P1566SKELETAL MUSCLE MASS BY COMPUTED TOMOGRAPHY AT THE LEVEL OF THE THIRD LUMBAR VERTEBRA AND MORTALITY IN END-STAGE KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alice Sabatino ◽  
Giuseppe Regolisti ◽  
Marco Delsante ◽  
Tommaso Di motta ◽  
Alice Parmigiani ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Ct Scan ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lumbar Vertebra ◽  
Chronic Hemodialysis ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
Fourth Quartile

Abstract Background and Aims Protein-Energy Wasting (PEW) is highly prevalent in patients with end-stage kidney disease on chronic hemodialysis (ESKD-HD). In such clinical setting PEW is associated to poor outcomes. The assessment of nutritional status is essential for the identification of patients at risk for the development of PEW. In the contest of nutritional evaluation, increasing attention is currently paid to the assessment of muscle mass, which represent the major protein asset in the body. Currently available bedside tools used for the assessment of nutritional status are not accurate enough for the assessment o skeletal muscle mass. In this clinical setting, the use of “gold standard” imaging methods (such as CT sca, DEXA or MRI) could allow a more accurate assessment of body composition. The aim of our study was to assess the correlation between skeletal muscle mass on the level of the third lumbar vertebra (L3) assessed by CT scan with mortality in ESKD-HD. Method In a retrospective observational study, 1260 ESKD-HD patients undergoing chronic hemodialysis treatment were identified between 2008 and 2015 in the Dialysis Centers of the National Health Service in the province of Parma. Among these patients, those with at least one available abdomen CT scan after the patient had already been on dialysis for at least 6 months were enrolled. The CT images obtained at the level corresponding to the L3 were analyzed using a dedicated software, in order to extrapolate the data related to the quantity of skeletal muscle tissue. Results We enrolled 183 ESKD-HD patients, aged 68.8 (± 15.1) yrs, 64% (117/183) males, median hemodialysis vintage 43.9 (range 6 – 208) months. The cohort was characterized by a high comorbidity burden, with a median Charlson Comorbidity Index of 9 (range 2-17). Baseline skeletal muscle mass at L3 was 118.5 cm2 (± 30.6). Median follow-up was 65.6 (range 6.6 – 132.5) months. During follow-up, 67% (122/183) of patients died. Patients were divided based on quartiles of muscle mass. Patients in the first quartile had 83% mortality, while mortality of patients in the fourth quartile was 52% (OR = 4.16 95% CI = 1.59 – 10.87; P = 0.003). Kaplan-Meier analysis identified significantly lower survival in patients in the first quartile of muscle mass compared to those in the fourth quartile (P = 0.03 at the Mantel-Cox Log-rank test) (Figure 1). Conclusion Low muscle mass by CT scan appears to be associated with an increased risk of mortality in ESKD on chronic hemodialysis.

scholarly journals Protein intake per day and at each daily meal and skeletal muscle mass declines among older community dwellers in Japan

2019 ◽  
Vol 23 (6) ◽  
pp. 1090-1097 ◽  
Author(s):  
Rei Otsuka ◽  
Yuki Kato ◽  
Chikako Tange ◽  
Yukiko Nishita ◽  
Makiko Tomida ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Total Protein ◽  
Protein Intake ◽  
Skeletal Muscle Mass ◽  
Total Protein Intake ◽  
Dietary Records ◽  
Logistic Modelling ◽  
Community Dwellers

AbstractObjective:To examine associations between protein intake per day and at different meals and skeletal muscle mass declines.Design:Two-year prospective cohort study among older community dwellers.Setting:National Institute for Longevity Sciences–Longitudinal Study of Aging (NILS-LSA) in Japan.Participants:Older men (n 292) and women (n 363) aged 60–87 years who participated in the baseline (2006–2008) and follow-up studies (2008–2010) of NILS-LSA and did not exhibit low skeletal muscle mass at baseline. Muscle mass was assessed using dual-energy X-ray absorptiometry at baseline and follow-up. Low muscle mass was defined as skeletal muscle mass index <7·0 kg/m2 for men and <5·4 kg/m2 for women at follow-up. Daily protein intake and protein intake at each meal were calculated from 3 d dietary records at baseline and sex-stratified tertiles were determined.Results:Mean (sd) protein intake at breakfast, lunch and dinner was 22·7 (7·8), 26·7 (9·3) and 37·4 (10·5) g for men and 19·3 (6·3), 23·2 (7·3) and 28·5 (7·0) g for women, respectively. After adjusting for age, baseline skeletal muscle mass and other confounders in logistic modelling, greater total protein intake was associated with lower prevalence of skeletal muscle mass decline among men at follow-up (P = 0·024). Particularly, the OR (95 % CI) for high lunchtime protein intake was low (0·11 (0·02, 0·61); P = 0·01). No significant association between total protein intake and prevalence of skeletal muscle mass decline was found among women.Conclusions:High total protein intake, particularly at lunchtime, is associated with retention of skeletal muscle mass in men.

scholarly journals Effect of Exercise Habit on Skeletal Muscle Mass Varies with Protein Intake in Elderly Patients with Type 2 Diabetes: A Retrospective Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3220 ◽  
Author(s):  
Yoshitaka Hashimoto ◽  
Ayumi Kaji ◽  
Ryosuke Sakai ◽  
Fuyuko Takahashi ◽  
Rena Kawano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Cohort Study ◽  
Muscle Mass ◽  
Protein Intake ◽  
Retrospective Cohort ◽  
Skeletal Muscle Mass ◽  
Exercise Habit

Exercise has been reported to be effective in maintaining and recovering muscle; however, the effect of exercise combined with adequate or inadequate protein intake on muscle mass is not clear. Therefore, this study investigates the effect of exercise habit on changes in muscle mass, with adequate or inadequate protein intake. This retrospective cohort study included 214 elderly patients with type 2 diabetes. The rate of skeletal muscle mass index (SMI) change (%) was defined as ((SMI at follow-up minus SMI at baseline)/(follow-up years [kg/m2/year] × SMI at baseline [kg/m2])) × 100. Adequate protein intake was defined as protein intake ≥1.2 g/kg ideal body weight/day. During a mean follow-up duration of 18.0 (7.1) months, the rate of SMI change was −1.14 (4.10)% in the whole sample. The rate of SMI change of non-habitual exercisers with inadequate protein intake, habitual exercisers with inadequate protein intake, non-habitual exercisers with adequate protein intake, and habitual exercisers with adequate protein intake was −1.22 (3.71), −2.31 (3.30), −1.88 (4.62), and 0.36 (4.29)%, respectively. Compared with patients with exercise habit and adequate protein intake, the odds ratio for decreasing SMI was 2.50 (0.90–6.90, p = 0.078) in patients with no exercise habit and inadequate protein intake, 3.58 (1.24–10.4, p = 0.019) in those with exercise habit and inadequate protein intake, and 3.03 (1.27–7.22, p = 0.012) in those with no exercise habit and adequate protein intake, after adjusting for covariates. Therefore, exercise habit without adequate protein intake was associated with an increased risk of decreasing SMI compared with exercise habit with adequate protein intake.

scholarly journals Loss of Skeletal Muscle Mass Affects the Incidence of Minimal Hepatic Encephalopathy: A Case Control Study

2020 ◽  
Author(s):  
Masakuni Tateyama ◽  
Hideaki Naoe ◽  
Motohiko Tanaka ◽  
Kentaro Tanaka ◽  
Satoshi Narahara ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Mass Loss ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lumbar Vertebra ◽  
Minimal Hepatic Encephalopathy ◽  
Skeletal Muscle Index ◽  
Muscle Mass Loss

Abstract Background: Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy.Methods: To clarify the relationship between minimal hepatic encephalopathy and sarcopenia and/or muscle mass loss in patients with liver cirrhosis. Ninety-nine patients with liver cirrhosis were enrolled. Minimal hepatic encephalopathy was diagnosed by a neuropsychiatric test. Skeletal mass index was calculated by dividing muscle area at the third lumbar vertebra by the square of height in meters.Results: MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. Skeletal muscle index was smaller in patients with minimal hepatic encephalopathy (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Skeletal muscle index represented a predictive factor related to minimal hepatic encephalopathy (<50 cm2/m2; odds ratio 0.300, P = 0.002).Conclusions: Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

scholarly journals Effect of Dairy Protein Intake on Muscle Mass among Korean Adults: A Prospective Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2537
Author(s):  
Eunjin So ◽  
Hyojee Joung
Keyword(s):  
Skeletal Muscle ◽  
Cohort Study ◽  
Muscle Mass ◽  
Protein Intake ◽  
Skeletal Muscle Mass ◽  
Cox Proportional Hazards ◽  
Middle Aged ◽  
Dairy Consumption ◽  
Dairy Protein

This cohort study aimed to identify the associations of dairy protein intake with the risk of developing a low muscle mass during a 12-year follow-up period, using data from 4412 middle-aged Korean Genome and Epidemiology Study participants with a normal baseline muscle mass. Dairy protein intake at baseline was assessed using a semi-quantitative Food Frequency Questionnaire. Skeletal muscle mass index (SMI), defined as the weight-adjusted skeletal muscle mass, was measured biennially using multi-frequency bioelectrical impedance analyses. Cox proportional hazards regression analysis was used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Overall, 395 subjects developed a low SMI (%) during an average follow-up of 141 (19–152) months. The average consumption of milk and other dairy products was 73.6 and 104.1 g/day, respectively. In men, a higher dairy protein intake was associated with a decreased risk of developing a low SMI (tertile 3 [T3] vs. T1, HR: 0.63; 95% CI: 0.42, 0.94; p for trend = 0.029). In a stratified analysis according to a total protein intake, this association was stronger in the lower-protein intake group (HR: 0.59; 95% CI: 0.35, 0.99; p for trend = 0.036) but not detected in the higher-protein intake group. Men who consumed milk ≥1 time/day had a significantly lower risk of developing a low SMI (HR: 0.62; 95% CI: 0.39, 0.98; p for trend = 0.023). No significant associations were observed in women. In summary, dairy consumption appears to be beneficial for decreasing the risk of developing a low muscle mass in middle-aged Korean men.

Dietary betaine intake is associated with skeletal muscle mass change over 3 years in middle-aged adults: the Guangzhou Nutrition and Health Study

2020 ◽  
pp. 1-8
Author(s):  
Jing-An Long ◽  
Rong-Huan Zhong ◽  
Si Chen ◽  
Fan Wang ◽  
Yun Luo ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Health Study ◽  
Middle Aged ◽  
Nutrition And Health ◽  
Skeletal Mass ◽  
Age Related ◽  
Middle Aged Adults

Abstract A higher dietary intake or serum concentration of betaine has been associated with greater lean body mass in middle-aged and older adults. However, it remains unknown whether betaine intake is associated with age-related loss of skeletal muscle mass (SMM). We assessed the association between dietary betaine intake and relative changes in SMM after 3 years in middle-aged adults. A total of 1242 participants aged 41–60 years from the Guangzhou Nutrition and Health Study 2011–2013 and 2014–2017 with body composition measurements by dual-energy X-ray absorptiometry were included. A face-to-face questionnaire was used to collect general baseline information. After adjustment for potential confounders, multiple linear regression found that energy-adjusted dietary betaine intake was significantly and positively associated with relative changes (i.e. percentage loss or increase) in SMM of legs, limbs and appendicular skeletal mass index (ASMI) over 3 years of follow-up (β 0·322 (se 0·157), 0·309 (se 0·142) and 0·303 (se 0·145), respectively; P < 0·05). The ANCOVA models revealed that participants in the highest betaine tertile had significantly less loss in SMM of limbs and ASMI and more increase in SMM of legs over 3 years of follow-up, compared with those in the bottom betaine tertile (all Ptrend < 0·05). In conclusion, our findings suggest that elevated higher dietary betaine intake may be associated with less loss of SMM of legs, limbs and ASMI in middle-aged adults.

Association of Serum Indoxyl Sulfate Levels with Skeletal Muscle Mass and Strength in Chronic Hemodialysis Patients: A 2-year Longitudinal Analysis

2020 ◽  
Vol 107 (3) ◽  
pp. 257-265
Author(s):  
Yu-Li Lin ◽  
Chin-Hung Liu ◽  
Yu-Hsien Lai ◽  
Chih-Hsien Wang ◽  
Chiu-Huang Kuo ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Longitudinal Analysis ◽  
Skeletal Muscle Mass ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Indoxyl Sulfate

scholarly journals Impact of skeletal muscle mass in patients with recurrent gastric cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tomoyuki Matsunaga ◽  
Hiroaki Satio ◽  
Wataru Miyauchi ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Side Effects ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Univariate Analysis ◽  
Lumbar Vertebra ◽  
Histological Type ◽  
Recurrent Gastric Cancer ◽  
Grade 3

Abstract Background We retrospectively examined the relationship among skeletal muscle mass index (SMI), prognosis, and chemotherapy side effects in patients with recurrent gastric cancer (RGC). Methods Sixty-seven patients who developed recurrence after undergoing curative gastrectomy for gastric cancer at Tottori University Hospital and received palliative chemotherapy were included in this study. Pretreatment computed tomography was performed to measure the skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra. We focused on haematologic toxicity (neutropenia, thrombocytopenia, and anaemia), febrile neutropenia, and gastrointestinal toxicity (diarrhoea, vomiting, and stomatitis) as the side effects of chemotherapy. Results Median SMIs for males and females (43.9 and 34.7 cm2/m2, respectively) were used as cutoff values. The patients were classified into high (SMIHigh; n = 34) and low SMI groups (SMILow; n = 33). The SMILow group included more patients treated with monotherapy (P = 0.016) compared with the SMIHigh group, had a significantly lower number of chemotherapy lines (P = 0.049), and had a significantly higher incidence of grade 3 or 4 side effects (P = 0.010). The median survival rate was significantly higher in the SMIHigh group (17.8 vs 15.8 months; P = 0.034). In the univariate analysis, body mass index, SMI, histological type, and prognostic nutritional index were identified as prognostic indicators. The multivariate analysis identified SMI (P = 0.037) and histological type (P = 0.028) as independent prognostic factors. Conclusion The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow RGC. SMI was a useful prognostic marker of RGC.

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