Relationship Between Adiposity Indices, Lipodystrophy, and Sarcopenia in HIV-Positive Individuals With and Without Lipodystrophy

Mialich, Mirele Savegnago; Santos, André Pereira dos; Silva, Bruna Ramos da; Paula, Francisco José Albuquerque de; Jordão, Alceu Afonso; Navarro, Anderson Marliere

doi:10.1016/j.jocd.2016.06.007

Cited by 18 publications

(17 citation statements)

References 21 publications

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“…To our knowledge, the negative impact of these 2 morbidities has not previously been reported in the literature. In the most recent series about HIV patients, sarcopenia was often described according to the European consensus with muscle mass being calculated as appendicular skeletal muscle mass/height 2 . This definition is not specific to HIV status, and the cutoffs were not calculated in this specific population.…”

Section: Discussionmentioning

confidence: 99%

“…In the most recent series about HIV patients, sarcopenia was often described according to the European consensus (23) with muscle mass being calculated as appendicular skeletal muscle mass/height 2 . (43)(44)(45) This definition is not specific to HIV status, and the cutoffs were not calculated in this specific population. Until new studies for this subgroup of patients are published, we consider that the PMA measure may probably be also applied to HIV patients.…”

Section: Interpretation With Reference To Other Studiesmentioning

confidence: 99%

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A new definition of sarcopenia in patients with cirrhosis undergoing liver transplantation

et al. 2017

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Although sarcopenia is a common complication of cirrhosis, its diagnosis remains nonconsensual: computed tomography (CT) scan determinations vary and no cutoff values have been established in cirrhotic populations undergoing liver transplantation (LT). Our aim was to compare the accuracy of the most widely used measurement techniques and to establish useful cutoffs in the setting of LT. From the 440 patients transplanted between January 2008 and May 2011 in our tertiary center, we selected 256 patients with cirrhosis for whom a recent CT scan was available during the 4 months prior to LT. We measured different muscle indexes: psoas muscle area (PMA), PMA normalized by height or body surface area (BSA), and the third lumbar vertebra skeletal muscle index (L3SMI). Receiver operating characteristic curves were evaluated and prognostic factors for post-LT 1-year survival were then analyzed. PMA offered better accuracy (area under the curve [AUC] = 0.753) than L3SMI (AUC = 0.707) and PMA/BSA (AUC = 0.732), and the same accuracy as PMA/squared height. So, for its accuracy and simplicity of use, the PMA index was used for the remainder of the analysis and to define sarcopenia. In men, the better cutoff value for PMA was 1561 mm (Se = 94%, Sp = 57%), whereas in women, it was 1464 mm (Se = 52%, Sp = 91%). A PMA lower than these values defined sarcopenia in patients with cirrhosis awaiting LT. One- and 5-year overall survival rates were significantly poorer in the sarcopenic group (n = 57) than in the nonsarcopenic group (n = 199), at 59% versus 94% and 54% versus 80%, respectively (P < 0.001). In conclusion, pre-LT PMA is a simple tool to assess sarcopenia. We established sex-specific cutoff values (1561 mm in men, 1464 mm in women) in a cirrhotic population and showed that 1-year survival was significantly poorer in sarcopenic patients. Liver Transplantation 23 143-154 2017 AASLD.

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Section: Discussionmentioning

confidence: 99%

Section: Interpretation With Reference To Other Studiesmentioning

confidence: 99%

A new definition of sarcopenia in patients with cirrhosis undergoing liver transplantation

et al. 2017

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“…In this regard, while adjusting the confounders such as T-cell count and CD 4 ,weight loss is still an independent predictor of mortality in HIV patients (Leyes et al, 2008). In these patient, in comparison to FFM reduction, weight gain which is mainly fat mass followed by antiviral therapy occurs (Mialich et al, 2017;Milleretal.,1998 (Clark et al, 2000). Rathmacher et al reported that the amino acid mixture, increase hemoglobin, and hematocrit which reflects the higher red blood cell volume, which is in favor of immune function enhancement.…”

Section: Discussionmentioning

confidence: 97%

“…In this regard, while adjusting the confounders such as T‐cell count and CD 4 ,weight loss is still an independent predictor of mortality in HIV patients (Leyes et al, ). In these patient, in comparison to FFM reduction, weight gain which is mainly fat mass followed by antiviral therapy occurs (Mialich et al, ; Miller et al, ). Catabolic state as the main factor, diarrhea and loss of appetite are also associated with upcoming cachexia in AIDS.…”

Section: Discussionmentioning

confidence: 99%

Effect of supplementation with a combination ofl‐arginine,l‐glutamine, and hydroxy methyl butyrate on cachexia: A systematic review

et al. 2018

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Weight loss in the form of cachexia is a comorbid condition which is associated with delayed recovery, especially in cancer and human immunodeficiency virus (HIV)‐infected patients. Arginine (Arg), Glutamine (Gln), and the Leucine metabolite, Hydroxy methyl butyrate (HMB) are substrates which have been investigated due to their potential role in ameliorating muscle mass. We conducted a systematic review to appraise available studies assessing the effect of Arg, Gln, and HMB supplementation on improving body weight and muscle mass in those with pathological conditions. A comprehensive search for studies published between January 1990 and November 2017 was performed. The interested primary outcome of this systematic review was weight. Two reviewers independently searched databases and 125 papers were identified from the initial search, overall, we selected five studies that were suitable for our systematic review. The results of the studies shows that this combination can improve fat free mass, weight and immune function in cachexia and morbid weight loss patients. Practical applications Cachexia is one of the main problems in many chronic diseases. Providing a nutritional support is usually the main concern in patients with severe weight loss due to the impaired appetite and gastrointestinal tract irritation. Among nutrition interventions, Protein and amino acid supplementation receive much attention due to the loss of muscle tissue and the negative balance of protein and nitrogen in patients with severe weight loss. Arg, Gln, and HMB (Arg/Gln/HMB) supplementation can improve weight gain and prevent weight loss in chronic diseases.

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“…considering that "the development of sarcopenia is now recognised to begin earlier in life" (37,46). This considers primary sarcopenia when no other specific cause is evident, and secondary when causal factors are detected such as AIDS, diabetes mellitus, unhealthy lifestyle, hormonal disorders etc (47,48,(49)(50)(51)(52)(53)(54)(55)(56). The EWGSOP2 recognized that strength is better than mass in predicting adverse outcomes (57,58) and made recommendations for diagnosis (59).…”

Section:  Muscle and Bone Compartments -Sarcopeniamentioning

confidence: 99%

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Relationship Between Adiposity Indices, Lipodystrophy, and Sarcopenia in HIV-Positive Individuals With and Without Lipodystrophy

Cited by 18 publications

References 21 publications

A new definition of sarcopenia in patients with cirrhosis undergoing liver transplantation

A new definition of sarcopenia in patients with cirrhosis undergoing liver transplantation

Effect of supplementation with a combination ofl‐arginine,l‐glutamine, and hydroxy methyl butyrate on cachexia: A systematic review

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