A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study

Abstract

Background Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Methods A prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged ≥65 years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris– Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson’s correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy< 75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy. Results Forty-eight patients were analyzed (mean age 84.4 ± 7.8 years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r = 0.733, p < 0.001). ROC analysis identified a percentage change in temporal muscle thickness of − 3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125–0.635). Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.

Temporal Muscle and Stroke—A Narrative Review on Current Meaning and Clinical Applications of Temporal Muscle Thickness, Area, and Volume

“…Four studies reported the association between TMT and SAH [ 9 , 21 , 23 , 24 ], two studies between TMT and ICH [ 25 , 26 ], and two studies between TMT and ischemic stroke [ 27 , 28 ]. The other four studies described the standard TMT values [ 18 , 29 ] and the relationship between TMT and nutritional status [ 19 , 20 ]. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram [ 30 ] for systematic review is shown as Figure 1 .…”

“…Hasegawa et al also performed a prospective study [ 19 ]. The study aimed to examine whether a change in TMT evaluated by the ultrasonography was directly correlated with energy adequacy, and to determine the cut-off value of a change in TMT to detect energy inadequacy.…”

“…Recently, temporal muscle thickness (TMT) on computed tomography (CT) images or magnetic resonance images (MRI) has been introduced as a novel surrogate marker with which to measure muscle mass [ 17 ], function [ 18 ], and nutritional status [ 19 , 20 ]. CT and MRI are routinely performed for stroke patients, and TMT measurement is easier than other methods such as quantitative measurements of the cross-sectional skeletal muscle area at the third lumbar vertebra using CT imaging, which is known to be significantly correlated with whole-body muscle [ 16 ].…”

Temporal Muscle Thickness as a Prognostic Marker in Patients with Newly Diagnosed Glioblastoma: Translational Imaging Analysis of the CENTRIC EORTC 26071–22072 and CORE Trials

“…[7][8][9][10][11] Recently, temporal muscle thickness (TMT) obtained on cranial magnetic resonance images (MRI) has been introduced as a new surrogate marker with which to identify patients at risk of sarcopenia due to its high correlation with the skeletal muscle mass, muscle function and nutritional status. [12][13][14][15][16] These studies suggest that the estimation of skeletal muscle mass can be derived from assessing cranio-facial muscles including TMT directly from brain MRI scans 8 that are routinely obtained for glioblastoma patients.…”

Temporal Muscle and Stroke—A Narrative Review on Current Meaning and Clinical Applications of Temporal Muscle Thickness, Area, and Volume

“…Hasegawa [19] 2021 48 TMT changes were directly correlated with energy adequacy in bedridden older adults.…”