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Czinege M, Halațiu VB, Nyulas V, Cojocariu LO, Ion B, Mașca V, Țolescu C, Benedek T. Nutritional Status and Recurrent Major Cardiovascular Events Following Acute Myocardial Infarction-A Follow-Up Study in a Primary Percutaneous Coronary Intervention Center. Nutrients 2024; 16:1088. [PMID: 38613121 PMCID: PMC11013633 DOI: 10.3390/nu16071088] [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: 02/26/2024] [Revised: 03/31/2024] [Accepted: 04/06/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Acute myocardial infarction is often accompanied by malnutrition, which is associated with an imbalance between catabolic and anabolic processes. This ultimately leads to cardiac cachexia, which worsens the patient's prognosis. We aimed to assess the correlation between nutritional status, assessed using the controlling nutritional status (CONUT) score, and the rate of major cardiovascular adverse events (MACE). METHODS The present investigation was a non-randomized, prospective, observational study in which 108 patients with acute myocardial infarction were included. Nutritional status was assessed using the CONUT score. Based on the CONUT score, the patients were divided as follows: Group 1-normal or mild nutritional status (CONUT < 3 points, n = 76), and Group 2-moderate to severe nutritional deficiency (CONUT ≥ 3 points, n = 32). Demographic, echocardiographic, and laboratory parameters were obtained for all patients, as well as the MACE rate at 1 and 3 months of follow-up. RESULTS The MACE occurred more frequently in patients with impaired nutritional status at both 1-month follow-up (46.9% versus 9.2%; p < 0.0001) and 3-month follow-up (68.8% versus 10.5%; p < 0.0001). In terms of cardiovascular events, patients with poor nutritional status, with a CONUT score ≥ 3, presented more frequent non-fatal myocardial infarction, stroke, revascularization procedure, and ventricular arrhythmia. Also, the number of cardiovascular deaths was higher in the undernourished group. CONCLUSIONS This study found that patients with poor nutritional status experienced inflammatory status, frailty, and cardiovascular events more often than those with normal nutritional status at 1-month and 3-month follow-up after an acute myocardial infarction.
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Affiliation(s)
- Maria Czinege
- Doctoral School of Medicine and Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (M.C.); (B.I.); (V.M.)
| | - Vasile-Bogdan Halațiu
- Department of Physiology, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania
- Clinic of Cardiology, County Emergency Clinical Hospital, 540136 Târgu Mureș, Romania; (L.-O.C.); (C.Ț.)
| | - Victoria Nyulas
- Department of Informatics and Medical Biostatistics, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania;
| | - Liliana-Oana Cojocariu
- Clinic of Cardiology, County Emergency Clinical Hospital, 540136 Târgu Mureș, Romania; (L.-O.C.); (C.Ț.)
| | - Bianca Ion
- Doctoral School of Medicine and Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (M.C.); (B.I.); (V.M.)
| | - Violeta Mașca
- Doctoral School of Medicine and Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania; (M.C.); (B.I.); (V.M.)
- Clinic of Cardiology, County Emergency Clinical Hospital, 540136 Târgu Mureș, Romania; (L.-O.C.); (C.Ț.)
| | - Constantin Țolescu
- Clinic of Cardiology, County Emergency Clinical Hospital, 540136 Târgu Mureș, Romania; (L.-O.C.); (C.Ț.)
| | - Theodora Benedek
- Department of Cardiology, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania;
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Chen LJ, Sha S, Stocker H, Brenner H, Schöttker B. The associations of serum vitamin D status and vitamin D supplements use with all-cause dementia, Alzheimer's disease, and vascular dementia: a UK Biobank based prospective cohort study. Am J Clin Nutr 2024; 119:1052-1064. [PMID: 38296029 PMCID: PMC11007746 DOI: 10.1016/j.ajcnut.2024.01.020] [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: 10/18/2023] [Revised: 01/15/2024] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Prior studies on vitamin D and dementia outcomes yielded mixed results and had several important limitations. OBJECTIVES We aimed to assess the associations of both serum vitamin D status and supplementation with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD) incidence. METHODS With a prospective cohort study design, we comprehensively assessed the associations of vitamin D and multivitamin supplementation, as well as vitamin D deficiency {25-hydroxyvitamin D [25(OH)D] <30 nmol/L}, and insufficiency [25(OH)D 30 to <50 nmol/L], with the 14-year incidence of all-cause dementia, AD, and VD in 269,229 participants, aged 55 to 69, from the UK Biobank. RESULTS Although 5.0% reported regular vitamin D use and 19.8% reported multivitamin use, the majority of participants exhibited either vitamin D deficiency (18.3%) or insufficiency (34.0%). However, vitamin D deficiency was less prevalent among users of vitamin D (6.9%) or multivitamin preparations (9.5%) than among nonusers (21.5%). Adjusted Cox regression models demonstrated 19% to 25% increased risk of all 3 dementia outcomes for those with vitamin D deficiency [hazard ratio (HR) 95% confidence interval (CI)]: 1.25 (1.16, 1.34) for all-cause dementia; 1.19 (1.07-1.31) for AD; 1.24 (1.08-1.43) for VD] and 10% to 15% increased risk of those with vitamin D insufficiency [HR (95% CI): 1.11 (1.05, 1.18) for all-cause dementia; 1.10 (1.02-1.19) for AD; 1.15 (1.03-1.29) for VD]. Regular users of vitamin D and multivitamins had 17% and 14% lower risk of AD [HR (95% CI): 0.83 (0.71, 0.98)] and VD [HR (95% CI): 0.86 (0.75, 0.98)] incidence, respectively. CONCLUSIONS Although our findings indicate the potential benefits of vitamin D supplementation for dementia prevention, randomized controlled trials are essential for definitive evidence.
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Affiliation(s)
- Li-Ju Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Sha Sha
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany
| | - Hannah Stocker
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany; Network Aging Research, Heidelberg University, Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ). Im Neuenheimer Feld 581, Heidelberg, Germany; Network Aging Research, Heidelberg University, Heidelberg, Germany.
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Kwaśny A, Uchmanowicz I, Juárez-Vela R, Młynarska A, Łokieć K, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in heart failure: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:176-187. [PMID: 37226867 DOI: 10.1093/eurjcn/zvad050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
AIMS A nutritional status is related to the length of hospitalization and in-hospital mortality of patients with heart failure (HF). The aim of this study is to assess the prognostic impact of nutritional status and body mass index (BMI) on in-hospital mortality among patients with HF relative to their sex. METHODS AND RESULTS We conducted a retrospective study and analysis of 809 medical records of patients admitted to the Institute of Heart Disease of the University Clinical Hospital in Wroclaw (Poland). Women were statistically significantly older than men (74.67 ± 11.15 vs. 66.76 ± 17.78; P < 0.001). In unadjusted model, significant predictors of the odds of in-hospital mortality for men were underweight (OR = 14.81, P = 0.001) and the risk of malnutrition (OR = 8.979, P < 0.001). In the case of women, none of the traits analysed was significant. In age-adjusted model, significant independent predictors of the odds of in-hospital mortality in the case of men were BMI < 18.5 (OR = 15.423, P = 0.001) and risk of malnutrition (OR = 5.557, P = 0.002). In the case of women, none of the nutritional status traits analysed were significant. In multivariable-adjusted model in men, significant independent predictors of the odds of in-hospital mortality were BMI < 18.5 (OR = 15.978, P = 0.007) compared with having normal body weight and the risk of malnutrition (OR = 4.686, P = 0.015). In the case of women, none of the nutritional status traits analysed were significant. CONCLUSION Both underweight and the risk of malnutrition are direct predictors of the odds of in-hospital mortality in men, but not in women. The study did not find a relationship between nutritional status and in-hospital mortality in women.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, The Academy of Business and Health Science, 90-361 Lodz, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
| | - Agnieszka Młynarska
- Department Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
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Fukuda T, Yokomachi J, Yamaguchi S, Yagi H, Shibasaki I, Ugata Y, Sakuma M, Yasuda T, Abe S, Fukuda H, Fujita H, Toyoda S, Nakajima T. CAN WE DIAGNOSE SARCOPENIA USING ANTERIOR FEMORAL MUSCLE THICKNESS IN PATIENTS WITH CARDIOVASCULAR DISEASE? JOURNAL OF REHABILITATION MEDICINE. CLINICAL COMMUNICATIONS 2024; 7:12378. [PMID: 38269334 PMCID: PMC10807543 DOI: 10.2340/jrmcc.v7.12378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024]
Abstract
Objective Making the diagnosis of sarcopenia is not always easy and this is especially true for those with cardiovascular disease. The purpose of this study is to investigate whether it is possible to diagnose sarcopenia by using ultrasound-guided measurements of anterior femoral muscle thickness. Methods We investigated the utility of ultrasound-guided measurements of anterior femoral muscle thickness in 1075 hospitalized patients with cardiovascular disease (675 men). As a comparison, sarcopenia was assessed by skeletal muscle mass index using bioelectrical impedance analysis and the Asia Working Group for Sarcopenia criteria. Results When the receiver operating characteristic curve using muscle thickness was examined, we found this could be used to make the diagnosis of sarcopenia (men: cutoff value 2.425 cm, area under the curve 0.796; women: cutoff value 1.995 cm, area under the curve 0.746). The prevalence of sarcopenia according to the criteria with skeletal muscle mass index was 34.2% in men and 51.8% in women, while its prevalence according to the cutoff value of muscle thickness was 29.2% in men and 36.7% in women. Conclusion Ultrasound-guided measurement of the anterior femoral muscle thickness is a simple and useful method to help make the diagnosis of sarcopenia in patients with cardiovascular disease.
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Affiliation(s)
- Taira Fukuda
- Department of Liberal Arts and Sciences, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Jun Yokomachi
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Suomi Yamaguchi
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Hiroshi Yagi
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Ikuko Shibasaki
- Department of Cardiovascular Surgery, Dokkyo Medical University, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Yuusuke Ugata
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Tomohiro Yasuda
- School of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
| | - Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Hirotsugu Fukuda
- Department of Cardiovascular Surgery, Dokkyo Medical University, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, Dokkyo Medical University and Heart Center, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi, Japan
- Department of Medical KAATSU Training, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
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Kwaśny A, Łokieć K, Uchmanowicz B, Młynarska A, Smereka J, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in acute coronary syndrome: A retrospective cohort study. Nutr Metab Cardiovasc Dis 2023; 33:2242-2250. [PMID: 37516641 DOI: 10.1016/j.numecd.2023.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND AIMS In patients with some cardiovascular disease conditions the result of Nutritional Risk Screening 2002 (NRS-2002) and body mass index (BMI) is related to the in-hospital mortality. The aim of this study was to assess the prognostic impact of BMI and NRS 2002 on in-hospital mortality among patients with acute myocardial infarction (AMI) in relation to sex. METHODS AND RESULTS The study was based on a retrospective analysis of 945 medical records of AMI patients admitted to the Cardiology Department between 2017 and 2019. Patients with a score NRS2002 ≥ 3 are considered to be nutritionally at risk. The WHO BMI criteria were used. The endpoint was in-hospital mortality. Logistic regression was used to analyse the impact of quantitative variables on dichotomous outcome. Odds ratios (OR) with 95% confidence intervals were reported. Female patients were significantly older than male patients (73.24 ± 11.81 vs 67 ± 11.81). In an unadjusted model, the risk of malnutrition was a significant predictor of the odds of in-hospital mortality only in female patients (OR = 7.51, p = 0.001). In a multivariate model adjusted by all variables, heart failure (HF) (OR = 8.408, p = 0.003) and the risk of malnutrition (OR = 6.555, p = 0.007) were independent predictors of the odds of in-hospital mortality in female patients. The only significant independent predictor of the odds of in-hospital mortality in male patients was HF (OR = 3.789 p = 0.006). CONCLUSIONS Only in the case of female patients with AMI, the risk of malnutrition was independently associated with the odds of in-hospital mortality. There was no effect of BMI on in-hospital mortality in both sexes.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, Academy of Business Administration and Health Sciences, Lodz, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, Lodz, Poland
| | - Bartosz Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
| | - Michał Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland; Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain; Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
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Śliż D, Jodczyk AM, Łakoma K, Kucharska A, Panczyk M, Rostkowska OM, Turlej K, Młynarska A, Drożdż J, Jarzębska-Wódka M, Wierzbiński P, Grabowski M, Ukleja A, Adamczyk N, Baska A, Wiecha S, Barylski M, Poliwczak AR, Mamcarz A. Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines-Hospital Diet Medical Investigation) (HDMI) Study. Nutrients 2023; 15:4606. [PMID: 37960260 PMCID: PMC10650773 DOI: 10.3390/nu15214606] [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: 10/09/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients' health by implementing dietary interventions that foster the development of healthy eating habits.
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Affiliation(s)
- Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Alicja Monika Jodczyk
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Klaudia Łakoma
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
| | - Alicja Kucharska
- Department of Human Nutrition, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Medical University of Warsaw, 00-518 Warsaw, Poland
| | - Olga Maria Rostkowska
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, 02-006 Warsaw, Poland
| | - Karolina Turlej
- Department of Human Nutrition, Medical University of Warsaw, 01-445 Warsaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, Medical University of Silesia, 40-635 Katowice, Poland
| | - Jarosław Drożdż
- Department of Cardiology, Medical University of Lodz, 92-213 Lodz, Poland
| | | | | | - Marcin Grabowski
- 1st Chair and Department and of Cardiology Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Anna Ukleja
- 1st Chair and Department and of Cardiology Medical University of Warsaw, 02-097 Warsaw, Poland
| | | | - Alicja Baska
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health in Biala Podlaska, Faculty in Biala Podlaska, Jozef Pilusdski University of Physical Education, 00-968 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-647 Lodz, Poland
| | - Adam Rafał Poliwczak
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-647 Lodz, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
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Yokomachi J, Fukuda T, Mizushima Y, Nozawa N, Ishizaka H, Matsumoto K, Kambe T, Inoue S, Nishikawa K, Toyama Y, Takahashi R, Arakawa T, Yagi H, Yamaguchi S, Ugata Y, Nakamura F, Sakuma M, Abe S, Fujita H, Mizushima T, Toyoda S, Nakajima T. Clinical usefulness of phase angle as an indicator of muscle wasting and malnutrition in inpatients with cardiovascular diseases. Asia Pac J Clin Nutr 2023; 32:297-307. [PMID: 37789650 PMCID: PMC11090388 DOI: 10.6133/apjcn.202309_32(3).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/29/2023] [Accepted: 07/17/2023] [Indexed: 10/05/2023]
Abstract
Background and Objectives: Extracellular water is increased in patients with edema, such as those with chronic heart failure, and it is difficult to assess skeletal muscle mass with the skeletal muscle mass index when extracellular water is high. We investigated the relationship between phase angle and physical function, nutritional indices, and sarcopenia in patients with cardiovascular diseases, including chronic heart failure. Methods and Study Design: In 590 patients with cardiovascular diseases (372 men), handgrip strength, gait speed, and anterior mid-thigh muscle thickness by ultrasound were measured, and the skeletal muscle mass index, phase angle, and the extracellular water: total body water ratio were measured with a bioelectrical impedance analyzer, and presence of sarcopenia was evaluated. Results: Phase angle, but not the skeletal muscle mass index, was correlated with serum albumin (r = 0.377, p < 0.001) and hemoglobin values in women. Multivariate regression analysis showed that at the extracellular water: total body water ratio below 0.4, both phase angle and skeletal muscle mass index were independent determinants of handgrip strength and log mid-thigh muscle thickness in men, after adjustment for age and presence of chronic heart failure. In contrast, for the ratio of 0.4 or greater, after adjustment for age and presence of chronic heart failure, phase angle was a stronger independent determinant of handgrip strength and log mid-thigh muscle thickness than the skeletal muscle mass index in men. Conclusions: Phase angle is a good marker of muscle wasting and malnutrition in patients with cardiovascular disease, including chronic heart failure.
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Affiliation(s)
- Jun Yokomachi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
| | - Taira Fukuda
- Department of Liberal Arts and Sciences, Kanagawa University of Human Services.
| | - Yuta Mizushima
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Naohiro Nozawa
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Hayato Ishizaka
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | | | - Takahiro Kambe
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Shohta Inoue
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Kaori Nishikawa
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Yohei Toyama
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Reiko Takahashi
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Tomoe Arakawa
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Hiroshi Yagi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
| | - Suomi Yamaguchi
- Department of Rehabilitation, Dokkyo Medical University Hospital
| | - Yuusuke Ugata
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University
| | - Fumitaka Nakamura
- Third Department of Internal Medicine, Teikyo University, Chiba Medical Center
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
| | - Shichiro Abe
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University
| | | | - Shigeru Toyoda
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University
- Department of Medical KAATSU Training, Dokkyo Medical University
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8
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Brecht P, Dring JC, Yanez F, Styczeń A, Mertowska P, Mertowski S, Grywalska E. How Do Minerals, Vitamins, and Intestinal Microbiota Affect the Development and Progression of Heart Disease in Adult and Pediatric Patients? Nutrients 2023; 15:3264. [PMID: 37513682 PMCID: PMC10384570 DOI: 10.3390/nu15143264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide, far ahead of cancer. Epidemiological data emphasize the participation of many risk factors that increase the incidence of CVDs, including genetic factors, age, and sex, but also lifestyle, mainly nutritional irregularities and, connected with them, overweight and obesity, as well as metabolic diseases. Despite the importance of cardiovascular problems in the whole society, the principles of prevention of CVDs are not widely disseminated, especially among the youngest. As a result, nutritional neglect, growing from childhood and adolescence, translates into the occurrence of numerous disease entities, including CVDs, in adult life. This review aimed to draw attention to the role of selected minerals and vitamins in health and the development and progression of CVDs in adults and children. Particular attention was paid to the effects of deficiency and toxicity of the analyzed compounds in the context of the cardiovascular system and to the role of intestinal microorganisms, which by interacting with nutrients, may contribute to the development of cardiovascular disorders. We hope this article will draw the attention of society and the medical community to emphasize promoting healthy eating and proper eating habits in children and adults, translating into increased awareness and a reduced risk of CVD.
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Affiliation(s)
- Peet Brecht
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - James Curtis Dring
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Felipe Yanez
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Agnieszka Styczeń
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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9
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Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, Sloan RP, Sesso HD, Manson JE, Brickman AM. Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. Am J Clin Nutr 2023; 118:273-282. [PMID: 37244291 PMCID: PMC10375458 DOI: 10.1016/j.ajcnut.2023.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Maintenance of cognitive abilities is of critical importance to older adults, yet few effective strategies to slow cognitive decline currently exist. Multivitamin supplementation is used to promote general health; it is unclear whether it favorably affects cognition in older age. OBJECTIVES To examine the effect of daily multivitamin/multimineral supplementation on memory in older adults. METHODS The COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study (NCT04582617) included 3562 older adults. Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y. The prespecified primary outcome measure was change in episodic memory, operationally defined as immediate recall performance on the ModRey test, after 1 y of intervention. Secondary outcome measures included changes in episodic memory over 3 y of follow-up and changes in performance on neuropsychological tasks of novel object recognition and executive function over 3 y. RESULTS Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes. Based on cross-sectional analysis of the association between age and performance on the ModRey, we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change. CONCLUSIONS Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age. This trial was registered at clinicaltrials.gov as NCT04582617.
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Affiliation(s)
- Lok-Kin Yeung
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Daniel M Alschuler
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Melanie Wall
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Heike Luttmann-Gibson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Christiane Hale
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Division of Behavioral Medicine, New York State Psychiatric Institute, New York, NY, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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10
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Baker LD, Manson JE, Rapp SR, Sesso HD, Gaussoin SA, Shumaker SA, Espeland MA. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimers Dement 2023; 19:1308-1319. [PMID: 36102337 PMCID: PMC10011015 DOI: 10.1002/alz.12767] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Dietary supplements are touted for cognitive protection, but supporting evidence is mixed. COSMOS-Mind tested whether daily administration of cocoa extract (containing 500 mg/day flavanols) versus placebo and a commercial multivitamin-mineral (MVM) versus placebo improved cognition in older women and men. METHODS COSMOS-Mind, a large randomized two-by-two factorial 3-year trial, assessed cognition by telephone at baseline and annually. The primary outcome was a global cognition composite formed from mean standardized (z) scores (relative to baseline) from individual tests, including the Telephone Interview of Cognitive Status, Word List and Story Recall, Oral Trail-Making, Verbal Fluency, Number Span, and Digit Ordering. Using intention-to-treat, the primary endpoint was change in this composite with 3 years of cocoa extract use. The pre-specified secondary endpoint was change in the composite with 3 years of MVM supplementation. Treatment effects were also examined for executive function and memory composite scores, and in pre-specified subgroups at higher risk for cognitive decline. RESULTS A total of 2262 participants were enrolled (mean age = 73y; 60% women; 89% non-Hispanic White), and 92% completed the baseline and at least one annual assessment. Cocoa extract had no effect on global cognition (mean z-score = 0.03, 95% CI: -0.02 to 0.08; P = .28). Daily MVM supplementation, relative to placebo, resulted in a statistically significant benefit on global cognition (mean z = 0.07, 95% CI 0.02 to 0.12; P = .007), and this effect was most pronounced in participants with a history of cardiovascular disease (no history: 0.06, 95% CI 0.01 to 0.11; history: 0.14, 95% CI -0.02 to 0.31; interaction, nominal P = .01). Multivitamin-mineral benefits were also observed for memory and executive function. The cocoa extract by MVM group interaction was not significant for any of the cognitive composites. DISCUSSION Cocoa extract did not benefit cognition. However, COSMOS-Mind provides the first evidence from a large, long-term, pragmatic trial to support the potential efficacy of a MVM to improve cognition in older adults. Additional work is needed to confirm these findings in a more diverse cohort and to identify mechanisms to account for MVM effects. HIGHLIGHTS COSMOS-Mind was a large simple pragmatic randomized clinical trial in older adults conducted by mail and telephone. The trial used a two-by-two factorial design to assess treatment effects of two different interventions within a single large study. We found no cognitive benefit of daily cocoa extract administration (containing 500 mg flavanols) for 3 years. Daily multivitamin-mineral (MVM) supplementation for 3 years improved global cognition, episodic memory, and executive function in older adults. The MVM benefit appeared to be greater for adults with cardiovascular disease.
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Affiliation(s)
- Laura D. Baker
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, 02215, U.S.A
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, 02115, U.S.A
| | - Stephen R. Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
| | - Howard D. Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, 02215, U.S.A
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, 02115, U.S.A
| | - Sarah A. Gaussoin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
| | - Sally A. Shumaker
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
| | - Mark A. Espeland
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, 27157, U.S.A
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11
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Czapla M, Uchmanowicz I, Juárez-Vela R, Durante A, Kałużna-Oleksy M, Łokieć K, Baeza-Trinidad R, Smereka J. Relationship between nutritional status and length of hospital stay among patients with atrial fibrillation - a result of the nutritional status heart study. Front Nutr 2022; 9:1086715. [PMID: 36590210 PMCID: PMC9794855 DOI: 10.3389/fnut.2022.1086715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background Nutritional status is related to the prognosis and length of hospital stay (LOHS) of patients with atrial fibrillation (AF). This study aimed to assess how nutritional status affects LOHS for patients with AF. Methods We performed retrospective analysis of the medical records of 1,813 patients admitted urgently with a diagnosis of AF to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland. Results In total, 1,813 patients were included in the analysis. The average LOHS in the entire group was 3.53 ± 3.41 days. The mean BMI was 28.7 kg/m2 (SD: 5.02). Patients who were hospitalized longer were statistically more likely to have a Nutritional Risk Score (NRS) ≥3 (p = 0.028). A higher percentage of longer hospitalized patients with LDL levels below 70 mg/dl (p < 0.001) and those with HDL ≥40 mg/dl (p < 0.001) were observed. Study participants with NRS ≥3 were an older group (M = 76.3 years), with longer mean LOHS (M = 4.44 days). The predictors of LOHS in the univariate model were age (OR = 1.04), LDL (OR = 0.99), HDL (OR = 0.98), TC (OR = 0.996), CRP (OR = 1, 02, p < 0.001), lymphocytes (OR = 0.97, p = 0.008) and in the multivariate model were age, LDL (mg/dl), HDL (mg/dl), Na, and K. Conclusion For nutritional status, factors indicating the risk of prolonged hospitalization in patients with AF are malnutrition, lower serum LDL, HDL, potassium, and sodium levels identified at the time of admission to the cardiology department. Assessment of nutritional status in patients with AF is important both in the context of evaluating obesity and malnutrition status, as both conditions can alter the prognosis of patients. Further studies are needed to determine the exact impact of the above on the risk of prolonged hospitalization.
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Affiliation(s)
- Michał Czapla
- Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland,Institute of Heart Diseases, University Hospital, Wrocław, Poland,Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Izabella Uchmanowicz
- Institute of Heart Diseases, University Hospital, Wrocław, Poland,Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain
| | - Angela Durante
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, Logroño, Spain,*Correspondence: Angela Durante,
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, Lodz, Poland
| | | | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland
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12
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Czapla M, Juárez-Vela R, Łokieć K, Wleklik M, Karniej P, Smereka J. The Association between Nutritional Status and Length of Hospital Stay among Patients with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105827. [PMID: 35627363 PMCID: PMC9140333 DOI: 10.3390/ijerph19105827] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023]
Abstract
Background: Nutritional status is related to the prognosis and length of hospital stay (LOS) of patients with hypertension (HT). This study aimed to assess how nutritional status and body mass index (BMI) affect LOS for patients with hypertension. Method: We performed a retrospective analysis of 586 medical records of patients who had been admitted to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw, Poland. Results: A total of 586 individuals were included in the analysis. Individuals who were at a nutritional risk represented less than 2% of the study population, but more than 60% were overweight or obese. The mean BMI was 28.4 kg/m2 (SD: 5.16). LOS averaged 3.53 days (SD = 2.78). In the case of obese individuals, hospitalisation lasted for 3.4 ± 2.43 days, which was significantly longer than for patients of normal weight. For underweight patients, hospitalisation lasted for 5.14 ± 2.27 days, which was also significantly longer than for those in other BMI categories (p = 0.017). The independent predictors of shorter hospitalisations involved higher LDL concentration (parameter of regression: −0.015) and HDL concentration (parameter of regression: −0.04). Conclusions: The study revealed that with regard to the nutritional status of hypertensive patients, being either underweight or obese was associated with longer LOS. Additional factors that related to prolonged LOS were lower LDL and HDL levels and higher CRP concentrations.
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Affiliation(s)
- Michał Czapla
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland; (M.C.); (J.S.)
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Nursing, University of La Rioja, 26006 Logroño, Spain;
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Nursing, University of La Rioja, 26006 Logroño, Spain;
- Correspondence:
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, 90-251 Lodz, Poland;
| | - Marta Wleklik
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland;
| | - Piotr Karniej
- Group of Research in Care (GRUPAC), Faculty of Nursing, University of La Rioja, 26006 Logroño, Spain;
- Faculty of Finance and Management, WSB University in Wrocław, 53-609 Wroclaw, Poland
| | - Jacek Smereka
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland; (M.C.); (J.S.)
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13
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Liang J, Zhang L, Huang Z, He Y, Ling Y, Chen K, Ying M, Lin M, Li G, Liu J, Liu Y, Liang Y, Chen S, Hu Y. Implications of Malnutrition on Contrast-Associated Acute Kidney Injury in Young and Old Patients Undergoing Percutaneous Coronary Intervention: A Multicenter Prospective Cohort. Front Nutr 2022; 8:795068. [PMID: 35211494 PMCID: PMC8861456 DOI: 10.3389/fnut.2021.795068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023] Open
Abstract
BackgroundThe relationship between malnutrition and the risk of contrast-associated acute kidney injury (CA-AKI) and the resulting prognosis in patients undergoing percutaneous coronary intervention (PCI) is still not well known.MethodsPatients undergoing PCI were consecutively enrolled in a multicenter study in China (NCT01402232), categorized by nutritional status (non-malnutrition, malnutrition) based on two different cut-off values (i.e., traditional threshold and the best cut-off value based on the receiver operating characteristic (ROC) curve) for the controlling nutritional status (CONUT) score. The primary endpoint was CA-AKI, diagnosed as a rise in serum creatinine >0.3 mg/dl or >50% than the baseline level occurring within 48 h after the intervention. The secondary endpoint was all-cause mortality. The relationships of malnutrition, CA-AKI, and all-cause mortality were examined using multivariate-adjusted logistic and Cox regression analyses, respectively.ResultsAmong 2,083 patients undergoing PCI (age: 62.8 ± 11.1 years; 79.0% men), 1,258 (60.4%) were malnourished. During hospitalization, 80 (3.8%) patients developed CA-AKI events. The incidence of CA-AKI in patients who did not have malnutrition (the non-malnutrition group) and those who did have malnutrition (the malnutrition group) was 1.7% and 5.25%, respectively. Patients with malnutrition had a 2-fold increased adjusted risk of CA-AKI compared to those with no malnutrition [adjusted odds ratio (aOR) (95% confidence interval CI): 2.41 (1.22 to 5.22)]. Malnutrition was associated with a 3-fold increased adjusted risk of CA-AKI in patients aged ≤ 75 years [N = 1,791, aOR (95% CI): 3.39 (1.46–9.25)]. Malnourished patients with CA-AKI had a higher risk of all-cause mortality than the others. Similar results were observed in the grouping of Supplemental Analyses based on the optimal cut-off value of the CONUT score identified by the ROC curve.ConclusionsMalnutrition is strongly associated with an increased risk of CA-AKI in both young and old patients undergoing PCI. Malnourished patients with CA-AKI had a significantly higher risk of all-cause mortality. Further studies are needed to prospectively assess the efficacy of nutritional interventions on outcomes in patients undergoing PCI.
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Affiliation(s)
- Jingjing Liang
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lingyu Zhang
- Department of Cardiology, Maoming People's Hospital, Maoming, China
| | - Zhidong Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yibo He
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yihang Ling
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kai Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ming Ying
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mengfei Lin
- Department of Cardiology, Maoming People's Hospital, Maoming, China
| | - Guode Li
- Department of Cardiology, Maoming People's Hospital, Maoming, China
| | - Jin Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yong Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yan Liang
- Department of Cardiology, Maoming People's Hospital, Maoming, China
- *Correspondence: Yan Liang
| | - Shiqun Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shiqun Chen
| | - Yunzhao Hu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Yunzhao Hu
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Tantisattamo E, Imhof C, Jager KJ, Hilbrands LB, Guidotti R, Islam M, Katicic D, Konings C, Molenaar FM, Nistor I, Noordzij M, Rodríguez Ferrero ML, Verhoeven MAM, de Vries APJ, Kalantar-Zadeh K, Gansevoort RT, Vart P. OUP accepted manuscript. Clin Kidney J 2022; 15:1348-1360. [PMID: 35747092 PMCID: PMC8992331 DOI: 10.1093/ckj/sfac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background In the general population with coronavirus disease 2019 (COVID-19), obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney transplant with COVID-19. Methods Data from the European Renal Association COVID-19 Database (ERACODA) were used. KFRT patients diagnosed with COVID-19 between 1 February 2020 and 31 January 2021 were included. The association of Quetelet's body mass index (BMI) (kg/m2), divided into: <18.5 (lean), 18.5–24.9 (normal weight), 25–29.9 (overweight), 30–34.9 (obese I) and ≥35 (obese II/III), with 3-month mortality was investigated using Cox proportional-hazards regression analyses. Results In 3160 patients on KFRT (mean age: 65 years, male: 61%), 99 patients were lean, 1151 normal weight (reference), 1160 overweight, 525 obese I and 225 obese II/III. During follow-up of 3 months, 28, 20, 21, 23 and 27% of patients died in these categories, respectively. In the fully adjusted model, the hazard ratios (HRs) for 3-month mortality were 1.65 [95% confidence interval (CI): 1.10, 2.47], 1 (ref.), 1.07 (95% CI: 0.89, 1.28), 1.17 (95% CI: 0.93, 1.46) and 1.71 (95% CI: 1.27, 2.30), respectively. Results were similar among dialysis patients (N = 2343) and among those living with a kidney transplant (N = 817) (Pinteraction = 0.99), but differed by sex (Pinteraction = 0.019). In males, the HRs for the association of aforementioned BMI categories with 3-month mortality were 2.07 (95% CI: 1.22, 3.52), 1 (ref.), 0.97 (95% CI: 0.78. 1.21), 0.99 (95% CI: 0.74, 1.33) and 1.22 (95% CI: 0.78, 1.91), respectively, and in females corresponding HRs were 1.34 (95% CI: 0.70, 2.57), 1 (ref.), 1.31 (95% CI: 0.94, 1.85), 1.54 (95% CI: 1.05, 2.26) and 2.49 (95% CI: 1.62, 3.84), respectively. Conclusion In KFRT patients with COVID-19, on dialysis or a kidney transplant, obesity is associated with an increased risk of mortality at 3 months. This is in contrast to the obesity paradox generally observed in dialysis patients. Additional studies are required to corroborate the sex difference in the association of obesity with mortality.
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Affiliation(s)
| | | | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca Guidotti
- Institute of Nephrology, City Hospital Waid and Triemli, Zurich, Switzerland
| | - Mahmud Islam
- Zonguldak Ataturk state hospital, Zonguldak, Turkey
| | - Dajana Katicic
- Croatian Society of Nephrology, Dialysis and Transplantation, Croatia
| | | | | | - Ionut Nistor
- Faculty of Medicine, University of Medicine and Pharmacy, Grigore T.Popa, Iași, Romania
| | - Marlies Noordzij
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA
| | - Ron T Gansevoort
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Priya Vart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Kim BS, Lee Y, Kim HJ, Shin JH, Park JK, Park HC, Lim YH, Shin J. Influence of changes in body fat on clinical outcomes in a general population: a 12-year follow-up report on the Ansan-Ansung cohort in the Korean Genome Environment Study. Ann Med 2021; 53:1646-1658. [PMID: 34533069 PMCID: PMC8451655 DOI: 10.1080/07853890.2021.1976416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The impact of the changes in the obesity status on mortality has not been established; thus, we investigated the long-term influence of body fat (BF) changes on all-cause deaths and cardiovascular outcomes in a general population. METHODS A total of 8374 participants were observed for 12 years. BF was measured at least two times using a bioimpedance method. The causes of death were acquired from the nationwide database. A major adverse cardiovascular event (MACE) was defined as a composite of myocardial infarction, coronary artery disease, stroke, and cardiovascular death. Standard deviations (SDs) were derived using a local regression model corresponding to the time elapsed between the initial and final BF measurements (SDT) and were used to standardize the changes in BF (ΔBF/SDT). RESULTS The incidence rates of all-cause death, cardiovascular death, and MACE were the highest in the participants with ΔBF/SDT <-1 and lowest in the participants with ΔBF/SDT ≥1. Multivariate Cox proportional hazard models adjusted for relevant covariates, including baseline obesity and physical activity, showed that the risks of all-cause deaths (hazard ratio [HR] 0.58; 95% confidence intervals [CI] 0.53-0.64), cardiovascular deaths (HR 0.63; 95% CI 0.51-0.78) and MACEs (HR 0.68; 95% CI 0.62-0.75) decreased as ΔBF/SDT increased. Subgroup analyses showed that existing cardiovascular diseases weakened the associations between higher ΔBF/SDT and better outcomes, while high physical activity and exercise did not impact the associations. CONCLUSION Increasing BF was associated with a lower risk of all-cause death, cardiovascular death, and MACE in the general population.Key messagesIncreasing body fat is associated with a lower risk of all-cause death, cardiovascular death, and major cardiovascular adverse events in a low-risk ageing general population, independently of physical activity, underlying cardiovascular disease burden, changes in muscle mass, and baseline obesity status.Fatness measured at baseline requires adjustment for the changes in fatness during the follow-up to reveal its impact on the clinical outcomes.
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Affiliation(s)
- Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Jin-Kyu Park
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, South Korea
| | - Hwan-Cheol Park
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, South Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, South Korea
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The Association between Nutritional Status and In-Hospital Mortality among Patients with Heart Failure-A Result of the Retrospective Nutritional Status Heart Study 2 (NSHS2). Nutrients 2021; 13:nu13051669. [PMID: 34069058 PMCID: PMC8156051 DOI: 10.3390/nu13051669] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A nutritional status is related to the prognosis and length of hospitalisation of patients with heart failure (HF). This study aims to assess the effect of nutritional status on in-hospital mortality in patients with heart failure. METHODS We conducted a retrospective study and analysis of medical records of 1056 patients admitted to the cardiology department of the University Clinical Hospital in Wroclaw (Poland). RESULTS A total of 1056 individuals were included in the analysis. A total of 5.5% of patients died during an in-hospital stay. It was found that in the sample group, 25% of patients who died had a BMI (body mass index) within the normal range, 6% were underweight, 47% were overweight, and 22% were obese. Our results show that non-survivors have a significantly higher nutrition risk screening (NRS) ≥3 (21% vs. 3%; p < 0.001); NYHA (New York Heart Association) grade 4 (70% vs. 24%; p < 0.001). The risk of death was lower in obese patients (HR = 0.51; p = 0.028) and those with LDL (low-density lipoprotein) levels from 116 to <190 mg/dL (HR = 0.10; p = 0.009, compared to those with LDL <55 mg/dL). The risk of death was higher in those with NRS (nutritional risk score) score ≥3 (HR = 2.31; p = 0.014), HFmrEF fraction (HR = 4.69; p < 0.001), and LDL levels > 190 mg/dL (HR = 3.20; p = 0.038). CONCLUSION The malnutrition status correlates with an increased risk of death during hospitalisation. Higher TC (total cholesterol) level were related to a lower risk of death, which may indicate the "lipid paradox". Higher BMI results were related to a lower risk of death, which may indicate the "obesity paradox".
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17
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Wang Z, Zhao L, He S. Prognostic nutritional index and the risk of mortality in patients with hypertrophic cardiomyopathy. Int J Cardiol 2021; 331:152-157. [PMID: 33529655 DOI: 10.1016/j.ijcard.2021.01.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/22/2021] [Indexed: 02/08/2023]
Abstract
AIMS Nutritional status has been related to clinical outcomes in patients with cardiovascular diseases. The prognostic impact of poor nutritional status in hypertrophic cardiomyopathy (HCM) is not clearly understood. The aim of the present study is to investigate the prognostic value of prognostic nutritional index (PNI), calculated from serum albumin level and total lymphocyte count, in HCM patients. METHODS A total of 393 HCM patients in a tertiary medical centre were enrolled. The primary and secondary endpoints were all-cause mortality and cardiovascular death. The association between PNI and endpoints was analysed. RESULTS During a mean follow-up duration of 4.8 years, patients with high PNI values (PNI ≥ 48.8) had significantly lower incidence of all-cause mortality (9.3% vs. 33.1%, P < 0.001) and cardiovascular death (7.1% vs. 21.0%, P < 0.001). After adjusting for potential confounders, PNI was independently associated with all-cause mortality and cardiovascular death (hazard ratio per 1 SD increase: 0.46 [95% CI: 0.34-0.62, P < 0.001] and 0.44 [95% CI: 0.30-0.63, P < 0.001]). In subgroup analysis stratified by age, gender, New York Heart Association class, atrial fibrillation, estimated glomerular filtration rate, left ventricular ejection fraction or left ventricular outflow tract obstruction, PNI was consistently related to mortality. CONCLUSIONS PNI is an independent prognostic factor for mortality in patients with HCM.
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Affiliation(s)
- Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Liming Zhao
- Department of Cardiovascular Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan 610041, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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The Association between Nutritional Status and In-Hospital Mortality among Patients with Acute Coronary Syndrome-A Result of the Retrospective Nutritional Status Heart Study (NSHS). Nutrients 2020; 12:nu12103091. [PMID: 33050636 PMCID: PMC7600326 DOI: 10.3390/nu12103091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nutritional status is related to the prognosis and the length of hospitalization of individuals with myocardial infarction. This study aimed to assess the effects of nutritional status on in-hospital mortality in patients with acute coronary syndrome. METHODS We performed a retrospective study of 1623 medical records of patients admitted to the cardiology department of the University Clinical Hospital in Wroclaw (Poland) between 2017 and 2019. RESULTS It was found that, of those who died in the sample, 50% had a BMI within the normal range, 29% were in the overweight range and 18% were in the obese range. Patients who died had significantly more frequent occurrences of the following: Nutrition Risk Screening (NRS) ≥ 3 (20% vs. 6%; p < 0.001); heart failure (53% vs. 25%; p < 0.001); or a history of stroke (22% vs. 9%; p < 0.001), arterial hypertension (66% vs. 19%; p < 0001) or diabetes (41% vs. 19%; p < 0.001). Statistically significant differences were found when considering the type of infarction, diabetes or people with low-density lipoprotein greater than or equal to 70 mg/dL. CONCLUSIONS This study shows that malnutrition correlates with an increased risk of death during hospitalization.
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Hirose S, Nakajima T, Nozawa N, Katayanagi S, Ishizaka H, Mizushima Y, Matsumoto K, Nishikawa K, Toyama Y, Takahashi R, Arakawa T, Yasuda T, Haruyama A, Yazawa H, Yamaguchi S, Toyoda S, Shibasaki I, Mizushima T, Fukuda H, Inoue T. Phase Angle as an Indicator of Sarcopenia, Malnutrition, and Cachexia in Inpatients with Cardiovascular Diseases. J Clin Med 2020; 9:jcm9082554. [PMID: 32781732 PMCID: PMC7463846 DOI: 10.3390/jcm9082554] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/25/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022] Open
Abstract
Malnutrition is associated with sarcopenia, cachexia, and prognosis. We investigated the usefulness of phase angle (PhA) as a marker of sarcopenia, cachexia, and malnutrition in 412 hospitalized patients with cardiovascular disease. We analyzed body composition with bioelectrical impedance analysis, and nutritional status such as controlling nutritional status (CONUT) score. Both skeletal muscle mass index (SMI) and PhA correlated with age, grip strength and knee extension strength (p < 0.0001) in both sexes. The SMI value correlated with CONUT score, Hb, and Alb in males. Phase angle also correlated with CONUT score, Hb, and Alb in males, and more strongly associated with these nutritional aspects. In females, PhA was correlated with Hb and Alb (p < 0.001). In both sexes, sarcopenia incidence was 31.6% and 32.4%; PhA cut-off in patients with sarcopenia was 4.55° and 4.25°; and cachexia incidence was 11.5% and 14.1%, respectively. The PhA cut-off in males with cachexia was 4.15°. Multivariate regression analysis showed that grip strength and brain natriuretic peptide (BNP) were independent determinants of SMI, whereas grip strength, BNP, and Hb were independent determinants of PhA. Thus, PhA appears to be a useful marker for sarcopenia, malnutrition, and cachexia in hospitalized patients with cardiovascular disease.
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Affiliation(s)
- Suguru Hirose
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
- Correspondence:
| | - Naohiro Nozawa
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Satoshi Katayanagi
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Hayato Ishizaka
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Yuta Mizushima
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Kazuhisa Matsumoto
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Kaori Nishikawa
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Yohei Toyama
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Reiko Takahashi
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Tomoe Arakawa
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Tomohiro Yasuda
- School of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka 433-8558, Japan;
| | - Akiko Haruyama
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
| | - Hiroko Yazawa
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
| | - Suomi Yamaguchi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
| | - Ikuko Shibasaki
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (I.S.); (H.F.)
| | - Takashi Mizushima
- Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan; (N.N.); (S.K.); (H.I.); (Y.M.); (K.M.); (K.N.); (Y.T.); (R.T.); (T.A.); (T.M.)
| | - Hirotsugu Fukuda
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (I.S.); (H.F.)
| | - Teruo Inoue
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan; (S.H.); (A.H.); (H.Y.); (S.Y.); (S.T.); (T.I.)
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20
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Dos Santos GJ, da Silva JP, Hippólito AG, Ferro BS, Oliveira ELR, Okamoto PTCG, Lourenço MLG, de Vasconcelos Machado VM, Rahal SC, Teixeira CR, Melchert A. Computed tomographic and radiographic morphometric study of cardiac and coelomic dimensions in captive blue-fronted Amazon parrots (Amazona aestiva, Linnaeus, 1758) with varying body condition scores. Anat Histol Embryol 2020; 49:299-306. [PMID: 31900979 DOI: 10.1111/ahe.12528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/04/2019] [Accepted: 12/11/2019] [Indexed: 11/26/2022]
Abstract
This study aimed to assess radiographic and tomographic cardiac parameters, including width and length of the heart, and the ratio of heart width to coelom width of blue-fronted Amazon parrots (Amazona aestiva) with varying body condition scores. Thirty-five captive birds were included in the study and were allocated into one of three groups according to their respective body condition score: lean, ideal and obese. No differences were observed among the groups with regard to radiographic and tomographic measurements. Computed tomography enabled better identification of the structures of the cardiovascular system without interference from the overlying structures of the celomatic cavity observed in radiographic images. However, radiographic examinations should still be considered the standard screening method to identify cardiac alterations, such as increased or reduced organ dimensions. Standardizing the techniques and measurements performed in this study may serve as a basis for further research in the field.
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Affiliation(s)
- Gisele J Dos Santos
- Graduate Program in Wild Animals, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Jeana P da Silva
- Graduate Program in Wild Animals, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Alícia G Hippólito
- Graduate Program in Wild Animals, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Bárbara S Ferro
- Graduate Program in Wild Animals, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Elton Luís R Oliveira
- Graduate Program in Wild Animals, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Priscylla Tatiana C G Okamoto
- Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Maria Lucia G Lourenço
- Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Vania Maria de Vasconcelos Machado
- Department of Animal Reproduction and Veterinary Radiology, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Sheila C Rahal
- Department of Veterinary Surgery and Anesthesiology, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Carlos R Teixeira
- Department of Veterinary Surgery and Anesthesiology, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
| | - Alessandra Melchert
- Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, Univ Estadual Paulista (Unesp), Botucatu, Brazil
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