggravation d'une AOS en période postopératoire. Notre objectif était d'évaluer la faisabilité de réaliser une analyse d'impédance bioélectrique (AIB) et de décrire la tendance et les prédicteurs des changements dans les volumes de fluides segmentaires chez des patients recevant une anesthésie générale pour une chirurgie non cardiaque. MéTHODE: Nous avons réalisé une étude de cohorte observationnelle prospective de démonstration de faisabilité chez des patients adultes bénéficiant d'une chirurgie non cardiaque non urgente en milieu hospitalier. Les patients ont subi une étude du sommeil grâce à un appareil portable avant la chirurgie, et les volumes de fluides segmentaires (volume de fluides du cou, angle de phase VLC et volume de fluides des jambes) ont été mesurés à l'aide d'une AIB à des moments définis : période préopératoire (préop), en salle de réveil, la nuit suivant la chirurgie à 22 h (N 0) et le lendemain à 10 h (JPO 1). Des modèles de régression linéaire ont été construits pour évaluer les prédicteurs significatifs de changements globaux des fluides segmentaires. Les variables incluses dans les modèles étaient le sexe, l'indice d'apnée-hypopnée préopératoire (IAH), l'équilibre hydrique, l'indice de masse corporelle (IMC), les opioïdes cumulés et le point de mesure temporel. RéSULTATS: Trente-cinq patients adultes (20/35 femmes, 57 %) ont été inclus. En ce qui concerne le critère de faisabilité, la mesure du recrutement était de 50/66 (76 %) et deux mesures de l'observance du protocole étaient les mesures liquidiennes (34/39, 87 %) et une étude préopératoire du sommeil (35/39, 90 %). Il y a eu une augmentation significative du volume de fluides du cou entre la période préopératoire et N 0 et du volume de fluides des jambes de la période préopératoire à la salle de réveil. Le volume de fluides du cou a également augmenté de la salle de réveil à N 0 et de la salle de réveil au JPO 1, tandis que le volume de fluides des jambes a diminué au cours des mêmes intervalles. Les changements globaux de volume de fluides du cou ont été associés à l'IAH préopératoire, à l'IMC et aux opioïdes après ajustement pour tenir compte de la position du corps et du pneumopéritoine. CONCLUSION: Cette étude de preuve de concept a démontré la faisabilité de l'évaluation et la variabilité des volumes de fluide segmentaire dans la période périopératoire en utilisant l'IAB. Nous avons constaté une augmentation du volume liquidien du cou et des jambes en période postopératoire immédiate chez les hommes et les femmes, suivie d'une augmentation continue du volume liquidien du cou et d'une diminution simultanée du volume liquidien des jambes, ce qui laisserait penser à la survenue d'un déplacement du liquide rostral. L'indice d'apnée-hypopnée préopératoire, l'IMC et les opioïdes étaient des prédicteurs de changements du volume liquidien du cou. ENREGISTREMENT DE L'éTUDE: ClinicalTrials.gov; NCT02666781, enregistré le 25 janvier 2016; NCT03850041, enregistré le 20 février 2019.

Comparisons of Two Bioelectrical Impedance Devices and Manual versus Sensor-Based Short Physical Performance Batteries for Assessment of Muscle Mass and Physical Performance.

The assessment of muscle mass and physical performance is essential for the diagnosis of sarcopenia. This study examined the validity of bioimpedance analysis (BIA) and a sensor-based short physical performance battery (SPPB) device for analyzing appendicular skeletal muscle mass (ASM) and physical performance. Forty-one older adults were measured for ASM and physical performance with two BIA devices (InBody770 vs. T-SCAN PLUS III) and two SPPB devices (manual mSPPB vs. sensor-based sSPPB). Validity statistics included the intraclass correlation coefficient (ICC) and Bland-Altman plots to examine the agreement of data from the BIA (InBody770 vs. T-SCAN PLUS III) and the SPPBs (mSPPB vs. sSPPB). There was a significant ICC for skeletal muscle mass between the T-SCAN PLUS III and InBody770 devices (ICC = 0.8822; p < 0.0001). The mSPPB and sSPPB values showed agreement across all components: 0.8654 for the total scores, 0.8879 for the walking speed, 0.8889 for the chair stand, and 0.6863 for the standing balance. No systemic bias was observed between the two methods for the BIA and SPPB devices. Measurements using the T-SCAN PLUS III and sSPPB seem to be highly correlated with the InBody770 and mSPPB devices in older adults and may be valid for assessing muscle mass and physical performance.

[Risk factors for low functional activity in people 80 years and older.]

The global aging of the population continues in the world, therefore, the extension of functional and cognitive independence in the elderly, senile and centenarians is a priority goal of the healthcare systems of all states. The aim of the study was to identify risk factors for low functional activity in senile people. The study included 122 people aged 80 years and older (mean age 84,74±2,98 years). Complaints were collected from all participants; history; anthropometric indicators, handgrip strength, functional activity using the SPPB battery of tests, body composition were determined. It was found that men aged 80 years and older showed better functional performance than women. Gender, age, and the number of drugs taken were significant predictors of functional activity. Patients at the age of 80 years and older with normal functional activity had better anthropometric parameters, body composition, and hand grip strength. Depression and osteoarthritis were more common in older people with low functional activity.

The bioimpedance phase angle may be associated with frailty in rheumatoid arthritis patients: Results from a prospective, cohort study.

OBJECTIVES: This study investigated whether the phase angle (PhA) on bioelectrical impedance analysis is related to frailty in rheumatoid arthritis (RA) patients. METHODS: Data from a prospective cohort study of RA patients were analysed. The PhA was assessed by the bioelectrical impedance analysis method, and frailty was assessed by the Kihon Check List (KCL) annually. The cut-off value of the PhA for frailty was calculated by receiver-operating characteristic analysis. The relationships between the PhA and frailty were evaluated by logistic regression analysis. The relationships between the change in PhA and frailty status and the KCL score were evaluated by analysis of covariance and multiple regression analysis. RESULTS: A total of 170 patients (81.2% female, 66.2 ± 13.1 years) were included in the analysis. A PhA of less than the cut-off for frailty was significantly associated with frailty (odds ratio: 4.75, 95% confidence interval: 1.86, 12.17). The change in the PhA was significantly associated with the change in the KCL score (ß = -0.15). In robust patients, there was a significant difference in the rate of change of the PhA between the group that became pre-frail in the next year and the group that remained robust. CONCLUSIONS: The PhA may be associated with frailty in RA patients.

The Role of Pre- and Post-Transplant Hydration Status in Kidney Graft Recovery and One-Year Function.

Background and Objectives: Early improvements to graft function are crucial for good outcomes in kidney transplantation (kTx). Various factors can influence early graft function. This study aimed to evaluate the pre- and post-transplant hydration statuses of kTx recipients using bioimpedance analysis (BIA) and lung ultrasonography (LUS) and to investigate the hydration status' relationship with the function of the transplanted kidney during the first year after transplantation. Materials and Methods: This observational prospective cohort study included deceased kidney recipients transplanted in the Hospital of the Lithuanian University of Health Sciences between September 2016 and January 2023. BIA and LUS were performed before transplantation, on days 3 and 7, and at discharge. Data on recipient and donor clinical characteristics were collected. Graft function was evaluated according to the serum creatinine reduction ratio and the need for dialysis. Hydration status was evaluated by calculating B-lines (BL) on LUS and the ratio of extracellular/total body water on BIA. Results: Ninety-eight kTx recipients were included in the study. Patients with immediate graft function (IGF) were compared to those with slow or delayed graft function (SGF + DGF). Recipients in the SGF + DGF group had a higher sum of BL on LUS before transplantation. After transplantation in early postoperative follow-up, both groups showed hyperhydration as determined by BIA and LUS. After one year, recipients with no BL before transplantation had better graft function than those with BL. Logistic regression analysis showed that having more than one BL in LUS was associated with a 2.5 times higher risk of SGF or DGF after transplantation. Conclusions: This study found that lung congestion detected by LUS before kTx was associated with slower graft recovery and worse kidney function after 1 year. Meanwhile, the hyperhydration status detected by BIA analysis did not correlate with the function of the transplanted kidney.

[The effect of overweight on the dental status and biochemical parameters of the oral fluid]. / Vliyanie izbytochnoi massy tela na stomatologicheskii status i biokhimicheskie parametry rotovoi zhidkosti.

OBJECTIVE: To increase the effectiveness of the diagnosis and treatment of dental diseases, based on the study of anthropometric and bioimpedance analysis data in adolescents and adult patients to identify the effect of overweight on dental status. MATERIAL AND METHODS: The study involved 60 adolescents aged 15-18 years, 28 of whom were overweight, and 32 with normal body weight. All 52 adult patients aged 30-50 years who participated in the study were overweight (body mass index >25 kg/m2) and had chronic generalized periodontitis. In all patients dental status was assessed by DMF and PMA index, Silness-Loe and Stallard hygienic indices, Muleman bleeding index, Green-Vermillion tartar index. Biochemical parameters of the oral fluid were also evaluated: malondialdehyde, elastase, urease, catalase and lysozyme activity. The adolescents underwent an anthropometric study with the determination of body mass index. Adult patients underwent bioimpedance analysis of body composition to determine the main indicators of fat metabolism in the body: body mass index, fat mass (kg), the proportion of adipose tissue (%) and the mass of extracellular fluid (kg). RESULTS: The study showed that overweight in patients of different ages worsens their dental status and biochemical parameters of oral fluid. CONCLUSION: The inclusion of an anthropometric study with the determination of body mass index and bioimpedance analysis of body composition in the examination of dental patients will allow the development of individual programs for the prevention of dental diseases, implementing a personalized approach to the provision of medical and preventive care.

Impact of a ketogenic diet intervention during radiotherapy on body composition: V. Final results of the KETOCOMP study for head and neck cancer patients.

PURPOSE: Patients with head and neck cancer (HNC) are at risk of malnutrition, especially during radiochemotherapy. We aimed to study the impact of a ketogenic diet (KD) versus an unspecified standard diet (SD) on body composition and survival in HNC patients undergoing radio(chemo)therapy. METHODS: As part of a controlled clinical trial, non-metastasized HNC patients were enrolled into either a KD (N = 11) or an SD (N = 21) group between May 2015 and May 2021. Body composition was measured weekly by bioimpedance analysis and analyzed using linear mixed effects models. Overall and progression-free survival was assessed during regular follow-up. RESULTS: A total of 7 KD and 21 SD patients completed the study and were eligible for comparative analysis. Chemotherapy was significantly associated with declines in all body composition parameters, while the KD had opposing, yet nonsignificant effects. In patients receiving chemotherapy, average weekly reductions of body mass (BM) and skeletal muscle mass (SMM) were 0.9 kg and 0.31 kg in the KD group versus 1.2 kg and 0.57 kg in the SD group, respectively. Patients in the KD group receiving no chemotherapy achieved an average increase of 0.04 kg BM and 0.12 kg SMM per week. After a median follow-up of 42 months (range 6.7-78 months) there were no significant differences in progression-free or overall survival between the groups. CONCLUSION: The KD may partially counteract the detrimental effects of radiochemotherapy on body composition in HNC patients. This should encourage further research into KDs in frail cancer patient populations and motivate their implementation as complementary therapy for selected patients.

Sarcopenia in idiopathic pulmonary fibrosis: a prospective study exploring prevalence, associated factors and diagnostic approach.

BACKGROUND: Sarcopenia gained importance in the evaluation of patients with chronic respiratory diseases, including idiopathic pulmonary fibrosis (IPF), since it may impact negatively on clinical outcomes. AIM: Aim of this study is to evaluate the prevalence and factors associated with sarcopenia, defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) 2019 definition, and to evaluate the prevalence of the single criteria that define the EWGSOP2 definition (muscle strength, muscle quantity and physical performance), in a cohort of consecutive patients with IPF prospectively followed up in 9 hospitals in Northern Italy between December 2018 and May 2021. METHODS: Enrolled patients underwent an extensive pulmonary and nutritional assessment, including bioelectrical impedance analysis, dynamometry and 4-m gait speed test, both at IPF diagnosis and at 6-month follow-up. RESULTS: Out of the 83 patients (81% males, mean age 72.5 years) with IPF at disease diagnosis enrolled in the study, 19 (22.9%) showed sarcopenia, including 2 (2.4%) with severe sarcopenia, 5 (6.0%) with confirmed sarcopenia and 12 (14.5%) with probable sarcopenia. Sarcopenia was associated with a significantly higher severity of the disease and sedentary lifestyle, while no differences were observed in regards to body mass index, history of weight loss and comorbidities between patients with and without sarcopenia. Out of the 64 patients without sarcopenia at baseline, 16 cases showed alteration of muscle quantity and/or physical performance. In the 51 patients with complete data at 6-month follow-up, there were no cases of severe sarcopenia, 1 case (2.0%) showed confirmed sarcopenia, while the prevalence of probable sarcopenia was 19.6% (10 cases). No differences in regards to antifibrotic treatment received and onset of gastrointestinal side effects were observed between patients with and without sarcopenia at follow-up. CONCLUSIONS: The prevalence of sarcopenia in patients with IPF both at diagnosis and at 6-month follow-up was low but not negligible and was associated with higher severity of the disease and sedentary lifestyle. In IPF patients, a comprehensive diagnostic work-up including all the criteria defining the EWGSOP2 definition might be more useful than a series testing for prompt recognition of nutritional and physical performance abnormalities.