Higher malnutrition risk is related to increased intramuscular adipose tissue of the quadriceps in older inpatients: A cross-sectional study

Akazawa, Naoki; Okawa, Naomi; Hino, Toshikazu; Tsuji, Ryota; Tamura, Kimiyuki; Moriyama, Hideki

doi:10.1016/j.clnu.2019.11.028

Cited by 26 publications

(28 citation statements)

References 39 publications

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“…We calculated the ideal body weight using the formula: 22 Â square of height because of its validity [12e14]. The weight-to-ideal body weight ratio was set to 1 if the patient's body weight exceeded the ideal body weight [6,13,14]. These variables were used at the baseline visit in enrollment.…”

Section: Geriatric Nutritional Risk Indexmentioning

confidence: 99%

Prognostic value of malnutrition using geriatric nutritional risk index in patients with coronary chronic total occlusion after percutaneous coronary intervention

et al. 2021

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Background: Malnutrition is associated with poor prognosis in a wide range of chronic illnesses, however, the impact of malnutrition on long-term outcomes of patients at advanced stages of atherosclerosis, coronary chronic artery occlusion (CTO), is not known. Aims: This study aims to investigate the relationship between malnutrition and adverse cardiovascular events in patients with CTO after percutaneous coronary intervention (PCI). Methods: Baseline malnutrition risk was determined in 669 patients with CTO after PCI in this study. All patients were divided into 3 groups according to 3 categories of the geriatric nutritional risk index (GNRI): moderate to severe, GNRI of <92 (n ¼ 70); low, GNRI of 92e98 (n ¼ 197); and absence of risk, GNRI of !98 (n ¼ 402). The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular events (MACE). Results: Average age in this study was 65.32 ± 9.97 years old. More than one-third of patients were at risk of malnutrition (moderate to severe: 10.5%; low: 29.4%; and absence of risk: 60.1%). Over a median follow-up of 33 months, compared to those with absent risk for malnutrition, moderate to severe risk was associated with significantly increased risk for the all-cause death, cardiovascular death and MACE (hazard ratio [HR]: 2.90, 95% confidence interval [CI]: 1.43 to 5.87, P for trend ¼ 0.002; HR: 3.72, 95% CI: 1.42 to 9.77, P for trend ¼ 0.010; HR: 1.76, 95% CI: 1.02 to 3.03, P for trend ¼ 0.040; respectively) after adjustment for baseline variables. Moreover, addition of the GNRI score significantly raised the predictive value for the all-cause death (0.383, p ¼ 0.004 and 0.022, p ¼ 0.011, NRI and IDI respectively), cardiovascular death (0.488, p < 0.001 and 0.013, p ¼ 0.014, NRI and IDI respectively) and MACE (0.368, p ¼ 0.004 and 0.014, p ¼ 0.008, NRI and IDI respectively) as compared to traditional factors. Conclusions: Malnutrition assessed by the GNRI score on admission was an independent predictor for adverse cardiovascular events in CTO patients after PCI. Addition of the GNRI score to the existing risk prediction model significantly increased the predictive ability for cardiovascular events in CTO patients after PCI.

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Section: Geriatric Nutritional Risk Indexmentioning

confidence: 99%

Prognostic value of malnutrition using geriatric nutritional risk index in patients with coronary chronic total occlusion after percutaneous coronary intervention

et al. 2021

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“…More recently, the International Society of Physical and Rehabilitation Medicine special interest group on sarcopenia included the quadriceps thickness as an indicator of muscle mass in the diagnosis criteria of sarcopenia. 32 Furthermore, intramuscular adipose tissue of the quadriceps is related to swallowing ability, 33 , 34 nutritional status, 35 aerobic capacity, 36 and occurrence of hospital‐associated complications (i.e. delirium, functional decline, incontinence, falls, pressure injuries, and nosocomial infections).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

Akazawa

Kishi²,

Hino³

et al. 2021

J cachexia sarcopenia muscle

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Background The longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living (ADL) in older inpatients remains unclear. This study aimed to examine whether decrease of intramuscular adipose tissue of the quadriceps in older inpatients is related to the recovery of ADL than increase of muscle mass. Methods This longitudinal study included 202 inpatients aged ≥65 years [median age: 83.0 (77.0–88.0), 56.4% female]. Recovery of ADL during hospital stay was assessed using the change in Barthel index (BI) score (i.e. BI score at discharge minus BI score at admission) and BI score at discharge. Intramuscular adipose tissue and muscle mass of the quadriceps were assessed using echo intensity and muscle thickness on ultrasound images, respectively. Higher echo intensity indicates greater intramuscular adipose tissue. Multiple regression analysis was performed to identify the factors independently associated with the change in BI score and BI score at discharge. Changes in quadriceps echo intensity and thickness and subcutaneous fat thickness of the thigh, quadriceps echo intensity and thickness, and subcutaneous fat thickness of the thigh at admission, age, sex, days from onset disease, BI score at admission, and disease were set as independent variables. Results The means of the change in quadriceps echo intensity and thickness were −2.3 ± 15.7 and 0.1 ± 0.4 cm, respectively. The median of the change in BI score was 15.0 (0.0–30.0). The quadriceps echo intensity at discharge was significantly lower than at admission (P = 0.043). The quadriceps thickness (P = 0.004) and BI score at discharge (P < 0.001) were significantly higher than those at admission. Change in quadriceps echo intensity was independently and significantly associated with the change in BI score (β = −0.25, P = 0.006) and BI score at discharge (β = −0.18, P = 0.006). In contrast, change in quadriceps thickness was not independently and significantly associated with the change in BI score (β = 0.09, P = 0.244) and BI score at discharge (β = 0.06, P = 0.244). Conclusions Our study indicates that a decrease of intramuscular adipose tissue of the quadriceps is related to the recovery of ADL than an increase of muscle mass in older inpatients. Intramuscular adipose tissue of the quadriceps in older inpatients is considered to be a predictor for the recovery of ADL, and intervening for intramuscular adipose tissue may be important for improving ADL in older inpatients.

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“…Previous studies revealed that low BMI caused by uncontrolled glycaemia was correlated with an increased risk of DR. 32,33 Other studies discovered that high BMI or overnutrition, accompanied by hypertension and hyperlipidemia, brought about oxidative stress and inflammation, and then resulted in endothelial dysfunction, ultimately leading to the progression of DR. 34,35 Thus, the relationship between BMI and DR remains inconsistent. Abdominal obesity is considered as the risk for DR. 36 However, Muhammad et al discovered that WC was inversely associated with the severity of DR. 32 The current research suggested that there was no relationship between BMI and DR. Nevertheless, the association of BMI and PNI level with DR was mutually independent.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Epidemiological Analysis of Prognostic Nutritional Index Associated with Diabetic Retinopathy

Yang¹,

Yu²,

Pan³

et al. 2021

DMSO

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Purpose Prognostic nutritional index (PNI) is an effective tool to evaluate the nutritional conditions and predict prognosis, but clinical data are limited for the use of PNI in diabetic retinopathy (DR). This study aimed to investigate the relationship of PNI with the prevalence and severity of DR in patients with type 2 diabetes mellitus (T2DM). Patients and Methods This cross-sectional analysis enrolled 1023 individuals with T2DM hospitalized between 2017–2020. PNI was calculated as 10 × serum albumin (g/l) + 0.005 × total lymphocyte count (cells/mL). DR severity was categorized as no, nonproliferative, and vision-threatened DR (VTDR) according to the modified Airlie House classification. Multivariate-adjusted odds ratio (OR) with 95% confidence interval (CI) for the prevalent DR in the top (Q4) compared with the bottom quartile (Q1) of PNI levels were estimated by using logistic regression analyses. Results PNI levels were significantly lower in individuals with VTDR than those with no and nonproliferative DR (both P < 0.001), and the proportions of individuals with DR were significantly decreased in the top quartile compared with the bottom quartile of PNI levels ( P < 0.001). After adjustments for age, gender, DM duration, obesity-related risk factors and clinical biochemical parameters, the higher levels of PNI were significantly associated with a lower prevalence of DR (Q4 vs Q1: OR = 0.402, 95% CI: 0.250–0.649, P < 0.001), with a 5.9% reduction in the prevalence of DR for a per-unit increment in the levels of PNI (OR = 0.941, 95% CI: 0.911–0.972, P < 0.001). The association of PNI and obesity-related indexes (body mass index and waist circumference) with the severity of DR was independent of each other (P<0.001). Conclusion PNI was inversely and independently associated with the severity and prevalence of DR, which suggested that PNI could likely be used to predict DR prognosis in clinical practice.

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Higher malnutrition risk is related to increased intramuscular adipose tissue of the quadriceps in older inpatients: A cross-sectional study

Cited by 26 publications

References 39 publications

Prognostic value of malnutrition using geriatric nutritional risk index in patients with coronary chronic total occlusion after percutaneous coronary intervention

Prognostic value of malnutrition using geriatric nutritional risk index in patients with coronary chronic total occlusion after percutaneous coronary intervention

Longitudinal relationship between intramuscular adipose tissue of the quadriceps and activities of daily living in older inpatients

A Clinical Epidemiological Analysis of Prognostic Nutritional Index Associated with Diabetic Retinopathy

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