Skeletal Muscle and Fat Mass Indexes Predict Discharge Disposition after Radical Cystectomy

Albersheim, Jacob; Sathianathen, Niranjan; Zabell, Joseph; Renier, Joseph; Bailey, Trent; Hanna, Peter; Konety, Badrinath R.; Weight, Christopher J.

doi:10.1097/ju.0000000000000450

Cited by 17 publications

(26 citation statements)

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“…Slice-O-Matic software (V.5.0, TomoVision, Montreal, Quebec, Canada) was used for image analysis by setting attenuation thresholds from −29 to 150 Hounsfield units (HU) for skeletal muscle, −150 to −30 HU for visceral adipose tissue and −190 to −30 HU for intramuscular/subcutaneous adipose tissue. 21 Each type of tissue found in each L3 CT image was then shaded with a different colour, corresponding to these thresholds. Data outputs for the area in cm 2 and the CT attenuation of each tissue type in each CT image were collected and used to calculate the SMI, MMA and FMI.…”

Section: Methodsmentioning

confidence: 99%

Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Yang

Zhang

Sun

et al. 2021

BMJ Open Diab Res Care

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IntroductionSince the ratio of creatinine to cystatin C (Cre/CysC) can reflect muscle volume, it has been proven to be a predictor of sarcopenia in patients with or without diabetes. Here, we investigated the predictive value of Cre/CysC for the skeletal muscle composition and its correlations with glucose disposal ability and diabetic complications in patients with type 2 diabetes.Research design and methodsThe skeletal muscle index (SMI) and mean skeletal muscle attenuation (MMA) values of 193 patients with type 2 diabetes were obtained through analyses of CT images at the lumbar 3 level.ResultsSerum Cre/CysC was significantly correlated with both the SMI (r=0.375, p<0.001) and MMA (r=0.378, p<0.001). Multiple stepwise linear regression analysis demonstrated that Cre/CysC was the only biochemical predictor of the SMI (β=0.48 (95% CI 0.02 to 0.94)) and MMA (β=0.57 (95% CI 0.14 to 1.01)). Furthermore, the fat mass index (FMI) was significantly associated with the MMA (r=−0.481, p<0.001) but not the SMI (r=0.101, p=0.164). In the diabetic complications analysis, Cre/CysC was significantly lower in patients with cardiovascular disease (95% CI (−1.47 to –0.22), p=0.008) and lower extremity arterial disease (95% CI (−1.44 to –0.29), p=0.004). Moreover, in the 100 g steamed bun test, Cre/CysC was significantly correlated with glucose levels at 60 min (r=−0.162, p=0.045), 120 min (r=−0.287, p<0.001) and 180 min (r=−0.313, p<0.001).ConclusionsCre/CysC may be a valuable predictor of skeletal muscle composition in type 2 diabetes. Patients with a higher Cre/CysC may have a better ability to dispose of postprandial glucose and are at a lower risk of macrovascular disease.

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Section: Methodsmentioning

confidence: 99%

Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Yang

Zhang

Sun

et al. 2021

BMJ Open Diab Res Care

View full text Add to dashboard Cite

show abstract

“…The skeletal muscle is a principal site of usage of glucose and fatty acids, and is one of the primary tissues responsible for insulin resistance in obesity and type 2 diabetes [71]. The skeletal muscle plays a crucial role in energy homeostasis by clearing serum-free fatty acid, whole-body FAO, and lipid utilization [72].…”

Section: Leu and Lipid Metabolism In Skeletal Musclementioning

confidence: 99%

Leucine Supplementation: A Novel Strategy for Modulating Lipid Metabolism and Energy Homeostasis

Zhang

Guo

et al. 2020

Nutrients

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Lipid metabolism is an important and complex biochemical process involved in the storage of energy and maintenance of normal biological functions. Leucine, a branched amino acid, has anti-obesity effects on glucose tolerance, lipid metabolism, and insulin sensitivity. Leucine also modulates mitochondrial dysfunction, representing a new strategy to target aging, neurodegenerative disease, obesity, diabetes, and cardiovascular disease. Although various studies have been carried out, much uncertainty still exists and further studies are required to fully elucidate the relationship between leucine and lipid metabolism. This review offers an up-to-date report on leucine, as key roles in both lipid metabolism and energy homeostasis in vivo and in vitro by acceleration of fatty acid oxidation, lipolysis, activation of the adenosine 5′-monophosphate-activated protein kinase (AMPK)–silent information regulator of transcription 1 (SIRT1)–proliferator-activated receptor γ coactivator-1α (PGC-1α) pathway, synthesis, and/or secretion of adipokines and stability of the gut microbiota.

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“…The urologic, trauma, and orthopedic specialties have likewise found utility in preoperative CT-measured SMM for determining postoperative destination. 43-47…”

Section: Discussionmentioning

confidence: 99%

Skeletal Muscle Index’s Impact on Discharge Disposition After Head and Neck Cancer Free Flap Reconstruction

Jones

Campiti

Alwani

et al. 2020

Otolaryngol.--head neck surg.

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Objective To determine the role of skeletal muscle index (SMI) in the assessment of frailty and determination of discharge to post–acute care facilities (PACF) after head and neck cancer free flap reconstruction (HNCFFR). Study Design Retrospective cohort. Setting Single-institution, academic tertiary referral center. Methods Adult patients undergoing HNCFFR from 2014 to 2019 with preoperative abdominal computed tomography imaging were retrospectively analyzed. Patient demographics, 5-factor modified frailty index (5-mFI), body mass index (BMI), SMI at the third lumbar vertebra, oncologic history, perioperative data, and Clavien-Dindo (CD) complications were collected. Binary logistic regression was used to identify independent predictors of discharge disposition. Results The cohort consisted of 206 patients, 62 (30.1%) of whom were discharged to PACF. Patients discharged to PACF were of older age (65.4 vs 57.1 years, P < .0001) and had a lower SMI (38.8 vs 46.8 cm2/m2, P < .0001), higher 5-mFI (≥3; 25.8% vs 4.2%, P < .0001), and greater incidence of stage IV (80.6% vs 64.1%, P = .0211) aerodigestive cancer (80.6% vs 66.7%, P = .0462). Patients discharged to PACF experienced more blood transfusions (74.2% vs 35.4%, P < .0001), major postoperative complications (CD ≥3, 40.3% vs 12.9%, P < .0001), and delirium (33.9% vs 4.2%, P < .0001). After adjusting for pre- and postoperative factors, multivariate binary logistic regression identified age ( P = .0255), 5-mFI ( P < .0042), SMI ( P = .0199), stage IV cancer ( P = .0250), aerodigestive tumor ( P = .0366), delirium ( P < .0001), and perioperative blood transfusion ( P = .0144) as independent predictors of discharge to PACF. Conclusions SMI and 5-mFI are independently associated with discharge to PACF after HNCFFR and should be considered in preoperative planning and assessment of frailty.

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Skeletal Muscle and Fat Mass Indexes Predict Discharge Disposition after Radical Cystectomy

Cited by 17 publications

References 0 publications

Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Cre/CysC ratio may predict muscle composition and is associated with glucose disposal ability and macrovascular disease in patients with type 2 diabetes

Leucine Supplementation: A Novel Strategy for Modulating Lipid Metabolism and Energy Homeostasis

Skeletal Muscle Index’s Impact on Discharge Disposition After Head and Neck Cancer Free Flap Reconstruction

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