Adductor Pollicis Muscle Thickness Research Articles

Phase Angle but Not Psoas Muscle Predicts Nutritional Risk and Prognosis in Males with Hepatocellular Carcinoma

Despite those with hepatocellular carcinoma (HCC) being at increased risk of malnutrition, there is a notable absence of practical approaches for nutritional assessment in clinical practice. We investigated the usefulness of phase angle (PhA) and Total Psoas Area Index (TPAI) for indicating nutritional risk and HCC prognosis. Weight, height, body mass index (BMI), adductor pollicis muscle thickness (APMT), and handgrip strength (HGS) were assessed. The Nutritional Risk Index (NRI) was calculated. Body composition was assessed using bioimpedance spectroscopy and magnetic resonance imaging. The Child-Turcotte-Pugh (CTP) score and Barcelona-Clinic Liver Cancer (BCLC) classification determined the prognosis. Fifty-one males with HCC were enrolled (CTP C = 11.8%). PhA showed a moderate positive correlation with APMT (r = 0.450; p < 0.001) and HGS (r = 0.418; p = 0.002) and a weak positive correlation with TPAI (r = 0.332; p = 0.021). PhA had a strong positive correlation with NRI (r = 0.614; p < 0.001). Mean PhA values were significantly different according to disease severity (CTP C p = 0.001, and BCLC D p = 0.053). TPAI had no significant correlation with HGS, CTP, or BCLC. PhA was a superior approach for predicting nutritional risk and prognosis in HCC than TPAI. Lower PhA is associated with disease progression, lower muscle mass and function, greater severity of nutritional risk, and increased mortality in HCC.

Predictive value of adductor pollicis muscle thickness for ultrasound-based sarcopenia in older adults.

The adductor pollicis muscle thickness (APMT) is least affected by subcutaneous adipose tissue and can be measured externally. The aim of this study is to identify the predictive value of APMT for the diagnosis of ultrasonography-based sarcopenia. A total of 245 outpatients who were aged ≥65 years (49 with sarcopenia and 196 without sarcopenia) were included in this cross-sectional study. Patients with knee or hip replacement, advanced dementia, cerebrovascular disease, neurodegenerative disease, or decompensated heart failure and those using drugs that affect muscle functions, such as steroids, were excluded. Comprehensive geriatric assessments and anthropometric measurements of the patients were performed. APMT was assessed with a skinfold caliper. The diagnosis of sarcopenia was based on a low Sonographic Thigh Adjustment Ratio (STAR)index (anterior thigh muscle thickness by ultrasonography/body mass index [BMI] ratio, cutoff points are <1.4 for men and <1.0 for women) and low handgrip strength. The predictive ability of APMT for ultrasound-based sarcopenia diagnosis was examined. There was no significant difference in terms of arm and calf circumference and BMI between the sarcopenic and nonsarcopenic groups. APMT, handgrip strength, anterior thigh muscle thickness, and gait speed were significantly lower in the patients with sarcopenia. The best cutoff points of APMT for sarcopenia were ≤16.5 for women and ≤21.5 for men with areas under the curve of 0.70 and 0.66, respectively, and negative predictive values of 91.2 and 94.3, respectively (P < 0.001). APMT can be a useful anthropometric marker for ultrasound-based sarcopenia diagnosis.

Risk of Sarcopenia Identified by Sarc-Calf, Nutritional Status and Hand Grip Strength in Patients with Hematological Cancer.

Background: Hematological cancer patients are prone to the development of sarcopenia and impaired nutritional and functional status. SARC-CalF is a screening tool for the risk of sarcopenia that has shown good results in this population. This study aimed to identify the risk of sarcopenia by SARC-CalF and to verify its association with nutritional status and Hand Grip Strength (HGS) in patients with hematological cancer. Materials and Methods: Adult patients, of both sexes, with hematological cancer, and in outpatient care participated in the study. We measured the Hand Grip Strength of the Dominant Hand (HGSD) and the Adductor Pollicis Muscle Thickness of the Dominant Hand (APMTD). Moreover, we applied the Patient-Generated Subjective Global Assessment (PG-SGA) and SARC-CalF. Data were analyzed with SPSS® software, 22.0, with a significance level of 5.0%. Results: Fifty-one patients aged an average of 60.4 ± 15.1 years were evaluated. Of those, 58.8% were elderly, 51% female, and 80.4% declared themselves non-white. The predominant diagnosis was Mature B Lymphoid Cell Neoplasia (37.7%), and 60.8% of the patients had a diagnosis time of ≤ 3 years. PG-SGA revealed that 35.3% of the patients were malnourished; APMTD and HGSD revealed that 60.8% and 25.5% had reduced muscle strength, respectively. SARC-CalF exposed that 39.2% of the patients were at risk for sarcopenia. Significant associations were found between SARC-CalF and diagnosis time ≤ 3 years (p = 0.039), PG-SGA (p = 0.020), APMTD (p = 0.039) and HGSD (p = 0.002). After binary logistic regression adjusted for age and sex, the reduced HGSD remained associated with the risk of sarcopenia. Conclusion: SARC-CalF identified a risk of sarcopenia in 39.2% of patients. The reduced HGSD was associated with the risk of sarcopenia.

The predictive capacity of adductor pollicis muscle thickness for physical frailty in older adults.

There is a need for an easily measurable and reliable surrogate marker for physical frailty. This study aims to investigate the predictive capacity of adductor pollicis muscle thickness (AMPT), which can be easily measured externally and minimally influenced by subcutaneous adipose tissue, for physical frailty. A total of 589 patients (16.3% physically frail, 54.7% pre-frail, 29% robust) were included. Comprehensive geriatric assessments and anthropometric measurements of the patients were performed. APMT was assessed with a skinfold caliper. Physical frailty was diagnosed using the fried frailty phenotype. The predictive ability of APMT for the diagnosis of frailty was examined. Of all the participants, 64.3% were women, and the average age was 74 ± 5.9years. There was no significant difference in waist and hip circumference, or body mass index between the frail and non-frail groups. APMT, handgrip strength, gait speed, and calf circumference were significantly lower in frail patients than in non-frail ones (p < 0.01). The area under the curve (AUC) of APMT for physical frailty was determined to be 0.627 (95% confidence interval [CI] 0.58-0.66; p < 0.001). The best cut-off value for APMT was ≤ 18.5mm for all individuals. Adductor pollicis muscle thickness can be a useful anthropometric marker for evaluating the risk of physical frailty.

ADDUCTOR POLLICIS MUSCLE THICKNESS AS A DIAGNOSTIC TOOL FOR MALNUTRITION IN HOSPITALIZED PATIENTS

Malnutrition causes changes in body composition and compromises the physical and mental functions of individuals. One of its main characteristics is involuntary weight loss, associated with worse health outcomes. In hospital environments, the risk for the condition is high, especially among critical patients, the elderly or those undergoing surgery. This study explores the potential of adductor pollicis muscle thickness (EMAP) as an auxiliary diagnostic tool for detecting malnutrition in hospitalized patients, given its accessibility and low cost. The research involved 100 adult individuals and evaluated the correlations between EMAP, arm circumference (CB) and calf circumference (CP) with the participants body mass index (BMI). Furthermore, it suggested cut-off points for these anthropometric measurements for detecting malnutrition. The results indicated that CB and CP correlated more strongly with BMI compared to EMAP, being more effective choices for nutritional diagnosis. Regarding cutoff points, the values with the highest sensitivity and specificity for diagnosing malnutrition were 12.50 mm for EMAP, 26.00 cm for CB and 30.50 cm for CP, respectively.

Association between adductor pollicis muscle thickness and low skeletal muscle mass index in community-dwelling older women undergoing outpatient rehabilitation

ObjectiveThe accuracy of sarcopenia determination using adductor pollicis muscle thickness (APMT) has been reported. However, the relationship between APMT and low skeletal muscle mass index (SMI) is unclear. The purpose of this study is to investigate the relationship between APMT and low SMI and APMT performance to diagnose low SMI in community-dwelling older women undergoing outpatient rehabilitation. MethodsThis study included 65 older women (mean age: 86.4 years). Subjects were received outpatient rehabilitation one to three times a week. The main outcomes were low SMI as determined using the Asian working group for sarcopenia 2019 and APMT. Logistic regression analysis was performed with low SMI as the dependent variable, APMT, and propensity score calculated using age, sex, number of medications, updated Charlson comorbidity index as the independent variable. A receiver operating characteristic (ROC) curve of APMT for low SMI was created. A cut-off value was calculated using the Youden index. ResultsAmong the 65 subjects, 45 (69.2%) had low SMI. The results of the logistic regression analysis showed a significant association between APMT and low SMI (odds ratio: 0.482 {95% confidence interval [CI]: 0.313–0.744}). The cut-off value of APMT calculated from the ROC curve was 13mm. The sensitivity and specificity of this cut-off value were 0.800 (95% CI: 0.654-0.904) (36 out of 45 subjects) and 0.850 (95% CI: 0.621-0.968) (17 out of 20 subjects), respectively. The positive predictive value, negative predictive value, and area under the curve were 0.923 (95% CI: 0.791-0.984), 0.654 (95% CI: 0.443-0.828), and 0.843 (95% CI: 0.731-0.955), respectively. The APMT cut-off value of 13mm is good to identify low SMI. ConclusionsThe results of this study show that APMT is associated with low SMI. Furthermore, the cut-off value of APMT for determining low SMI was 13 mm. The APMT cut-off value of 13mm is good to identify low SMI. Our findings indicate that measuring APMT is useful for determining low SMI in community-dwelling older women undergoing outpatient rehabilitation.

Adductor pollicis muscle thickness as an anthropometric marker of ultrasonography based sarcopenia

Adductor pollicis muscle thickness as an anthropometric marker of ultrasonography based sarcopenia

Predictive ability of adductor pollicis muscle thickness on glim criteria based malnutrition

Predictive ability of adductor pollicis muscle thickness on glim criteria based malnutrition

Influence of levodopa use on the nutritional status o folder adults with Parkinson’s disease

This study aimed to assess the effect of levodopa on the nutritional status of older adults with Parkinson’s disease (PD) and associated factors. This cross-sectional, analytical, descriptive, observational study collected sociodemographic, clinical, and levodopa daily dose data and conducted nutritional assessment with the Mini-Nutritional Assessment (MNA) and adductor pollicis muscle thickness (APMT). The chi-square test was used to compare proportions and independence, considering p&lt;0.05. The study sample comprised 40 older adults with PD, with a mean age of 69.4±7.6 years; 70% were males. MNA verified a prevalence of malnutrition among those with more than 10 years with the disease, in an advanced stage, and whose levodopa equivalent daily dose was above 600 mg. It was verified that having chronic comorbidities may significantly increase the risk of malnutrition according to the APMT classification. Hence, it is greatly important to assess the nutritional status in the follow-up of older adults with PD to diagnose malnutrition early and ensure assertive and multidisciplinary intervention.

Adductor Pollicis Muscle Thickness and Its Relationship with Other Anthropometric Measurements: A Sample of Healthy Turkish Population

Objective: The aim of the authors of this study was to determine the reference values for the Adductor Pollicis Muscle Thickness (APMT) in individuals belonging to a healthy population and to compare these values with other anthropometric measurements. Materials and Methods: In this cross-sectional study, the APMT in the dominant and non-dominant hands of 385 healthy individuals categorized according to age and gender variables were measured with a caliper. Individuals in the “A” category according to the Subjective Global Assessment (SGA) test were included in the study, and anthropometric measurements. Results: In the study, 193 women and 192 men were included, and various anthropometric measurements were taken. The mean APMT values of the dominant and non-dominant hands were 20.87 ± 3.23 mm and 19.28 ± 2.93 mm in men and 16.78 ± 3.10 mm and 15.43 ± 2.92 mm in women, respectively, which indicates that there were significant differences between the members of the two genders and between the members of the same gender (p&amp;lt;0.001). There was a high level of positive correlation between the mean APMT values of the dominant hand and the mid-upper arm circumference (p&amp;lt;0.001). Conclusion: In this study, a high-level and positive correlation was found between APMT values and mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUAMC) and mid-upper arm muscle area (AMA) values. APMT measurement emerges as a useful and new anthropometric measurement method in the assessment of the nutritional status of a person.

The effect of β-hydroxy β-methylbutyrate (HMB) with nutritional counselling on anthropometric muscle mass markers, strength, functionality, and quality of life in patients on the waiting list for liver transplantation: A double-blind study

ObjectivePatients on the waiting list for liver transplantation (LTx) usually lose muscle mass. Supplementation with β-hydroxy β-methylbutyrate (HMB) may have a promising effect on this clinical condition. This study aimed to evaluate the effects of HMB on muscle mass, strength, functionality, and quality of life in patients on the LTx waiting list. MethodsA double-blind, randomized study was conducted of 3g supplementation of HMB or 3g supplementation of maltodextrin (active control) with nutritional counselling for 12 wk in patients >18 y, evaluated at five points or timepoints. Body composition and anthropometric data (resistance, reactance, phase angle, weight, body mass index, arm circumference [AC], arm muscle area, and adductor pollicis muscle thickness) were collected, and muscle strength was assessed through dynamometry and muscle function by the frailty index (FI). Quality of life was assessed. ResultsA total of 47 patients were enrolled (HMB: 23 and active control: 24). There was a significant difference in both groups for AC (P = 0.03), dynamometry (P = 0.02), and FI (P = 0.01). There was an increase in dynamometry between weeks 0 and 12 in both groups (HMB [Δdynamometry: 10.1% ± 16.4%; P < 0.05] and active control [Δdynamometry: 23.0% ± 70.3%; P < 0.05]). The AC increased in both groups between weeks 0 and 4 (HMB [ΔAC: 0.9% ± 2.8%; P < 0.05] and active control [ΔAC: 1.6% ± 3.6%; P < 0.05]) and between weeks 0 and 12 (HMB [ΔAC: 3.2% ± 6.7%; P < 0.05] and active control [ΔAC: 2.1% ± 6.6%; P < 0.05]). The FI decreased in both groups, between weeks 0 and 4 (HMB [ΔFI: –4.2% ± 6.9%; P < 0.05) and active control [ΔFI: –3.2% ± 9.6%; P < 0.05]) and between weeks 0 and 12 (HMB ΔFI: –4.4% ± 11.2%; P < 0.05] and active control [ΔFI: –5.5% ± 11.3%; P < 0.05]). The other variables did not change (P > 0.05). ConclusionsNutritional counselling with supplementation with HMB or active control in patients on the LTx waiting list improved AC, dynamometry, and the FI in both groups.

Calf circumference is an independent predictor of postoperative complications in the surgical treatment of head and neck cance

Introduction: The prevalence of malnutrition is high among head and neck cancer (HNC) patients and negatively impacts their quality of life, treatment, and survival rates. Objective: To identify preoperative nutritional variables capable of predicting postoperative complications in surgically treated HNC patients. Methods: This was a prospective cohort study of HNC patients referred for surgery as initial treatment. Results: Sixty patients were included in the study; they had a median age of 65.5 years, were mostly men (85%), and most had low education levels (90%) and low household income (78.3%). The incidence rate of severe postoperative complications (grades II, III, IV, and V according to the Clavien-Dindo grading system) was found to be 50%. The nutritional variables under investigation, namely calf circumference (CC), triceps skinfold, body mass index, and adductor pollicis muscle thickness were shown to predict postoperative complications in HNC patients, especially CC, which was found to be an independent predictor of complications (OR=0.8; 95%CI: 0.65–0.96). Each 1-cm increase in calf circumference was associated with a 20% decrease in the risk of postoperative complications. Conclusion: Our findings show the nutritional variables studied are useful in the prognostic assessment of HNC surgery.

Determination of Adductor Pollicis Muscle Thickness in Overweight or Obese Young Women

The Adductor Pollicis Muscle Thickness (APMT) value is the numerical value obtained by measuring the thickness that contains components such as tissue, skin, nerve and adipose tissue by means of a caliper. A new anthropometric measurement technique, APMT, is promising for clinical use in conditions such as obesity and malnutrition. In this study, it is aimed to compare APMT measurement with other anthropometric measurements in overweight-obese and normal weight female individuals. Healthy female individuals living in Sivas, between the ages of 18-25, overweight-obese and with normal weight were included in the study. APMT measurements were taken from both the right and left hands of the participants. The measurements were repeated twice and the average of the measurements was taken. The study sample was divided into normal weight and overweight-obese groups. A total of 46 individuals were included in the study by including 23 women in the groups. While obese individuals constitute 15.2% of the sample; overweight individuals constitute 34.8%. While APMT-R was 15.37±1.90, APMT-L was 15.04±1.78 mm in individuals with normal weight; APMT-R was 17.10±2.81 and APMT-L was 16.69±22.75 mm in overweight and obese individuals. APMT and APMT index values measured on both the right and left hands were found to be higher in overweight-obese individuals than in individuals with normal weight (p

Low appendicular skeletal muscle mass index is associated with the anthropometric variables of post-menopausal women

BackgroundSkeletal muscle mass is a central component of body composition and its decline is enhanced during aging. We verified the association between the appendicular skeletal muscle mass index (ASMI) with the anthropometric variables, biochemical variables, and lifestyle of postmenopausal women.MethodsCross-sectional observational study conducted with postmenopausal women. Sociodemographic, clinical, lifestyle, physical activity level, biochemical, and anthropometric markers were collected. Body composition was assessed by dual-energy densitometry. Multivariate logistic regression analysis was applied.ResultsOne hundred fourteen women aged in average 66.0 ± 5.8 years were evaluated. There was a significant association between ASMI and age (p = 0.004), body mass (p < 0.001), body mass index (BMI) (p < 0.001), adductor pollicis muscle thickness (APMT) (p < 0.001), plasma calcium levels (p = 0.003), calf circumference (CC), and waist circumference (WC) (p < 0.001 for both). Adjusted regression analyses revealed the influence of BMI, CC, and APMT in the 1st tertile of ASMI (p < 0.05), BMI and CC in the 2rd tertile of ASMI.ConclusionsASMI was associated with BMI and muscle mass reserve indicators such as CC and DAPMT. In clinical practice, this indicates that simple, low-cost measures with good applicability can be used to predict and track the risk of depletion of skeletal muscle mass and consequent sarcopenia.

Adductor pollicis muscle thickness in Brazilian adolescents and associations with nutritional status, sexual maturation and physical activity (EVA-JF Study)

Objective: The present study aims to assess the associations of adductor pollicis muscle thickness (APMT) with age, skin color, sexual maturation, anthropometric indicators and physical activity in Brazilian adolescents. Materials and methods: Cross-sectional study of adolescents aged 14-19 years. Weight, height, body mass index (BMI), arm circumference (AC), APMT, body fat, fat-free mass (FFM), fat-free mass index (FFMI), sexual maturation, time of physical activity and skin color were evaluated. APMT was associated with categorical variables using Mann-Whitney or Kruskal-Wallis tests and correlated with anthropometric variables using Spearman’s correlation. Linear regression was used with APMT as a dependent and the other variables as predictors. Data analysis was carried out in SPSS® software (version 17.0) with a 5% significance level. Results: 828 adolescents were evaluated, 57.6% female, with a mean age of 16.13 ± 1.20 years. APMT had an average value of 18.0 mm in females and 21.0 mm in males. The measure was greater in males, in more advanced stages of sexual maturation, overweight and physical activity. It presented a moderate correlation with FFM, FFMI, body fat and AC. In the final model of multiple linear regression for females, the variables AC and body fat explain 20.1% of the APMT variability. For men, the variables AC and FFMI explain 30.5% of the APMT variability. Conclusion: It is recommended that APMT be used in a complementary manner in the nutritional assessment of adolescents.

Analysis of the relationship between adductor pollicis muscle thickness and malnutrition in hospitalized patients diagnosed with congestive heart failure

Rationale: Congestive Heart Failure (CHF) is a disease that causes insufficient blood pumping from the heart to the rest of the body, and can lead to malnutrition, The main objective was to verify the presence of malnutrition in hospitalized adult and elderly patients diagnosed with congestive heart failure (CHF), by APTM and BMI.

Association of Subjective Global Assessment and Adductor pollicis muscle thickness with the Sarcopenia in older patients with type 2 diabetes

Background and AimSarcopenia is prevalent in older patients and increases the risk for negative outcomes during hospitalization and after hospital discharge. In patients with type 2 diabetes (T2D) this association may be even worse. Upon hospital admission, it is often difficult to identify sarcopenia, so the objective of this study was to assess whether the subjective global assessment (SGA), the European Society for Clinical Nutrition and Metabolism (ESPEN) and Global Leadership Initiative on Malnutrition (GLIM) criteria and/or usual anthropometric measures can predict sarcopenia. A secondary objective, to evaluate the accuracy of variables in the prediction of sarcopenia.MethodologyPatients ≥60 years old and with T2D were included. Malnutrition was evaluated in accordance with the guidelines of ESPEN and GLIM, and SGA. Anthropometric measurements were performed by Mid-arm circumference (MAC), mid-upper arm muscle circumference (MUAMC), and adductor pollicis muscle thickness (APMT) was performed. The sarcopenia was evaluated by handgrip strength, timed Up and Go (TUG) test and muscle mass by measuring the calf circumference (CC). Logistic regression was performed to assess the association of variables with Sarcopenia.ResultsA total of 311 patients were included. The prevalence of malnutrition in accordance to ESPEN, GLIM and SGA was 18 (5.8%), 65 (21%) and 15 (4%), respectively. The MAC and MUAMC showed a negative relationship with sarcopenia (HR: 0.92 CI95% 0.85–0.99). However, patients with overweight had a 66% reduction in the risk of sarcopenia (HR: 0.34 CI95% 0.19–0.59). After adjustments, malnourished patients according to the SGA had a risk of HR: 5.65 (CI95% 1.64–19.38) of sarcopenia, similarly to patients with APMT <5 th HR: 2.81 (CI95% 1.53–5.13), ESPEN and GLIM criteria presented HR:3.10 (CI95%1.12–8.22) and HR:2.94 (CI95%1.64–5.27), respectively. The interaction between SGA and APMT after adjusting the model has been significant (HR: 7.23 CI95% 2.98–17.67). In the area under the curve (ROC), only SGA + APMT showed greater accuracy in the prediction of sarcopenia (AUC: 0.713 CI95% 0.650–0.803).ConclusionIn our sample, it was possible to predict sarcopenia through the malnutrition criteria of ESPEN and GLIM, SGA, MAC and APMT. Measures such as APMT associated with the SGA tool seem to better predict sarcopenia in older patients with T2D. Sarcopenia is prevalent in older patients and increases the risk for negative outcomes during hospitalization and after hospital discharge. In patients with type 2 diabetes (T2D) this association may be even worse. Upon hospital admission, it is often difficult to identify sarcopenia, so the objective of this study was to assess whether the subjective global assessment (SGA), the European Society for Clinical Nutrition and Metabolism (ESPEN) and Global Leadership Initiative on Malnutrition (GLIM) criteria and/or usual anthropometric measures can predict sarcopenia. A secondary objective, to evaluate the accuracy of variables in the prediction of sarcopenia. Patients ≥60 years old and with T2D were included. Malnutrition was evaluated in accordance with the guidelines of ESPEN and GLIM, and SGA. Anthropometric measurements were performed by Mid-arm circumference (MAC), mid-upper arm muscle circumference (MUAMC), and adductor pollicis muscle thickness (APMT) was performed. The sarcopenia was evaluated by handgrip strength, timed Up and Go (TUG) test and muscle mass by measuring the calf circumference (CC). Logistic regression was performed to assess the association of variables with Sarcopenia. A total of 311 patients were included. The prevalence of malnutrition in accordance to ESPEN, GLIM and SGA was 18 (5.8%), 65 (21%) and 15 (4%), respectively. The MAC and MUAMC showed a negative relationship with sarcopenia (HR: 0.92 CI95% 0.85–0.99). However, patients with overweight had a 66% reduction in the risk of sarcopenia (HR: 0.34 CI95% 0.19–0.59). After adjustments, malnourished patients according to the SGA had a risk of HR: 5.65 (CI95% 1.64–19.38) of sarcopenia, similarly to patients with APMT <5 th HR: 2.81 (CI95% 1.53–5.13), ESPEN and GLIM criteria presented HR:3.10 (CI95%1.12–8.22) and HR:2.94 (CI95%1.64–5.27), respectively. The interaction between SGA and APMT after adjusting the model has been significant (HR: 7.23 CI95% 2.98–17.67). In the area under the curve (ROC), only SGA + APMT showed greater accuracy in the prediction of sarcopenia (AUC: 0.713 CI95% 0.650–0.803). In our sample, it was possible to predict sarcopenia through the malnutrition criteria of ESPEN and GLIM, SGA, MAC and APMT. Measures such as APMT associated with the SGA tool seem to better predict sarcopenia in older patients with T2D.

Low-cost and fast-performing indicators of muscle mass loss are good predictors of clinical outcomes in hospitalized patients: A longitudinal observational study.

"Gold standard" methods for muscle mass (MM) assessment are expensive and difficult to use in clinical practice. The present study aimed to evaluate the association between easy-to-apply and low-cost indicators of MM and clinical outcomes in hospitalized patients. In this cohort study, calf circumference [CC], adductor pollicis muscle thickness [APMT], midarm muscle circumference [MAMC], and arm muscle area [AMA] were measured within 48 h of admission to detect MM loss, and it was also evaluated by physical examination. Patients were followed up until discharge for collection of in-hospital death and length of hospital stay (LOS) data, and they were contacted by phone to assess hospital readmission and mortality at 6 months after discharge. We evaluated 601 patients (55.8 ± 14.8 years). Moderate/severe loss of MM (hazard ratio [HR], 4.12; 95% CI, 1.26-13.49), low CC (HR, 3.67; 95% CI: 1.07-12.55), low MAMC (HR, 5.20; 95% CI, 1.48-18.35), and low AMA (HR, 14.28; 95% CI, 1.80-113.14) were predictors of in-hospital mortality. Moderate/severe loss of MM was a predictor of prolonged LOS (odds ratio [OR], 2.27; 95% CI, 1.53-3.36), hospital readmission (OR, 4.14; 95% CI, 1.26-13.55), and mortality at 6 months (OR, 3.20; 95% CI, 1.71-6.01). Low CC (OR, 2.49; 95% CI, 1.27-4.85) and low APMT (OR, 3.22; 95% CI, 1.56-6.66) were associated with death 6 months after discharge. Easy-to-apply and low-cost indicators of MM were associated with negative clinical outcomes and should be part of nutrition assessment in hospitals.

Adductor Pollicis Muscle Thickness, Energy Intake, Serum Albumin, and Neutrophil-to-Lymphocyte Ratio as Predictors of Mortality in Critically Ill Patients

Background: Critically ill patients usually experience muscle wasting, inadequate energy intake and hypoalbuminemia, all of which were associated with poor outcomes. Adductor pollicis muscle thickness (APMT) can be used to assess nutritional status. Assessment of nutritional status cannot ignore the importance of inflammatory process. Neutrophil-to-lymphocyte ratio (NLR) was recently introduced as an inflammatory biomarker. Aims: To analyze the relationship between APMT, energy intake, serum albumin, and NLR with 28-day mortality. Methods: A prospective study was conducted in intensive care unit (ICU)’s of a tertiary care hospital, Indonesia, from February to March 2020. APMT was measured at admission with a caliper. Energy intake was calculated based on the number of calories received by the patient. Albumin serum and leukocyte differential count were checked at ICU admission. The primary outcome was 28-day mortality. Results: This study involved 49 patients with mortality rate of 20.4%. There was no statistically significant difference in the mean APMT between non-survivor and survivor groups (24.25±4.65 vs. 24.97±3.59 mm, p=0.596). Mean energy intake at first day was 552.2±235.6 kcal or 47.0% of the target. There was no statistically significant relationship between energy intake and mortality (less energy intake category as a comparison). There was no statistically significant difference in the mean serum albumin between non-survivor and survivor groups (2.67±0.54 vs. 2.64±0.80 g/dl, p=0.928). Median value of NLR of all subjects was 13.28 (minimum 3.50 – maximum 59.56). There was statistically significant relationship between the subject group with high NLR (≥13.28) and low NLR group (<13.28) for mortality (p=0.031). Multivariate analysis to assess combined ability of independent variables to predict mortality obtained a satisfactory area under curve (AUC) value of 78.7%. Conclusions: The combination of APMT, energy intake, serum albumin, and NLR can be considered as predictors of mortality in critically ill patients.

A espessura do músculo adutor do polegar não está associada a Proteína C Reativa em pacientes com câncer hospitalizados

Objective: To evaluate the association between blood of C-reactive protein concentrations and an indicator of muscle mass in hospitalized cancer patients. Methods: A cross-sectional study carried out with 110 patients of both sexes, aged ≥18 years, with solid and/or liquid cancer undergoing clinical and/or surgical treatment. Clinical and socioeconomic data were obtained from medical records. The adductor pollicis muscle thickness was obtained using skinfold caliper. Patients were divided into two groups: altered adductor pollicis muscle thickness (&lt;13.4 mm) and normal adductor pollicis muscle thickness (≥13.4 mm). Logistic regression was performed to verify the association between adductor pollicis muscle thickness and C-reactive protein. Results: It was observed that 90% (n = 100) of the patients were classified with reduced adductor pollicis muscle thickness, higher prevalence of the solid tumor, low usual weight, current weight, and body mass index. The logistic regression analysis showed no association between the adductor pollicis muscle thickness and C-reactive protein concentrations, in any of models used: model without adjustment (OR: 1.01; 95% CI [0.94-1.09], p = 0.65); adjusted for sex and age (OR: 1.01; 95% CI [0.94-1.09], p = 0.61); and adjusted model for sex, age and body mass index (BMI) (OR: 1.04; 95% CI [0.96-1.13], p = 0.29). Conclusion: Although adductor pollicis muscle thickness is validated method for nutritional assessment, we did not find an association with the inflammation marker (C-reactive protein).