scholarly journals Adipose tissue is a predictor of 30-days mortality in patients with bloodstream infection caused by carbapenem-resistant Klebsiella pneumoniae 

2021 ◽  
Author(s):  
weiyang cai ◽  
piaopiao ying ◽  
yinchai ye ◽  
jianzhong ye ◽  
jiajing chen
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Bloodstream Infection ◽  
Cox Regression ◽  
Statistical Significance ◽  
The Body ◽  
Pneumonia Severity ◽  
Carbapenem Resistant ◽  
All Cause Mortality ◽  
Total Adipose Tissue

Abstract Background Prevalence of CRKP bloodstream infection with high mortality has attached physicians' attention. High-VAT and high-SAT were confirmed by previous studies that closely related to increased pneumonia severity, more complications, and higher mortality in COVID-19. Thus, we speculate that CT-quantified body composition may also be connected to all-cause mortality and bacterial clearance in patients with CRKP bloodstream infection. Methods We investigated the associations of CT-quantified body composition with CRKP bloodstream infectious patients. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body composition was analyzed using the Cox regression model, and precise clinical nomograms were established. Results Factors associated with 30-day all-in hospital mortality included TAT [adjusted odds ratio (OR) = 1.028, 95% confidence interval (CI), 1.004–1.053; p = 0.028], age [OR = 1.031, 95% CI, 1.001–1.062; p = 0.046] and SOFA score [OR = 1.137, 95% CI 1.047–1.235; p = 0.002]. Compared with low-VAT, patients with high-VAT show a strikingly poor prognosis in both 30-day mortality (P = 0.0449, Fig. 2A) and all-cause mortality (P = 0.0048, Fig. 2C). The results of TAT were similar with VAT. Conclusions Our study suggests that CT-derived composition could be a credible and effective alternative to assess the prognosis of patients with BSIs owing to CRKP. CT-quantified total adipose tissue, age and SOFA scores were independently associated with 30-day all-cause mortality in these severe infectious patients, while skeletal muscle did not have obvious statistical significance.

scholarly journals Adipose Tissue is a Predictor of 30-days Mortality in Patients with Bloodstream Infection Caused by Carbapenem-Resistant Klebsiella Pneumoniae

2021 ◽  
Author(s):  
piaopiao ying ◽  
jiajing chen ◽  
yinchai ye ◽  
jiayong ye ◽  
weiyang cai
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Bloodstream Infection ◽  
Cox Regression ◽  
Statistical Significance ◽  
The Body ◽  
Pneumonia Severity ◽  
Carbapenem Resistant ◽  
All Cause Mortality ◽  
Total Adipose Tissue

Abstract Background: Prevalence of CRKP bloodstream infection with high mortality has attached physicians' attention. High-VAT and high-SAT were confirmed by previous studies that closely related to increased pneumonia severity, more complications, and higher mortality in COVID-19. Thus, we speculate that CT-quantified body composition may also be connected to all-cause mortality and bacterial clearance in patients with CRKP bloodstream infection. Methods: We investigated the associations of CT-quantified body composition with CRKP bloodstream infectious patients. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body composition was analyzed using the Cox regression model, and precise clinical nomograms were established. Results: Factors associated with 30-day all-in hospital mortality included TAT [adjusted odds ratio (OR)=1.028, 95% confidence interval (CI), 1.004–1.053; p = 0.028], age [OR=1.031, 95% CI, 1.001–1.062; p = 0.046] and SOFA score [OR=1.137, 95% CI 1.047–1.235; p = 0.002]. Compared with low-VAT, patients with high-VAT show a strikingly poor prognosis in both 30-day mortality (P=0.0449, Figure 2A) and all-cause mortality (P=0.0048, Figure 2C). The results of TAT were similar with VAT. Conclusions: Our study suggests that CT-derived composition could be a credible and effective alternative to assess the prognosis of patients with BSIs owing to CRKP. CT-quantified total adipose tissue, age and SOFA scores were independently associated with 30-day all-cause mortality in these severe infectious patients, while skeletal muscle did not have obvious statistical significance.

scholarly journals Risk Factors of 30-Day All-Cause Mortality in Patients with Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infection

2021 ◽  
Vol 11 (7) ◽  
pp. 616
Author(s):  
Keh-Sen Liu ◽  
Yao-Shen Tong ◽  
Ming-Tsung Lee ◽  
Hung-Yu Lin ◽  
Min-Chi Lu
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Carbapenem Resistant ◽  
All Cause Mortality ◽  
Insight Into ◽  
Antimicrobial Regimen

An optimal antimicrobial regimen for the treatment of patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection (BSI) is currently unavailable. This study aimed to identify the appropriate antibiotics and the risk factors of all-cause mortality for CRKP BSI patients. This retrospective cohort study included the hospitalized patients with CRKP BSI. Primary outcome was 30-day all-cause mortality. Cox regression analysis was used to evaluate the risk factors of 30-day mortality. A total of 89 patients were included with a 30-day mortality of 52.1%. A total of 52 (58.4%) patients were treated with appropriate antimicrobial regimens and 58 (65.2%) isolates carried blaKPC-2 genes. Microbiologic eradication within 7 days (adjusted hazard ratio [HR] = 0.09, p < 0.001), platelet count (per 1 × 104/mm3, adjusted HR = 0.95, p = 0.002), and Pitt bacteremia scores (adjusted HR = 1.40, p < 0.001) were independently associated with 30-day all-cause mortality. No effective antimicrobial regimens were identified. In conclusion, risk factors of 30-day mortality in patients with CRKP BSI included microbiologic eradication > 7 days, lower platelet count, and a higher Pitt bacteremia score. These findings render a new insight into the clinical landscape of CRKP BSI.

scholarly journals Changes in Children’s Body Composition and Posture during Puberty Growth

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 288
Author(s):  
Wojciech Rusek ◽  
Joanna Baran ◽  
Justyna Leszczak ◽  
Marzena Adamczyk ◽  
Rafał Baran ◽  
...  
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Regression Analysis ◽  
Body Mass ◽  
Pelvic Obliquity ◽  
The Body ◽  
Body Posture ◽  
Older Children ◽  
The Difference ◽  
The Right

The main goal of our study was to determine how the age of children, puberty and anthropometric parameters affect the formation of body composition and faulty body posture development in children. The secondary goal was to determine in which body segments abnormalities most often occur and how gender differentiates the occurrence of adverse changes in children’s body posture and body composition during puberty. The study group consisted of 464 schoolchildren aged from 6–16. Body posture was assessed with the Zebris system. The composition of the body mass was tested with Tanita MC 780 MA body mass analyzer and the body height was measured using a portable stadiometer PORTSTAND 210. The participants were further divided due to the age of puberty. Tanner division was adopted. The cut-off age for girls is ≥10 years and for boys it is ≥12 years. The analyses applied descriptive statistics, the Pearson correlation, stepwise regression analysis and the t-test. The accepted level of significance was p < 0.05. The pelvic obliquity was lower in older children (beta = −0.15). We also see that age played a significant role in the difference in the height of the right pelvis (beta = −0.28), and the difference in the height of the right shoulder (beta = 0.23). Regression analysis showed that the content of adipose tissue (FAT%) increased with body mass index (BMI) and decreased with increasing weight, age, and height. Moreover, the FAT% was lower in boys than in girls (beta negative equal to −0.39). It turned out that older children (puberty), had greater asymmetry in the right shoulder blade (p < 0.001) and right shoulder (p = 0.003). On the other hand, younger children (who were still before puberty) had greater anomalies in the left trunk inclination (p = 0.048) as well as in the pelvic obliquity (p = 0.008). Girls in puberty were characterized by greater asymmetry on the right side, including the shoulders (p = 0.001), the scapula (p = 0.001) and the pelvis (p < 0.001). In boys, the problem related only to the asymmetry of the shoulder blades (p < 0.001). Girls were characterized by a greater increase in adipose tissue and boys by muscle tissue. Significant differences also appeared in the body posture of the examined children. Greater asymmetry within scapulas and shoulders were seen in children during puberty. Therefore, a growing child should be closely monitored to protect them from the adverse consequences of poor posture or excessive accumulation of adipose tissue in the body.

scholarly journals Association between Serum Zinc Levels and Clinical Index or the Body Composition in Incident Hemodialysis Patients

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3187
Author(s):  
Tatsunori Toida ◽  
Reiko Toida ◽  
Shou Ebihara ◽  
Risa Takahashi ◽  
Hiroyuki Komatsu ◽  
...  
Keyword(s):  
Body Composition ◽  
Regression Analysis ◽  
Cardiovascular Events ◽  
Serum Zinc ◽  
Fluid Volume ◽  
The Body ◽  
All Cause Mortality ◽  
Cox's Regression ◽  
Zinc Levels ◽  
Serum Zinc Levels

Background: The relationships between serum zinc levels and body composition or clinical outcomes of incident hemodialysis (HD) patients remain unclear. Methods: This prospective observational study examined the relationships between serum zinc levels and clinical indexes, including body composition, in 142 incident HD patients using a bioelectrical impedance analysis. Patients were divided into three groups according to baseline serum zinc levels: tertile, <45, 45–59, and ≥60 µg/dL. The reference group was set as ≥60 µg/dL. Cox’s regression analysis was performed to investigate the relationships between serum zinc categories and cardiovascular events and all-cause mortality after adjustments for potential confounders. Results: Serum zinc levels positively correlated with the nutritional index and negatively correlated with fluid volume markers. In a mean follow-up of 2.5 years, there were 20 cases of cardiovascular events and 15 of all-cause mortality. In the Cox’s regression analysis for cardiovascular events and all-cause mortality, the hazard ratio increased with a decrease in serum zinc levels, but was not significant. Conclusion: Serum zinc levels were associated with nutritional and fluid volume markers in incident HD patients. To clarify the relationship between serum zinc levels and cardiovascular events or mortality, further studies with a larger number of cases will be necessary.

scholarly journals Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254942
Author(s):  
Seok Hui Kang ◽  
A. Young Kim ◽  
Jun Young Do
Keyword(s):  
Peritoneal Dialysis ◽  
Lean Mass ◽  
Operating Characteristic ◽  
Cox Regression ◽  
Statistical Significance ◽  
Characteristic Curve ◽  
Lower Extremities ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Upper And Lower Extremities

Background Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. Methods Total 528 incident PD patients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht2), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. Results A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. Conclusion Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PD patients.

scholarly journals The Effect of The Body Composition to Prognosis in Young Breast Cancer Patients

2020 ◽  
Author(s):  
Ismail Beypinar ◽  
Furkan Kaya ◽  
Hacer Demir
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Adipose Tissue ◽  
Cancer Patients ◽  
Ct Images ◽  
The Body ◽  
Erector Spinae ◽  
Area Of Interest ◽  
Axial Ct ◽  
The Difference

Abstract Background In cancer patients, the effect of the body composition on prognosis is a new clinical area of interest. In patients with class 2 or 3 obesity (BMI > 35), survival found to be worse control groups in a pooled analysis. BMI category is not truly representing body composition and hard to use to determine the true muscle and fat quantity. Computed tomography (CT) is a frequent method to determine body composition precisely.Methods Axial CT images, including all abdominal muscles (psoas, erector spinae, quadratus lumborum) external and internal oblique and rectus abdominis) total skeletal muscle area (SMA), was calculated. Besides, axial CT images of the body fat subcutaneous adipose and visceral adipose tissue distribution (VAT, SAT) areas were calculated in cm2 using threshold values ​​of -30 to -190 for adipose tissue.Results Eighty-four women included in the study. Most of the patients were normal or over-weighted. Invasive ductal carcinoma was the dominant histological subtypes, with 94% of the study population. The count of the sarcopenic and non-sarcopenic patients was 11 and 68 respectively. Although the median OS cannot be reached at the end of the follow-up period for both sarcopenic and non-sarcopenic patients, the difference between groups statistically insignificant. The median OS was not reached for both groups, the difference between low and high VAT groups was statistically significant.Conclusion In this study, we demonstrate sarcopenia may be seen in patients with breast cancer under 40 years old, and it may not have a prognostic effect.

scholarly journals Visceral Adiposity Associates With Malnutrition Risk Determined by Royal Free Hospital-Nutritional Prioritizing Tool in Cirrhosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyu Wang ◽  
Yifan Li ◽  
Mingyu Sun ◽  
Gaoyue Guo ◽  
Wanting Yang ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Subcutaneous Adipose Tissue ◽  
Statistical Significance ◽  
Visceral Adiposity ◽  
Royal Free Hospital ◽  
Significant Difference ◽  
Total Adipose Tissue ◽  
Male Patients ◽  
Visceral Adipose ◽  
Subcutaneous Adipose

Mounting evidence has suggested the clinical significance of body composition abnormalities in the context of cirrhosis. Herein, we aimed to investigate the association between visceral adiposity and malnutrition risk in 176 hospitalized patients with cirrhosis. The adiposity parameters were obtained by computed tomography (CT) as follows: total adipose tissue index (TATI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR). Malnutrition risk was screened using Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT). Visceral adiposity was determined given a higher VSR based on our previously established cutoffs. Multivariate analysis implicated that male gender (OR = 2.884, 95% CI: 1.360–6.115, p = 0.006), BMI (OR = 0.879, 95% CI: 0.812–0.951, P = 0.001), albumin (OR = 0.934, 95% CI: 0.882–0.989, P = 0.019), and visceral adiposity (OR = 3.413, 95% CI: 1.344–8.670, P = 0.010) were independent risk factors of malnutrition risk. No significant difference was observed regarding TATI, SATI, and VATI among patients with low or moderate and high risk of malnutrition. In contrast, the proportion of male patients embracing visceral adiposity was higher in high malnutrition risk group compared with that in low or moderate group (47.27 vs. 17.86%, p = 0.009). Moreover, this disparity was of borderline statistical significance in women (19.05 vs. 5.88%, p = 0.061). Assessing adipose tissue distribution might potentiate the estimation of malnutrition risk in cirrhotics. It is pivotal to recognize visceral adiposity and develop targeted therapeutic strategies.

Effects of abiraterone acetate and enzalutamide on muscle and adipose mass in men with metastatic castration-resistant prostate cancer (mCRPC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5088-5088
Author(s):  
Ecaterina Ileana ◽  
Sami Antoun ◽  
Laurence Albiges ◽  
Christophe Massard ◽  
Mario Di Palma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Body Composition ◽  
Adipose Tissue ◽  
Lumbar Vertebra ◽  
Abiraterone Acetate ◽  
The Body ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Significant Difference ◽  
Composition Changes

5088 Background: Abiraterone acetate (AA) and enzalutamide (MDV3100), two androgen receptor-directed compounds, have been shown to improve survival for patients with metastatic castration-resistant prostate cancer (mCRPC) progressing after Docetaxel.. Since these drugs might be used at an early-stage in the future, and skeletal muscle (SM) and adipose tissue (AT) are known to be prognosis parameters, the aim of this study was to evaluate the body composition changes in patients with mCRPC treated with AA and MDV3100. Methods: Patients included in AFFIRM (n=62 treated with MDV3100 and placebo n=28) and COU-AA-301 (n=24 treated with AA+Prednisone (P)10mg/day and placebo+P n= 13) trials at the Institute Gustave Roussy were included in the analysis. Cross-sectional areas (cm2) of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and SM were assessed by computed tomography imaging at 3rd lumbar vertebra and were indexed for height (cm2/m2) with Slice-O-Matic software V4.3 at baseline, 3, 6 and 12 months of treatment. The data from patients treated with AA or MDV3100 were compared to placebo-patients and tissues changes were compared to baseline. We used the validated sarcopenic definitions as SM index less than 52.4 (cm2/m2). Results: For all cohort, median age was 69 years (range: 48-83), median weight was 79 kg (range: 47-150) and median BMI was 25.9 kg/m2(range: 18-46). At inclusion, 74 patients (58%) were overweight or obese (BMI>24.9 kg/m2), and only 2 patients were underweight (BMI<18.5kg/m2). 97 patients (81%) were sarcopenic, and 56 (75%) of overweight or obese patients were sarcopenic. Over 3 months, the patients from the entire cohort lost muscle mass (mean change: 4.5±7.5% (» 0.7 kg of muscle)) (P=0.01) . A non significant loss of SAT -4.6±19.2% and a non significant increase of VAT (+10.7±50.3% ) were observed. A similar pattern was observed at 6 months. There was no significant difference between body composition changes in treated groups and placebo. Conclusions: Sarcopenia is highly prevalent in patients with advanced CRPC. Unexpectedly, no difference in body composition changes was observed between patients treated with MDV3100 or AA and placebo.

Weight loss and exercise differentially affect insulin sensitivity, body composition, cardiorespiratory fitness and muscle strength in older adults with obesity; a randomized controlled trial

2021 ◽  
Author(s):  
Andrea M Brennan ◽  
Robert A Standley ◽  
Steven J Anthony ◽  
Kory E Grench ◽  
Nicole L Helbling ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Body Composition ◽  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Lean Mass ◽  
Disease Risk ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Intermuscular Adipose Tissue

Abstract Background Aging-related disease risk is exacerbated by obesity and physical inactivity. It is unclear how weight loss and increased activity improve risk in older adults. We aimed to determine the effects of diet-induced weight loss with and without exercise on insulin sensitivity, VO2peak, body composition, and physical function in older obese adults. Methods Physically inactive older (68.6 ± 4.5 years) obese (BMI 37.4 ± 4.9 kg/m 2) adults were randomized to: Health education control (HEC; n=25); Diet-induced weight loss (WL; n=31); or Weight loss and exercise (WLEX; n=28) for 6 months. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp, body composition by DXA and MRI, strength by isokinetic dynamometry, and VO2peak by graded exercise test. Results WLEX improved (p&lt;0.05) peripheral insulin sensitivity (+75 ± 103%) vs. HEC (+12 ± 67%); WL (+36 ± 47%) vs. HEC did not reach statistical significance. WLEX increased VO2peak (+7 ± 12%) vs. WL (-2 ± 24%), and prevented reductions in strength and lean mass induced by WL (p&lt;0.05). WLEX decreased abdominal adipose tissue (-16 ± 9%) vs. HEC (-3 ± 8%) and intermuscular adipose tissue (-15 ± 13 %) vs. both HEC (+9 ± 15%) and WL (+2 ± 11%) (p&lt;0.01). Conclusions Exercise with weight loss improved insulin sensitivity and VO2peak, decreased ectopic fat, and preserved lean mass and strength. Weight loss alone decreased lean mass and strength. Older adults intending to lose weight should perform regular exercise to promote cardiometabolic and functional benefits, which may not occur with calorie restriction-induced weight loss alone.

EFFECTS OF FREQUENCY OF FEEDING ON ENERGY METABOLISM AND BODY COMPOSITION OF YOUNG PIGS

1973 ◽  
Vol 53 (1) ◽  
pp. 157-164 ◽  
Author(s):  
V. D. SHARMA ◽  
L. G. YOUNG ◽  
R. G. BROWN ◽  
J. BUCHANAN-SMITH ◽  
G. C. SMITH
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
The Body ◽  
Metabolizable Energy ◽  
Dietary Energy ◽  
Feeding Experiment ◽  
Feeding Frequency ◽  
Young Pigs ◽  
Energy Inputs ◽  
Frequent Feeding

The influence of frequency of feeding on the coefficient of digestibility and metabolizability of dietary energy, fasting heat production, maintenance energy requirements, efficiency of utilization of metabolizable energy (ME) for maintenance and growth, net energy value of diet, rate of lipogenesis in adipose tissue, and the body composition of young pigs was investigated. A total of 40 pigs was used in this study, of which four constituted the initial slaughter group. The remaining 36 pigs were allotted to a feeding experiment of a randomized complete-block design involving a 3 × 2 factorial arrangement (level of dietary energy inputs: 140, 240, and 340 kcal ME/W0.75kg daily; and feeding frequency: two and five times daily). One metabolism experiment was conducted during the 3rd wk of the 37-day feeding experiment. Subcutaneous adipose tissue slices taken immediately after electrocution of 24 pigs were used to determine the rate of lipogenesis as indicated by the metabolism of glucose-U-14C. Frequency of feeding had no effect on the digestible energy, ME, and NEm value of the diet or the efficiency of utilization of ME for maintenance. However, frequent feeding increased the fasting heat production, metabolizable energy requirement for maintenance, net efficiency of utilization of metabolizable energy for production and the NEg value of the diet. Frequency of feeding did not produce any change in the weights of empty stomach or small intestine. Although the rate of lipogenesis in the adipose tissue was not affected by feeding frequency, lipogenesis was increased by an increase in the level of dietary energy inputs. Feeding frequency did not influence the body composition and energy concentration in the empty body of pigs fed 240 and 340 kcal ME/W0.75kg but frequent feeding increased percent water and reduced percent fat in pigs fed 140 kcal ME/W0.75kg daily. Several of the latter pigs were in negative energy balance.

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