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Montalvão-Sousa TM, Ferreira PDA, Colombelli NL, de Carvalho KMB, Blazevich AJ, Lima RM. Sarcopenic obesity defined by the ESPEN and EASO consensus statement in older women: Risk of falls and bone mineral density implications. Arch Gerontol Geriatr 2024; 124:105444. [PMID: 38643667 DOI: 10.1016/j.archger.2024.105444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To apply the ESPEN-EASO diagnostic criteria for Sarcopenic Obesity (SO) in older women and to assess its association with the risk of falls, fear of falls (FOF), and bone mineral density (BMD). METHODS After exclusion criteria, 232 women aged ≥60 years (68.2 ± 6.1) were enrolled in the study. Volunteers had handgrip strength (HGS; dynamometer) and body composition assessed by DXA before risk of falls was evaluated using the QuickScreen and FOF evaluated by the Falls Efficiency Scale. SO was defined according to the ESPEN-EASO algorithm, which includes reduced HGS and fat-free mass, and elevated fat mass. RESULTS The prevalence of SO was 6.5 %, which was associated with a higher proportion of fallers in the previous year (X2 6.2, P = 0.04), reduced reaction time (X2 6.2, P = 0.04), reduced sit-to-stand performance (X2 6.2, P = 0.04), and a higher probability of falls [ꭓ2(6) = 17.689, p = 0.004]. FOF was lower in the eutrophic group (ꭓ2(2) = 15,662, p < 0,001) than both the obesity (p = 0.001) and SO (p = 0.05) groups. For total and femoral neck BMD, the eutrophic group presented significantly lower values (1.05 and 0.79 g/cm2) than the obesity group (1.10 and 0.87 g/cm2), but similar to the SO group (1.02 and 0.83 g/cm2). These results remained significant after adjustments for potential confounders. CONCLUSIONS SO specified by the ESPEN-EASO framework was associated with a higher risk of falls but not with increased FOF than obesity alone. The favorable influence of overweight and obesity on BMD seems to be attenuated in individuals with SO. Our findings support the clinical significance of the ESPEN-EASO definition.
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Affiliation(s)
| | | | | | | | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
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Yang J, Yu J, Kim J, Park E. Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex. Nutrients 2024; 16:2136. [PMID: 38999883 PMCID: PMC11242964 DOI: 10.3390/nu16132136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.
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Affiliation(s)
- Jiwon Yang
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jiho Yu
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Euncheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
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Hafızoğlu M, Yıldırım HK, Öztürk Y, Şahiner Z, Karaduman D, Atbaş C, Doğu BB, Halil MG, Cankurtaran M, Balcı C. Assessment of phase angle as a novel indicator for sarcopenic obesity according to the ESPEN/EASO criteria in older adults with diabetes mellitus. Nutrition 2024; 123:112412. [PMID: 38554459 DOI: 10.1016/j.nut.2024.112412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/10/2024] [Accepted: 02/25/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Sarcopenic obesity (SO) is a clinical condition in which sarcopenia and obesity occur together, and is associated with more poor clinical outcomes, increased mortality, and morbidity than sarcopenia. Phase angle (PhA), a parameter derived from bioimpedance analysis (BIA), provides data on cellular health, membrane integrity, and cellular function. This study aimed to evaluate the relationship between SO and PhA among older adults with type 2 diabetes mellitus (DM). METHODS We performed a cross-sectional study in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment, the hand-grip strength test (HGST), the chair stand test (CST) for muscle strength evaluation, the 4-meter walking test, and the timed up-and-go (TUG) test for physical performance assessment. The diagnosis of SO was made according to the ESPEN/EASO criteria. The PhA was determined automatically by the BIA using resistance and reactance at 50 kHz for each participant. RESULTS A total of 322 participants were included in the study. The mean age of the participants was 72.5 ±5.8, and 203 (63%) of them were female; 63 (19.6%) of them were sarcopenic obese. In multivariable logistic regression analyses, a significant relationship was found when the model was adjusted for age, female gender, MNA-sf scores, HbA1c level, and CCI scores (OR: 0.53, 95%CI: 0.29-0.98, P = 0.04). In ROC analyses, for PhA in predicting SO diagnosis, the AUC was 0.586 (95%CI: 0.505-0.678, P = 0.033). At the cut-off score 4.4, sensitivity was 57.1% and specificity was 61.4%; positive predictive value (PPV) was 26.5%; negative predictive value (NPV) was 85.5%. CONCLUSIONS The study identified a significant relationship between SO and PhA among older adults with type 2 DM. However, larger prospective studies are needed to confirm the potential utility of PhA as a biomarker for SO.
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Affiliation(s)
- Merve Hafızoğlu
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Hatice Kübra Yıldırım
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Öztürk
- Division of Geriatrics, Department of Internal Medicine, Eskişehir City Hospital, Eskişehir
| | - Zeynep Şahiner
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Didem Karaduman
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cansu Atbaş
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Balam Doğu
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Gülhan Halil
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cafer Balcı
- Division of Geriatrics, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hu Z, Li C, Zhu S, Ge Y, Gong D. The association between the change in severity score from baseline and the outcomes of critically ill patients was enhanced by integration of bioimpedance analysis parameters. Sci Rep 2024; 14:14681. [PMID: 38918462 PMCID: PMC11199583 DOI: 10.1038/s41598-024-65782-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/24/2024] [Indexed: 06/27/2024] Open
Abstract
The study of the outcomes of critically ill patients has been a hard stuff in the field of intensive care. To explore the relationship between changes of severity scores, bioelectrical impedance analysis (BIA) and outcomes of critically ill patients, we enrolled patients (n = 206) admitted to intensive care unit (ICU) in Jinling Hospital from 2018 to 2021 with records of BIA on the days 1- and 3- ICU. Collected BIA and clinical data including simplified acute physiology score II (SAPS II) and sequential organ failure assessment. According to the baseline and change of severity scores or phase angle (PA) values, the patients were divided into: G-G, baseline good status, 3rd day unchanged; G-B, baseline good status, 3rd day deteriorated; B-G, baseline bad status, 3rd day improved; and B-B, baseline bad status, 3rd day unchanged. According to PA, the mortality of group G-G was 8.6%, and it was greater than 50% in group B-B for severity scores. The new score combining PA and severity scores established. Multivariate logistic regression analysis revealed that PA-SAPS II score was the only independent factor for 90-day mortality (P < 0.05). A linear correlation was found between mortality and PA-SAPS II score (prediction equation: Y ( % ) = 16.97 × X - 9.67 , R2 = 0.96, P < 0.05).
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Affiliation(s)
- Zhen Hu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Chuan Li
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Shuhua Zhu
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Yongchun Ge
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Dehua Gong
- National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China.
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Yoshimura Y, Wakabayashi H, Nagano F, Matsumoto A, Shimazu S, Shiraishi A, Kido Y, Bise T, Kuzuhara A, Hori K, Hamada T, Yoneda K, Maekawa K. Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients. Prog Rehabil Med 2024; 9:20240019. [PMID: 38827580 PMCID: PMC11136866 DOI: 10.2490/prm.20240019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/13/2024] [Indexed: 06/04/2024] Open
Abstract
Objectives Evidence is scarce regarding the association between hyponatremia and functional outcomes among older hospitalized patients. We aimed to evaluate the associations between baseline hyponatremia and improvement in activities of daily living (ADL) and muscle health in hospitalized post-stroke patients. Methods This retrospective cohort study included hospitalized post-stroke patients. Serum sodium concentrations were extracted from medical records based on blood tests performed within 24 h of admission, with hyponatremia defined as a serum sodium concentration below135 mEq/L. Primary outcome was the discharge ADL as assessed by the motor domain of the Functional Independence Measure (FIM-motor) and its corresponding gain during hospitalization. Other outcomes encompassed the discharge scores for skeletal muscle mass (SMI) and handgrip strength (HGS). Multivariate linear regression analyses were used to determine the association between hyponatremia and outcomes of interest, adjusted for potential confounders. Results Data from 955 patients (mean age 73.2 years; 53.6% men) were analyzed. The median baseline blood sodium level was 139 [interquartile range: 137, 141] mEq/L, and 84 patients (8.8%) exhibited hyponatremia. After full adjustment for confounders, baseline hyponatremia was significantly and negatively associated with FIM-motor at discharge (β=-0.036, P=0.033) and its gain during hospital stay (β=-0.051, P=0.033). Baseline hyponatremia exhibited an independent and negative association with discharge HGS (β=-0.031, P=0.027), whereas no significant association was found between baseline hyponatremia and discharge SMI (β=-0.015, P=0.244). Conclusions Baseline hyponatremia demonstrated a correlation with compromised ADL and muscle health in individuals undergoing rehabilitation after stroke.
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Affiliation(s)
- Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical
University Hospital, Tokyo, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Yoshifumi Kido
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Takahiro Bise
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Aomi Kuzuhara
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Kota Hori
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Takenori Hamada
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Kouki Yoneda
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
| | - Kenichiro Maekawa
- Center for Sarcopenia and Malnutrition Research, Kumamoto
Rehabilitation Hospital, Kikuyo, Japan
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Marini E, Sulis S, Vorobel'ová L, Stagi S. Specific bioelectrical vectors pattern in individuals with sarcopenic obesity. Clin Nutr 2024; 43:620-628. [PMID: 38306890 DOI: 10.1016/j.clnu.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sarcopenic obesity is a common condition in the elderly associated with excessive adiposity and low muscle mass and strength. AIMS This study aims to establish a method for detecting bioelectrical characteristics in individuals with sarcopenic obesity through specific Bioelectrical Impedance Vector Analysis (specific BIVA), while considering the characteristics of individuals with healthy, sarcopenic, and obese conditions. METHODS The sample was composed by 915 Italian adults over 50 years of age (men: 74.6 ± 8.8 y; women:76.3 ± 8.8 y) living in Sardinia (Italy). A dataset of 1590 US adults aged 21 - 49 years retrieved from the 2003 - 2004 National Health and Nutrition Examination Survey was also considered in a final step of the study. Anthropometric (stature, weight, waist, arm, and calf circumferences) and whole-body bioelectrical variables were taken. In the Italian sample, bioelectrical impedance was applied to estimate the relative content of fat mass and skeletal muscle mass. Groups with healthy body composition (NS-NO), or consistent with sarcopenia (S), sarcopenic obesity (S-O), and obesity (O) were defined based on the cut-offs suggested by European expert guidelines (EWGSOP2 and ESPEN-EASO). Specific BIVA was applied to compare groups and to identify the area for sarcopenic obesity within young-adults tolerance ellipses. The position of the specific vector of US individuals with S-O, selected on the basis of DXA measurements, was also considered. RESULTS In both sexes of the Italian sample, the bioelectrical characteristics of the four groups were different (p < 0.001). The differences were mainly related to vector length, indicative of higher fat mass, which was longer in the O and S-O groups, and phase angle, a proxy of intracellular/extracellular water and muscle mass, lower in the sarcopenic groups. Bioelectrical vectors of the S-O group fell in the right quadrant, outside of the 95 % tolerance ellipses of young adults. The mean vector of the US sample with S-O fell in the same area. Within the S-O area, women had similar bioelectrical values, while men showed phase angle variability, which was related to the severity of the condition. CONCLUSIONS Specific BIVA detects body composition peculiarities of individuals with sarcopenic obesity, thus allowing their diagnosis when associated with low handgrip strength values.
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Affiliation(s)
- Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy.
| | - Simona Sulis
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Lenka Vorobel'ová
- Department of Anthropology, Comenius University, 84104, Bratislava, Slovakia
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042 Cagliari, Italy
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Yoshimura Y, Wakabayashi H, Nagano F, Matsumoto A, Shimazu S, Shiraishi A, Kido Y, Bise T, Hori K, Yoneda K. Reply to the Letter to the Editor - "Phase angle is associated with sarcopenic obesity in post-stroke patients". Clin Nutr 2024; 43:305-306. [PMID: 37993394 DOI: 10.1016/j.clnu.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan.
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Yoshifumi Kido
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Takahiro Bise
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Kota Hori
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Koki Yoneda
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
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Güner M, Okyar Baş A, Ceylan S. Letter to editor: Phase angle is associated with sarcopenic obesity in post-stroke patients. Clin Nutr 2024; 43:304. [PMID: 38008708 DOI: 10.1016/j.clnu.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Merve Güner
- Ministry of Health of Republic of Türkiye, Erzurum City Hospital, Division of Geriatric Medicine, Erzurum, Türkiye.
| | - Arzu Okyar Baş
- Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Türkiye
| | - Serdar Ceylan
- Ministry of Health of Republic of Türkiye, Antalya Atatürk State Hospital, Division of Geriatric Medicine, Antalya, Türkiye
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Kamijikkoku S, Yoshimura Y. Concurrent Negative Impact of Undernutrition and Heart Failure on Functional and Cognitive Recovery in Hip Fracture Patients. Nutrients 2023; 15:4800. [PMID: 38004194 PMCID: PMC10674784 DOI: 10.3390/nu15224800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
Evidence on the effects of frailty, undernutrition, and heart failure (HF) on patients with hip fractures is scarce. This retrospective cohort study aimed to examine the effects of undernutrition and HF on outcomes in patients who underwent convalescent rehabilitation after hip fracture. Undernutrition was defined as body mass index (BMI) < 20.0 (Low BMI). Heart failure (HF) was defined as a B-type natriuretic peptide (BNP) > 100 (High BNP). The study outcomes included the Functional Independence Measure motor domain (FIM-motor) and cognitive domain (FIM-cognition) at discharge. To consider the effects of low BMI, high BNP, and the simultaneous presence of both ("low BMI and high BNP"), we used multivariate linear regression analyses to examine whether these were associated with the outcomes. A total of 110 (mean age 87.4 years, 24.8% male) were analyzed. As a result, low BMI (β = -0.088, p = 0.027) and high BNP (β = -0.053, p = 0.015), each alone, were significantly associated with the FIM motor at discharge, whereas the simultaneous presence of "low BMI and high BNP" was significantly associated with the FIM motor at discharge, while the strength of the association was greater than each association alone (β = -0.152, p = 0.010). Further, the simultaneous presence of "low BMI and high BNP" was significantly associated with FIM cognition at discharge (β = -0.109, p = 0.014). Comprehensive multidisciplinary management is needed, including preoperative or early postoperative nutritional support and rehabilitation, followed by rehabilitation nutrition care management, in patients with hip fracture.
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Affiliation(s)
- Shuichi Kamijikkoku
- Department of Cardiology Medicine, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan;
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan
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