Skeletal Muscle Composition Predicts Outcome in Critically Ill Patients

Loosen, Sven H.; Schulze-Hagen, Maximilian; Püngel, Tobias; Bündgens, Lukas; Wirtz, Theresa H.; Kather, Jakob Nikolas; Vucur, Mihael; Paffenholz, Pia; Demir, Münevver; Bruners, Philipp; Kuhl, Christiane K.; Tacke, Frank; Luedde, Tom; Koch, Alexander; Roderburg, Christoph

doi:10.1097/cce.0000000000000171

Cited by 35 publications

(34 citation statements)

References 30 publications

(33 reference statements)

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“…This result is also consistent with a previous study showing that Cre/CysC predicts muscle strength in patients with non-dialysis-requiring chronic kidney disease [11]. Moreover, both the SMI and MMA are independent predictors of the outcome in critically ill patients [21]. Therefore, Cre/CysC has also been proven to be a predictor of outcome in patients treated in the ICU [22,23].…”

Section: Discussionsupporting

confidence: 91%

The Cre/CysC Ratio Can Predict Muscle Composition and is Associated with Glucose Disposal Ability and Macrovascular Disease in Patients with Type 2 Diabetes

et al. 2021

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Background: Since the ratio of creatinine to cystatin C (Cre/CysC) can re ect 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 in skeletal muscle composition and its correlations with glucose disposal ability and diabetic complications in patients with type 2 diabetes. Methods: The 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.Results: Serum Cre/CysC was signi cantly 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 [b = 0.48, (95% Cl, 0.02 to 0.94) and MMA [b= 0.57, (95% Cl, 0.14 to 1.01). In the diabetic complications analysis, Cre/CysC was negatively correlated with cardiovascular disease (r = -0.190, P = 0.008) and lower extremity arterial disease (r = -0.209, P = 0.004). Moreover, in the 100 g steamed bun test, Cre/CysC was signi cantly 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).Conclusions: Cre/CysC is a valuable predictor of skeletal muscle composition in type 2 diabetes. Patients with higher levels of Cre/CysC may have a better ability to dispose of postprandial glucose and lower risk of macrovascular disease.

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Section: Discussionsupporting

confidence: 91%

The Cre/CysC Ratio Can Predict Muscle Composition and is Associated with Glucose Disposal Ability and Macrovascular Disease in Patients with Type 2 Diabetes

et al. 2021

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“…Without doubt, the evolving field of CT-based body composition analysis shows great potential for being implemented soon into the clinical practice. [104], [105], [108] Low VAT at the time of intensive care unit admission is associated with increased mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The CT-determined loss of skeletal muscle mass at the level of the 3rd lumbar vertebra was associated with longer hospital stays [104] and higher 30-day mortality [104], [105], [106], [107] in patients admitted to the intensive care unit (ICU). Interestingly, one study found no correlation between the initial BCA parameters measured from the CT obtained at the time of the hospital admission and mortality but those who experienced a loss of muscle and fat tissue during the hospital stay had increased mortality [108].…”

Section: The Ct-determined Loss Of Skeletal Muscle Mass In Clinical Contextmentioning

confidence: 99%

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

Tolonen

Pakarinen

Sassi

et al. 2021

European Journal of Radiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…19 Therefore, the loss of muscle is a characteristic phenomenon of protein deficiency and a predictor of clinical outcomes. [43][44][45][46][47]…”

Section: Protein Deficiency and Clinical Outcomes Protein Deficiencymentioning

confidence: 99%

Metabolism of Proteins and Amino Acids in Critical Illness: From Physiological Alterations to Relevant Clinical Practice

Hsu¹,

Sun²,

Tsai³

et al. 2021

JMDH

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The clinical impact of nutrition therapy in critically ill patients has been known for years, and relevant guidelines regarding nutrition therapy have emphasized the importance of proteins. During critical illness, such as sepsis or the state following major surgery, major trauma, or major burn injury, patients suffer from a high degree of stress/inflammation, and during this time, metabolism deviates from homeostasis. The increased degradation of endogenous proteins in response to stress hormones is among the most important events in the acute phase of critical illness. Currently published evidence suggests that adequate protein supplementation might improve the clinical outcomes of critically ill patients. The role of sufficient protein supplementation may even surpass that of caloric supplementation. In this review, we focus on relevant physiological alterations in critical illness, the effects of critical illness on protein metabolism, nutrition therapy in clinical practice, and the function of specific amino acids.

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Skeletal Muscle Composition Predicts Outcome in Critically Ill Patients

Abstract: Supplemental Digital Content is available in the text.

Cited by 35 publications

References 30 publications

The Cre/CysC Ratio Can Predict Muscle Composition and is Associated with Glucose Disposal Ability and Macrovascular Disease in Patients with Type 2 Diabetes

The Cre/CysC Ratio Can Predict Muscle Composition and is Associated with Glucose Disposal Ability and Macrovascular Disease in Patients with Type 2 Diabetes

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

Metabolism of Proteins and Amino Acids in Critical Illness: From Physiological Alterations to Relevant Clinical Practice

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