Abstracts of the 10th International Conference on Cachexia, Sarcopenia and Muscle Wasting, Rome, Italy, 8-10 December 2017 (Part 1)

Abstract

Journal of Cachexia, Sarcopenia and MuscleVolume 8, Issue 6 p. 999-1080 AbstractsOpen Access Abstracts of the 10th International Conference on Cachexia, Sarcopenia and Muscle Wasting, Rome, Italy, 8–10 December 2017 (Part 1) First published: 23 November 2017 https://doi.org/10.1002/jcsm.12255Citations: 2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat 1-01 Body composition changes over three years in older adults: a descriptive longitudinal analysis Maria Teresa Tomás1,3, Alejandro Galán-Mercant2,3 and Beatriz Fernandes1,3 1Escola Superior de Tecnologia da Saúde de Lisboa, Portugal; 2Universidade de Jaén, Spain; 32GHRG—Gerontology and Geriatric Health Research Group Introduction: Many studies analyse body composition changes in older adults. However, few studies analyse body composition in elderly people with functional measures. Studies using Double X-Ray analysis (DXA) or Bioimpedance analysis proved to be reliable but expensive or only possible in a laboratory environment. The purpose of our study was to analyse changes in body composition over three years using anthropometric measures in a sample of elderly people in order to perceive functional changes. Methods: Forty-three participants (12 men; 31 women) aged 60 years and over and independent in activities of daily life were assessed using anthropometric measures in a first moment and past three years. Weight, height, waist and hip circumference were measured, and body mass index (BMI) and waist-to-hip ratio (WHR) were also calculated. Skeletal muscle mass (SMM) was also calculated using Al-Gindan et al. (2014) equations and normalized for height to found skeletal muscle index (SMI) in order to analyze cut-off points associated with physical disability according to Janssen et al (2004). Results: A significant difference was found over three years in SMM (p = 0.007), SMI (p = 0.027), BMI (p = 0.041) and WHR (p = 0.003). The majority of the participants has decreased SMM, SMI and BMI and increased WHR, which favors a worst prognostic for comorbidities associated with these variables, and a tendency for sarcopenic obesity seems to be present although more studies are needed. Also, we found that using cut-off points for disability risk 83.3% of the men and 38.7% of the women of our sample were at moderate or high risk of disability. Three years later this percentage has increased but only for women to 54.8%. Conclusions: Although men are at risk of disability, women quickly lose their functional capacity, making necessary a rapid intervention to reduce the risk of disability in this population. IPL/2016/SFQ2017_ESTeSL 1-02 Prevalence of cachexia in dogs with congestive heart failure Pamela L. Bay, Lisa M. Freeman and John E. Rush Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA Background and Aims: Congestive heart failure (CHF) is a common, naturally occurring disease in pet dogs that is often associated with cardiac cachexia, as defined by a loss of muscle. One study of dogs with dilated cardiomyopathy (DCM) and CHF showed that 54% of dogs were affected by cachexia. No studies have been conducted to confirm these findings in dogs with DCM or to assess prevalence in CHF from other forms of heart disease causing CHF. Therefore, the aim of this study was to determine prevalence of cardiac cachexia in dogs with CHF due to acquired heart disease. Methods: Dogs with CHF evaluated by the Cardiology Service at the Cummings School of Veterinary Medicine between June 2015 and June 2017 were eligible. Dogs with DCM and myxomatous mitral valve disease (MMVD) were enrolled. Data from the medical records were retrospectively reviewed, including body weight, body condition score (BCS), and muscle condition score (MCS). Body condition score, which assesses fat stores, was measured on a 1–9 scale, with 1 = emaciated, 9 = obese, and 4–5 considered ideal. Muscle condition was categorized using the World Small Animal Veterinary Association scoring system as normal muscle, mild muscle loss, moderate muscle loss, or severe muscle loss. Results: Median age of the dogs (n = 196) was 10.7 years (range, 1.7–18.0 years). Underlying diseases included MMVD (n = 168) and DCM (n = 28). Mean body weight was 7.6 kg (range, 2.4–75.8 kg). Only 6.1% of dogs were underweight (BCS < 4/9), and 41.8% of dogs were overweight or obese (BCS > 5/9). However, muscle loss was identified in 48.0% of dogs: Mild muscle loss: 73/196 (37.3%), moderate muscle loss: 14/196 (7.1%), and severe muscle loss: 7/196 (3.6%). 52.0% of dogs were assessed to have normal muscle. Muscle condition score and BCS were not significantly different between dogs with MMVD or DCM. Conclusions: Although many dogs were overweight or obese, cachexia was present in 48% of dogs with CHF. 1-03 Comorbidities and mortality after cachexia hospitalization in Slovenia between 2004 and 2015 Daniel Omersa1, Jerneja Farkas2 and Mitja Lainscak2,3 1National Institute of Public Health, Ljubljana, Slovenia; 2General Hospital Murska Sobota, Murska Sobota, Slovenia; 3Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Introduction: Cachexia is common in several chronic diseases and significantly increases morbidity and mortality. There is a lack of data regarding cachexia hospitalization burden and mortality after cachexia hospitalization. Thus, we aimed to identify all patients that were hospitalized due to cachexia and determine their mortality and prognostic implications of different comorbidities. Methods: The Slovenian National Hospitalization Database has been searched for all individuals with main Cachexia hospitalization (ICD-10 codes: C80, R64 and B22.2) between 2004 and 2015, and sex, age, length of stay and comorbidities were recorded. For all patients with cachexia hospitalization, date of death was recorded from Slovenian Death Registry. Prevalence of comorbidities during cachexia hospitalization were calculated and hazard ratios (HR) for mortality for sex, age and patients' comorbidities were calculated using multiple Cox proportional hazards model. Results: Overall, we identified 1774 main cachexia hospitalizations in 1406 patients. Main cachexia hospitalizations contributed to 17.7% of all the hospitalizations of an individual during the study period. Cancer, cardiovascular and pulmonary diseases were the most prevalent in cachexia patients (62%, 27% and 10%, respectively). In-hospital mortality was 29%. Median survival for discharged patients were 103 days (95% confidence intervals, 90–123 days). Older patients, those with cancer and pulmonary disease, had significantly higher HR for mortality (1.16 for 10 year increase, 1.79 and 1.34, respectively). Conclusions: Patients hospitalized due to cachexia have extremely poor prognosis. Cancer, which is the most prevalent comorbidity in patients hospitalized due to cachexia, is associated with the worst prognosis. 1-04 Prevalence of cachexia among COPD cases in the ECLIPSE study Merry-Lynn N. McDonald1,2, Erica Rutten3, Richard Casaburi4, Emiel F.M. Wouters3, Stephen I. Rennard5, David A. Lomas6, Bartolome Celli7, Alvar Agusti8, Ruth Tal-Singer9, Craig P. Hersh7,10 and Edwin K. Silverman7,10 1Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA; 3Centre of expertise for chronic organ failure, Horn, the Netherlands; 4Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor Harbor-UCLA Medical Center, Torrance, CA, USA; 5Department of Medicine, Nebraska Medical Center, Omaha, NE, USA; 6Wolfson Institute for Biomedical Research, University College London, UK; 7Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA; 8Fundació Investigació Sanitària Illes Balears (FISIB), Ciber Enfermedades Respiratorias (CIBERES), Barcelona, Catalunya, Spain Thorax Institute, Hospital Clinic, IDIBAPS, Univ. Barcelona, Barcelona, Spain; 9Respiratory R&D, GSK, Philadelphia, PA, USA; 10Channing Division of Network Medicine, Harvard Medical School, Boston, MA, USA Background: By population prevalence, there are more chronic obstructive pulmonary disease (COPD) cases than cancer cases with cachexia. The consensus definition of cachexia incorporates weight loss (WL) >5% in 12 months in addition to 3 out of 5 of decreased muscle strength, fatigue, anorexia, low fat-free mass index (FFMI) and abnormal biochemistry (anemia, CRP, IL6, albumin). More recently, cancer cachexia has been classified using WL >5% or, in the presence of low BMI or FFMI, WL >2%. Further, the importance of pre-cachexia (WL ≤5%, anorexia and inflammation) has been highlighted as more advanced cachexia may indicate a refractory state. Thus, we aimed to examine the prevalence of cachexia using these definitions in a cohort of COPD cases from the ECLIPSE Study. Methods: A total of 1901 COPD cases were assessed for cachexia. Annual weight, muscle strength, FFMI and anemia data were analyzed. Fatigue and anorexia data were available at baseline and end of study. CRP levels were measured at baseline and over the first year. The consensus definition was coded at each annual visit an individual participated in the study. Where data were not available for the specific visit, an aggregate was created (e.g., ever had fatigue). Participants who exhibited WL at an early visit with evidence it was regained were coded as non-cachectic. Results: The prevalence of cachexia based on the consensus definition ranged from 4.0% (Year 1) to 6.6% (Year 3). Over 3 years of the study, 11% of COPD cases were classified as cachectic at some time point. The prevalence of cachexia using the cancer cachexia definition ranged from 9.7% (Year 1) to 17.7% (Year 3). The prevalence of pre-cachexia ranged from 2.0% (Year 2) to 3.1% (Year 1). Summary: Based on definition of cachexia and visit used, the prevalence in a large cohort of COPD cases ranged from 4.0% to 17.7%. 1-05 SARA-data: Integrated, real-time ICT Platform for the SARA interventional Clinical Trial in Age-related SARcopenia Susanna Del Signore1,2, Waly Dioh2, Stefania Del Signore1 and Gianluca Zia1 1Bluecompanion ltd, London, UK; 2Biophytis, Paris, France Introduction: SARA-Int(erventional), a randomized, double-blind clinical trial, will evaluate the safety and efficacy of two oral doses of SARconeos (BIO101) versus placebo over 6 months in 333 sarcopenic or obese sarcopenic patients Aged ≥65 years complaining of loss of strength and muscular function. Methods: We deployed an integrated Information&Communication Technology (ICT) platform, SARA-data, to monitor on quasi real-time different source data (clinical, imaging (DEXA), laboratory and physical activity). Data can be generated at investigation sites, by the centralised lab and by the patients themselves via wearable devices and auto-evaluation questionnaires. Bluecompanion implemented for Biophytis SARA Data, which allows to collect and integrate on one single web-based portal: an electronic Case Report Form (Clean WEB by Telemedicine), participants row data from DEXA scans, and biochemistry-haematology results from a centralised laboratory, including sarcopenia-related biomarkers. Of note, continuous physical activity recording is enabled during the whole clinical trial duration by providing each older participant with a wrist-worn accelerometer. The device transmits anonymised activity data to SARA platform via a non-intrusive, unattended, home-centred machine-to-machine technology. This kind of high volume data, directly generated by the patient during several months, fulfils the definition “Big data in health”, encompassing “high volume, high diversity biological, clinical, environmental, and lifestyle information collected from single individuals to large cohorts, in relation to their health and wellness status, at one or several time points” (Auffray C. et al., 2016), and will constitute an important resource for additional, supportive analyses complementing standardised muscular function assessments. These data are generated in a real-life context and could provide answers to specific questions by regulators and payers. Conclusions: SARA-data are a single real-time ICT platform enabling data capture, storage, analysis and retrieval of long-term clinical data generated during SARA-Int, a randomized CT evaluating Sarconeos (Bio101) in Age-related Sarcopenia, including Sarcopenic Obesity. 1-06 Changes of body weight and body composition and cachexia after stroke Nadja Scherbakov1, Charlotte Pietrock1, Nicole Ebner2,3, Anja Sandek2,3, Miroslava Valentova2,3, Jochen B. Fiebach1, Joerg C. Schefold4, Stephan von Haehling2,3, Stefan D. Anker2,5, Kristina Norman6, Karl Georg Haeusler1,7 and Wolfram Doehner1,5 1Center for Stroke Research Berlin CSB, Charité - Universitätsmedizin Berlin, Berlin, Germany; 2Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medicine Goettingen (UMG), Goettingen, Germany; 3German Centre for Cardiovascular Research (DZHK), partner site Goettingen, Goettingen, Germany; 4Department of Intensive Care Medicine, Inselspital, Bern University Hospital, Switzerland; 5Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany; 6Research Group on Geriatrics, Charité - Universitätsmedizin Berlin, Berlin, Germany; 7Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany Background and Purpose: Body weight loss after stroke has been shown in several clinical trials. Cachexia after stroke has not been studied systematically yet. The purpose of this prospective study was to investigate dynamical changes of body composition and body weight one year after ischemic stroke, and its association with functional outcome. Methods: 67 consecutive patients with acute ischemic stroke (age 69 ± 11 years, BMI 27 ± 4 kg/m2) with mild to moderate neurological deficit (mean NIHSS 4.3, range 0–12) were analyzed. Body composition was examined by dual energy X-ray absorptiometry (DEXA) in acute phase (4 ± 2 days) and at 1-year follow-up (389 ± 26 days). Cachexia was defined according to consensus definition by body weight loss ≥5% within one year and clinical symptoms. Functional assessments included Barthel Index (BI), modified Rankin scale (mRS), and muscle strength tests. Results: Cachexia was diagnosed in 21% of the patients at 1-year follow-up. Most changes of body composition concerned the fat tissue with the highest fat mass decline of 12.5% in cachectic patients, followed by 5% loss in non-cachectic patients with weight loss, and fat mass increase by 8% in patients with weight gain. In addition, cachectic patients lost 3% of the lean mass (P < 0.05). At baseline patients who developed cachexia during follow up were older (75 ± 9 years), had moderate neurologic deficit (mean NIHSS 5.8), and the lowest physical and functional capacity. They remained with the worse functional impairment (mRS 2.1 ± 1.6, P < 0.05, Barthel Index 74 ± 36, P = 0.002) and handgrip strength (22.4 ± 14.9 kg, P < 0.05) compared to other patients at 1-year FU. After adjustment for multiple confounders, patients with higher functional impairment (OR 1.87, 95% CI 1.09–3.20) and neurologic deficit (OR 3.63, 95% CI 0.97–13.6) were at risk for cachexia. Conclusions: The most changes of body composition after stroke with mild-to-moderate neurologic deficit concerned the fat tissue. Attention should be focused on identification and targeting of cachexia in the early phase following the stroke. 2-01 Ultrasound: a new strategy to evaluate body composition in crohn's patients undergoing hematopoietic stem cell transplantation (HSCT) Andrea Z. Pereira1, Sandra E.A. Gonçalves1, Bianca L. de Sá2, Marister Cocco3, Andreza A.F. Ribeiro1 and Nelson Hamerschlak1 1Oncology and Hematology Department, Hospital Israelita Albert Einstein, S. Paolo, Brazil; 2Nutrition Department, Hospital Israelita Albert Einstein, S.Paulo, Brazil; 3Physiotherapy Department, Hospital Israelita Albert Einstein, S.Paulo, Brazil Introduction: Crohn disease is a chronic inflammatory disorder of the gastrointestinal tract with a strong polygenic immune component. In refractory cases, autologous HSCT can decrease disease activity and mucosal healing and improve quality of life. Reduced muscular mass and excess visceral fat in patients undergoing HSCT are associated with higher mortality, longer hospitalization, longer use of immunosuppressive drugs, graft-versus-host disease, shorter disease-free interval after the HSCT and comorbidities leading to shorter survival time. Objectives: To evaluate muscle thickness and visceral fat by US. Methods: We evaluated 5 HSCT patients (≥18 years) at Hospital Israelita Albert Einstein, São Paulo, Brazil, on their first day of hospitalization, before HSCT and after the engraftment. The thickness of the right femoral quadriceps muscle (RFQ), measured at 6 cm from the top edge of the patella was measured using US in B-mode. The VF was measured in the abdominal region, by the thickness of the fat layer between the linea alba and the anterior wall of the aorta. Results: Most patients were men (75%) with a mean age of 35 years (±14 years). Most patients were undernutrition, with body mass index (BMI) of 21 kg/m2 (±2.5 kg/m2). The average time EN was 11 days (±1 day). In the baseline, RFQ was 1.5 cm (±0.2 cm), and the VF was 4.2 cm (±1.3 cm). After engrafment, RFQ was 1.3 cm (±0.2 cm), and the VF was 4.2 cm (±1.2 cm). There wasn't significant difference between baseline and after engraftment, although RFQ had reduced in all patients. Conclusions: In this cohort of patients, we found reduced muscle thickness after engraftment, and VF didn't have any alterations. The US was a practical, economical and effective method to evaluate these patients. 2–02 Elderly patients undergone hematopoietic stem cell transplantation: body composition and engraftment Andrea Z. Pereira1, Ludmila M. Koch1, Polianna M.R. Souza1, Bianca L. de Sá2, Andreza A.F. Ribeiro1 and Nelson Hamerschlak1 1Oncology and Hematology Department, Hospital Israelita Albert Einstein, S.Paulo, Brazil; 2Nutrition Department, Hospital Israelita Albert Einstein, S.Paulo, Brazil Introduction: Hematopoietic Stem Cell Transplantation (HSCT) in elderly is a brand-new issue. Changes in body composition after HSCT have been the subject of previous studies; however, there aren't many studies in elderly people. Objectives: To evaluate muscle thickness and visceral fat by US; % muscle mass, % fat mass and phase angle by BIA. To correlate body composition with engraftment (EN). Methods: In this prospective study, we evaluated 16 HSCT patients (≥60 years) at Hospital Israelita Albert Einstein, São Paulo, Brazil, on their first day of hospitalization, before HSCT and after the EN. The thickness of the right femoral quadriceps muscle (RFQ), measured at 6 cm from the top edge of the patella was measured using ultrasound (US) in B-mode, transversal plane. The visceral fat (VF) was measured in the abdominal region, by the thickness of the fat layer between the linea alba and the anterior wall of the aorta. The % muscle mass (MM), % fat mass (FM) and phase angle (PA) were evaluated by Bioimpedanciometry(BIA). Results: Most patients were men (75%) with a mean age of 64(±5.0 years). We had 50% of autologous HSCT and 50% allogenic HSCT. The mean time EN was 13(±4 days). In the baseline, weight was 80(±17 kg), RFQ was 1.8(±0.3 cm) and the VF was 5.5(± 2.0 cm); %MM was 68.5(±11); %FM was 27.5(±7.5); PA was 5.3((±0.7). After EN, weight was 73(±13 kg). RFQ was 1.5(±0.3 cm) and the VF was 5,0(±2.2 cm); %MM was 55.5(±20.5); %FM was 25(±7.0); PA was 7.4(±0.8). There wasn't significant difference between baseline and after engraftment, although all measurements had reduced in all patients, exception for PA and VF had increased. We found the negative correlation between engraftment and RFQ(rp: −0,6), independently of HSCT type by regression. (rp: −0,6). Conclusions: In this cohort of patients, muscle thickness and mass was reduced, and visceral fat and phase angle was increased after engraftment. The higher muscle thickness correlated faster engraftment. Elderly quilombolas: Prevalence of sarcopenia using algorithm proposed by the European working group on sarcopenia in older people. 2-03 Prognostic value of psoas muscle area and density in patients undergoing cardiovascular surgery Masashi Yamashita1, Kentaro Kamiya1,2, Atsuhiko Matsunaga1,2, Tadashi Kitamura3, Nobuaki Hamazaki4,5, Ryota Matsuzawa4, Kohei Nozaki4, Shinya Tanaka5, Junya Ako6 and Kagami Miyaji3 1Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; 2Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan; 3Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan; 4Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan; 5Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; 6Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan Introduction: Low skeletal muscle area and density, as determined by computed tomography (CT), have yet to be examined and compared in terms of prognostic capability in patients requiring open cardiovascular surgery. This study was performed to examine whether psoas muscle area and density are associated with postoperative mortality and physical performance in patients undergoing cardiovascular surgery. Methods: We reviewed the findings in 773 consecutive patients undergoing preoperative CT imaging including the level of the third lumbar vertebra for clinical purposes. Skeletal muscle area was calculated from psoas muscle cross-sectional area (CSA) on preoperative CT images at the level of the third lumbar vertebra divided by the square of the patient's height to give the skeletal muscle index (SMI: cm2/m2). Skeletal muscle density determined by muscle attenuation (MA) was calculated by measuring the average Hounsfield units of the psoas muscle CSA. Quadriceps strength and 6-minute walking distance were examined as indices of physical performance. Results: The mean age of the study population was 68.6 ± 14.0 years, and 64.7% of the patients were male. Multivariate Cox regression analysis showed that low MA (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.14–4.16, P = 0.018), but not low SMI (HR, 1.35; 95% CI, 0.71–2.56, P = 0.361), was significantly associated with all-cause mortality. Kaplan–Meier analysis showed that low MA, but not low SMI, predicted poor prognosis (P = 0.014). Correlation analysis indicated that MA was more strongly associated with quadriceps strength and 6-minute walking distance than SMI. Conclusions: Low skeletal muscle density, but not skeletal muscle area, predicted survival in patients undergoing cardiac surgery. 2-04 The usefulness of body weight for predicting skeletal muscle mass in congested state of heart failure outpatients Shunichi Doi1, Norio Suzuki1, Keisuke Kida2, Chikayuki Ito3, Kohei Ashikaga3, Kengo Suzuki2, Hisao Matsuda1, Tomoo Harada2 and Yoshihiro J. Akashi2 1Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan; 2Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan; 3Division of Cardiology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Japan Introduction: Body mass index is cited as an index to recognize significant correlation with skeletal muscle mass. However, body weight changes due to edema are often observed in chronic heart failure (CHF). We investigated the usefulness of body weight for evaluating skeletal muscle mass wasting in congested CHF outpatients. Methods: Totally 45 CHF outpatients with brain natriuretic peptide (BNP) ≥200 pg/ml were enrolled. Total skeletal muscle mass was measured at the level of the third lumbar vertebra using available preoperative computed tomography images (Cutoff value: male 36.2cm2/m2, female 29.6cm2/m2). It was investigated on the relationship between skeletal muscle mass and each nutritional indicator. Results: The mean age was 75.6 ± 6.4 years old, body mass index (BMI) was 22.4 ± 2.9 kg/m2 and left ventricular ejection fraction was 44.3 ± 18.9%. Median BNP was 417.5 pg/ml (interquartile range, 271.1–590.8). Of the study patients, 53.3% patients were male, 26.7% patients had ischemic heart failure, 57.8% patients had New York Heart Association (NYHA) classification ≥2, and 68.9% patients had Mini Nutritional Assessment Short Form (MNA-SF) score ≤ 11. Correlation between skeletal muscle mass and each index was BMI (r = 0.51, p < 0.01), Geriatric Nutritional Risk Index (GNRI; r = 0.42, p = 0.04), MNA-SF(r = 0.28, p = 0.15) and serum albumin value (Alb; r = −0.06, p = 0.77). The logistic regression analysis indicated that the odds ratio, in BMI, was 0.66 (95% confidence interval; 0.48–0.85, p < 0.01) and area under the receiver operating characteristic curve (AUC) was 0.76, suggesting that BMI might be independent predictors for muscle mass wasting. Conclusions: Though the congested state of CHF outpatients, it was suggested the usefulness of body weight for predicting skeletal muscle mass. 2-08 Comparison of height-, weight-, body surface area-, and body mass index-adjusted muscle mass indices for prediction of physical performance in Korean hemodialysis patients Jun Chul Kim1, Jun Young Do2, Kyu Hyang Cho2 and Seok Hui Kang2 1Division of Nephrology, Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gumi, Gyeongsangbuk-do, Republic of Korea; 2Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea Introduction: Our study aims to evaluate the association between height-, weight-, body surface area- (BSA), or body mass index- (BMI) adjusted muscle mass indices and physical performance in Korean hemodialysis patients. Methods: Patients were included if they were on HD for ≥6 months (n = 84). Each patient's appendicular skeletal muscle mass (ASM, the sum of both upper extremities and lower extremities) was measured by dual X-ray absorptiometry. ASM was adjusted to body weight (BW, kg), height2 (Ht2, m2), BSA (m2), or BMI (kg/m2). Low muscle mass was defined as muscle mass of 2SD below sex-specific means of healthy young adults (20–29 years). Each participant performed a gait speed test (GS), a hand grip strength (HGS) test, a sit-to-stand test performed 5 times (5STS), a sit-to-stand for 30 second test (STS30), a 6-minute walk test (6MWT), a timed up and go test (TUG), and an average steps count (AS). Results: In men, Pearson's correlation coefficients for GS, 5STS, STS30, 6-MWT, TUG, and AS were highest in ASM/Ht2. Results from partial correlation or linear regression analyses displayed similar trends to those derived from Pearson's correlation analyses. ASM/Ht2 had the greatest negative predictive value for low GS. Patients with low muscle mass had significantly lower physical performances (HGS, 5STS, 6MWT, TUG) than those with normal muscle mass by ASM/Ht2. In women, the association between muscle mass indices and physical performance was lack. Conclusions: Height adjusted muscle mass may be the best for predicting physical performance in men on hemodialysis. 2-12 Prevalence and progression of limb contractures amongst long-term care residents: data from a 5-year observational study Kuen Lam1, Joseph Kwan2, Chi Wai Kwan3 and Iris Chi4 1Cheshire Home, Shati, Hong Kong; 2Department of Medicine, The University of Hong Kong, Hong Kong SAR; 3Department of Statistics and Actuarial Science, The University of Hong Kong; 4Suzanne Dwork-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA Background: Limb contractures are associated with poor outcomes and quality of life in long-term care facility (LTCF) residents. We aimed to study the prevalence and progression of limb contractures over a 5-year follow-up period amongst LTCF residents in Hong Kong. Methods: From the Hong Kong Longitudinal Study on LTCF Residents between 2005 and 2015, we analyzed the data for residents who had assessment from the 1st up to 5th year since admission. Trained nurses, social workers and therapists utilized the Minimum Data Set Resident Assessment Instrument (MDS-RAI 2.0) in 10 residential LTCFs. Limb contractures were defined as functional limitation in the range of motion involving the upper or lower limbs. Primary outcomes were annual prevalence and time trend of limb contractures over 5 years. Results: We analyzed the data for 1,736 older residents (611 men, mean age 83.2 years). During the first 5 years since admission, the annual prevalence of upper limb contractures increased from 30% to 36%, and lower limb contractures increased from 41% to 56%. Time trends were as follows: the proportion of residents who had no contractures on admission remained contracture-free after 5 years was 59.7% for upper limbs and 39.8% for lower limbs, while the proportion of residents who had developed new contractures after 5 years was 15.1% for upper limbs and 26.5% for lo