Bioimpedance Method Research Articles

Comparative analysis of measuring the body fat percentage by anthropometric methods and bioimpedance

Introduction/Objective. Body fat percentage (BFP) is the most reliable indicator of the nutritional status. For clinical practice, it is important but also insufficiently examined whether the determination of BFP should be relied exclusively on the latest methods or whether classical anthropometric methods are also reliable. The aim was to investigate the correlation between the results of BFP measuring using a contemporary method of bioimpedance and classic methods of skin fold thickness (SFT) and body mass index (BMI). Method. There were 279 patients of the Dietetic Counseling Center of the Institute for Public Health in Nis who were included in the research during 2015. BFP was determined using three classic anthropometric methods: SFT over the triceps, SFT over the scapula, and BMI. OMRON BF 302 apparatus was used for BFP measuring using the bioimpedance method. Results. Using single-factor analysis of variance we found a statistically significant difference between the mean values of the BFP obtained with bioimpedance and those obtained with anthropometric methods (F = 24.19, p < 0.05). Post hoc analysis revealed a statistically significant difference between the BFP determined with bioimpedance and SFT over the triceps and the scapula, while the anthropometric method based on BMI gave the results similar to those from bioimpedance. Conclusion. We show that the most reliable anthropometric method of determination of BFP is that based on BMI, as its results correlate best with those obtained with a contemporary method of bioimpedance.

Nutritional status assessment of the Polish Border Guards officers – Body Mass Index or Fat Mass Index?

AbstractIntroduction:Border Guards service requirements are very specific. Very good health and excellent psycho-physical condition are the main factors that determine effectiveness and reliability of designated tasks. Disorders of nutritional status, such as underweight, overweight or obesity not only impairs well-being, but also are health problem associated with limitation of possibilities to perform Border Guard's tasks and duties and can lead to earlier elimination from the service. The aim of the study was to assess nutritional status, using two indicators: Body Mass Index (BMI) and Fat Mass Index (FMI).Materials and methods:The study was carried out with participation of 259 Border Guards (64 women and 195 men), aged 38 ± 6; years of service: 12 ± 6. An electric bioimpedance method (TANITA MC-780) was used to determine body composition. Body Mass Index (BMI [kg/m2] = body mass [kg] / height2 [m2]) and Fat Mass Index FMI [kg/m2] = fat mass [kg] / height2 [m2]) were calculated for each of the participants.Results and discussion:Examined group of Polish Border Guards officers was characterized by a large variety of assessed anthropometric indicators. According to the BMI classification excess body mass was more often (p < 0.001) observed in men (68%) than in women (25%) and according to the FMI classification excess fat was also more often (p < 0.001) observed in men (55%) than in women (28%). BMI classification of overweight or obese was observed in 41 of participants with the normal FMI level. Fat percentage of women with normal BMI ranged from 11.6 to 33.5% and tat percentage of men with normal BMI ranged from 7.3 to 21.6%. There are difficulties in BMI interpretation in adults with increased physical activity. It seems more reasonable to assess correctness of nutritional status on the basis of an analyze of FMI value, as this indicator assesses degree of fatness, and not the entire body weight, which, in case of uniformed services usually is greater due to extensive muscle mass, which can increase BMI value. It is necessary to take educational activities in the field of health promotion of these people, with a focus on nutrition prevention of metabolic civilization diseases, as well as to motivate Border Guards officers to respect basic principles of proper nutrition to maintain proper body mass and fat mass.

Influence of a diet and physical activity on the nutritional status of soldiers of the Polish Air Cavalry units

AbstractIntroductionResearch from recent years indicate a problem of excessive body weight among soldiers, who due to the kind of carried out work should reveal the best health and fitness. Moreover, proper nutritional status in case of soldiers is extremely important, as it significantly affects their physical fitness. The aim of the study was to determine impact of the diet and physical activity on selected indicators of protein-energy and mineral nutritional status.Materials and methodsOne hundred and twenty male soldiers (aged: 28 ± 5; years of service: 5 ± 5), serving completed validated for Polish population the Food Frequency Questionnaire and long-form International Physical Activity Questionnaire. Body composition was determined by an electric bioimpedance method (TANITA MC-780) and bone mineral density of forearm bone of the non-dominant hand was assessed by the DEXA densitometric method, using apparatus EXA 3000.Results and discussionThis study confirmed the impact of both the diet and physical activity on selected measures of soldiers’ nutritional status, i.e. fat mass index and bone mineral density. Out of selected 61 products negative correlation between FMI and frequency of apples and pears consumption (r = -0.23, p = 0,023), and positive correlation with frequency of beer (r = 0.20, p = 0.049) and vodka and spirits drinking (r = 0.26, p = 0.010) consumption were found. While the T-score value positively correlated with frequency of tropical fruits (r = 0.23, p = 0.024), avocado (r = 0.25, p = 0.014), fine-grained not refined groats (r = 0.22, p = 0.030) and eggs (r = 0.29, p = 0.004) consumption. A negative correlation was found for frequency of refined bread (r = -0.24, p = 0.019), sausages(r = -0.35, p < 0.023), high-quality cold cuts (r = -0.25, p = 0.014, sugar to sweeten beverages (r = -0.31, p = 0.002), biscuits and cakes (r = -0.23, p = 0.016), salty snacks (r = -0.23, p = 0.023), fruit juices and nectars (r = -0.28, p = 0.005) and sugar-sweetened beverages (r = -0.34, p = 0.001). A negative correlation with FMI (r = -0.22, p = 0.036) for weekly physical activity expressed in MET-minutes/week was found. Positive correlations were found between T-score value and physical activity expressed in MET-minutes per week in total, housework, house maintenance and caring for family (r = 0.22; p = 0.040), and recreation, sport and physical activity in leisure time (r = 0.25, p = 0.019), as well as moderate physical activity (r = 0.28, p = 0.008) and intense one (r = 0.21, p = 0.046). The founded abnormalities in nutritional status, as well as numerous nutritional errors indicate a need for further monitoring of this group of soldiers, not only in terms of accuracy of nutritional status, their diet and physical activity, but also wider understood health behavior

Determination of influence effectiveness of ethnic games on the componential body composition of adult people (in the age of 50-57 y.o.) with the help of bioimpedance analysis

The paper presents the results of research conducted for the first time in Kyrgyzstan under conditions of middle mountains aimed at studying the influence of ethnic games on the parameters of the componential composition of adults’ bodies with the help of bioimpedance analysis. 92 adults in the age of 50-57 y.o. have been studied. In the group of ethnic games, 47 out of 92 (30 men and 17 women) were studied during the first inspection. 23 people (11 men and 12 women) had been studied during the second inspection. 22 people (9 men and 13 women) had been investigated in the group of modern physical culture. Analysis of methodological literature, bioimpedance analysis (TANITA RD-953). Statistical data processing was supported by the program SPSS 22. The application of the bioimpedance method aimed at analyzing the influence of ethnic games and modern means of physical culture on the parameters of the adults’ body componential composition has shown the objective results of changes in the indices of respondents’ body componential structure. During the second inspection of the healthy men and women at the age of 50-57 body composition involved into playing ethnic games, there had been revealed reliable changes (Р<0,05) in such indices, as body weight, body build index, the total mass of fat, physical type, visceral fat, biological age, and water content. Comparative analysis of body composition between the group of men and women engaged in ethnic games and the groups of respondents engaged in modern physical culture means revealed that the men and women of both groups have indices of body build index, the total mass of fat, visceral fat, bone mass, physical type and biological age conforming to norms. The obtained results indicate the effectiveness and productivity of the bioimpedance analysis application for determining the influence on the componential composition of body and physical condition of adult people at the age of 50-57 years. They are occupied with ethnic games and modern means of physical culture in the conditions of mountain climate.

Anthropometric characteristics and health self-assessment of female university students

Background/Aim: An important period in becoming a young woman is studying at the University. It is a period of taking responsibility for yourself, your health and social relationships. The abilities formed during this period directly affect one's physical and mental health. The study was undertaken in order to determine anthropometric characteristics and to evaluate the health of female students aged 19 to 22. Methods: An analytical population study based on a survey using a standardised SF36 self-report health test and measurement using an objective bioimpedance method with Omron BF 511 estimated 408 female students of the University of Banja Luka aged 19 to 22, based on inclusion criteria. Results: The mean body mass index (BMI) ± standard deviation of female students was 22.1 ± 3.2 kg/m2 , with 31.80 ± 6.47 percent fat and 28.15 ± 2.81 percent muscle mass. The mean values ± standard deviation of the SF 36 for mental health (MH) questionnaires was 60.7 ± 24.95 and for physical health (FH) 72.21 ± 25.89. Conclusion: Female students have ideal BMI values. Physical health self-assessment reached higher values than the mental health self-assessment, which is probably related to mental distress and problems during studying.

Health status of woman from a small and big town in Poland: the subjective and objective assessment

The way of defining the concept of health varies depending on the age, sex, social position of a person conditioned by place of residence, economic and family situation. The aim of the study was to assess subjective and objective health status of women over 65 living in a small and big town. In the subjective assessment of the nutritional status were the MNA questionnaire used, in the objective assessment was BMI used. Body composition analysis was carried out using the bioimpedance method. Lab tests were made using standard methods. The quantitative assessment of the diet was made using the 24-hour intake method, the results calculated in software Dieta 5. Significantly more often women from Nysa than from Wroclaw assessed their health status in comparison with their peers as just as good or better (p <0.05). The BMI value among Nysa women shows the overweight, and among women from Wroclaw, obesity. The average content of adipose tissue among all examined women indicated significant fatness of the examined group (36 - 37%). The average energy supply in the food rations of women from Nysa and Wroclaw differed statistically significantly and did not meet the accepted norms. In conclusion, we can say that older women from a small city assessed their health as better or as good compared to older women in a large city. The implementation of dietary norms and recommendations in the food rations of the subjects was insufficient. However, women from a small town provided statistically significantly more nutrients in their diets.

Effects of Melatonin on Chronic Pancreatitis and Atherosclerosis

The effect of melatonin on chronic pancreatitis and atherosclerosis in patients on the complex therapy background is describeda nd analyzed in the article.The objective: to study the clinical efficacy and melatonin influence on the clinical and laboratory parameters dynamics on the complex therapy background in patients with chronic pancreatitis and atherosclerosis.Materials and methods. All patients underwent laboratory and instrumental studies before and after the assigned treatment: dyslipidemia detection – the lipid profile indicators` study with the calculation of the atherogenicity coefficient (CA = total cholesterol (TC) – high-density lipoprotein) /HDL)); endothelial dysfunction detection – ultrasonic duplex scan of the brachial artery with the endothelium-dependent vasodilation determination; body composition study by bioimpedance method.Results. A positive melatonin effect was found in chronic pancreatitis and atherosclerosis complex treatment, which showed a statistically significant improvement in lipid profile. Patients who received the drug melatonin in the complex treatment showed more pronounced changes in the ultrasonic duplex scan of the brachial artery results, which showed an increase in blood flow velocity in the brachial artery through increasing its diameter by 30 and 60 seconds of reactive hyperemia. Patients who were treated with melatonin had a more pronounced reduction in fat mass and, consequently, an increase in muscle, according to the bioimpedance method results.Conclusions. Administration of melatonin («Vita-melatonin») on the standard therapy background in patients with chronic pancreatitis and atherosclerosis leads to improvement of endothelial function, vascular stiffness indicators and atherosclerosis in general due to its antioxidant and anti-inflammatory properties, ability to synthesize NO.

Profile and Reference Values for Body Fat and Skeletal Muscle Mass Percent at Females, Aged from 18.0 to 69.9, Measured by Multichannel Segmental Bioimpedance Method: Serbian Population Study

Profile and Reference Values for Body Fat and Skeletal Muscle Mass Percent at Females, Aged from 18.0 to 69.9, Measured by Multichannel Segmental Bioimpedance Method: Serbian Population Study

Consumption of dietary supplements to support weight reduction in adults according to sociodemographic background, body mass index, waist-hip ratio, body fat and physical activity

BackgroundThe aim of this study was to analyse the use of dietary supplements to support weight reduction (DSSWR) in adults according to sociodemographic background, body mass index (BMI), waist-hip ratio (WHR), body fat percentage (%BF) and level of physical activity (PA).MethodParticipants (n = 1130) were recruited from a region of Poland with a high rate of adult overweight and obesity. Based on anthropometric data, BMI and WHR were calculated. %BF was assessed using a bioimpedance method. To examine the association between DSSWR use and sociodemographic factors, BMI, WHR, %BF and PA multiple logistic regression were conducted.ResultsThe rate of DSSWR use in the group studied was high (69.5%). A higher proportion of women, individuals aged 18–35 years, those who had completed higher education, those who did not report financial status as “poor”, with a BMI < 18.5, normal %BF and individuals with a high level of PA used DSSWR. In complete case analysis (n = 1108), primarily financial status reported as “good” (OR = 2.18, 95% CI: 1.69, 2.81) or “hard to say” (OR = 2.41, 95% CI: 1.86, 3.12) (vs. “poor”) and female sex (OR = 2.59, 95% CI: 2.17, 3.08) were associated with DSSWR intake.ConclusionIt seems that primarily financial status and sex, but also age, education, and level of PA, have significance in DSSWR use in adults and may be considered when developing appropriate strategies for body weight management and health promotion.

P5298Influence of the changes in body fat on all-cause and cardiovascular mortality in a general population: a report from Ansan-Ansung cohort in the Korean genome environment study

Abstract Background Paradoxical beneficial effects of obesity on all-cause and cardiovascular mortality have been reported in multiple cohort studies based on patients with cardiovascular disease as well as general populations. However, the association between the presence of obesity at baseline and the better survival rates could not be directly interpreted into the beneficial effect of gain in obesity or fatness on the mortality, which makes it difficult to provide any recommendation for the management of obesity. Therefore, we investigated the influence of the changes in body fat on all-cause and cardiovascular mortality in a general population. Methods A population-based cohort study has been conducted for 12 years (from 2001 to 2012). A total of 5,259 subjects in whom body compositions using a bio-impedance method were measured at least 2 times during the observational period were included. The causes of death was identified from the nation-wide database in KOSTAT. I20-I82 and R99 in the International Classification of Disease-10 codes were defined as a cardiovascular death. The subjects were evenly divided into 3 groups by the percentages of the changes in body fat (Δ%BF; decreased [Δ%BF &lt;0.0%] vs. increased [Δ%BF 0.0–13.7%] vs. highly increased [Δ%BF ≥13.7%]). Inverse probability of treatment weighting was applied to balance the covariate differences among the groups. Results The age was 51.2±8.5 years and 51.6% was male. Median observation duration was 163 (the interquartile range: 157–168) months. The all-cause death and cardiovascular death occurred most frequently in the decreased Δ%BF group and least frequent in the highly increased Δ%BF group in both unweighted and weighted cohort. Multivariate Cox proportional hazard models showed that the risk of all-cause death was lower in the increased and highly increased Δ%BF groups (hazard ratio [HR] 0.61 [0.47–0.80] and 0.24 [0.17–0.34], respectively) and the risk of cardiovascular death was lower in the highly increased Δ%BF group (HR 0.20 [0.08–0.48]), compared to those in the decreased Δ%BF group after adjustment for all covariates including physical activities and the changes in muscle mass. The risk of all-cause death and cardiovascular death linearly decreased with increasing Δ%BF (HR 0.72 [0.67–0.77] and 0.70 [0.60–0.82], respectively). Conclusion The increase in body fat is associated with a lower risk of all-cause death and cardiovascular death in a middle-age general population, independently with physical activities and the changes in muscle mass.

Changes in electrolyte concentrations alter the impedance during ischemia-reperfusion injury in rat brain

Objective: Ischemic stroke is a major cause of death and disability worldwide. Nowadays, electrical impedance spectroscopy is an emerging tool to differentiate between normal and stroke conditions. Approach: In this study, changes in the bio-impedance spectroscopy using a two-electrode method with varying frequencies from 100 to 35 kHz have been assessed in a model of global cerebral ischemia in anesthetized rats during normal, occlusion and reperfusion conditions. Global cerebral ischemia was induced by bilateral common carotid artery occlusion for 40 min following 40 min of reperfusion. The concentration of sodium, potassium, calcium and chloride ions in the whole rat brain was determined by electrolyte analyzer. For the interpretation of in vivo results, changes in electrical impedance with varying concentrations of sodium, potassium and calcium ions in artificial cerebrospinal fluid (aCSF) were also observed using the bio-impedance spectroscopy method. Main results: The in vivo bio-impedance analysis suggests that the impedance is consistently increased during occlusion as compared to the normal condition. The in vitro study revealed that the impedance escalates with an increase in the concentration of potassium and calcium ions and reduces with an increase in the concentration of sodium ions in aCSF. A further electrolyte analysis suggested that the level of sodium and chloride ions is significantly decreased and the level of calcium and potassium is significantly increased during occlusion as compared to the normal condition. Significance: These findings suggest that the increase in impedance during occlusion may be due to changes in the ionic concentration of the rat brain. The above in vivo and in vitro studies successfully demonstrated and interrelated the change in impedance with corresponding changes in ionic concentration.

Performance of Electrical Velocimetry for Noninvasive Cardiac Output Measurements in Perioperative Patients After Subarachnoid Hemorrhage

Fluid therapy guided by cardiac output measurements is of particular importance for adequate cerebral perfusion and oxygenation in neurosurgical patients. We examined the usefulness of a noninvasive electrical velocimetry (EV) device based on the thoracic bioimpedance method for perioperative hemodynamic monitoring in patients after aneurysmal subarachnoid hemorrhage. In total, 18 patients who underwent surgical clipping or endovascular coiling for ruptured aneurysms were examined prospectively. Simultaneous cardiac index (CI) measurements obtained with EV (CIEV) and reference transpulmonary thermodilution (CITPTD) were compared. A total of 223 pairs of data were collected. A significant correlation was found between CIEV and CITPTD (r=0.86; P<0.001). Bland and Altman analysis revealed a bias between CIEV and CITPTD of -0.06 L/min/m, with limits of agreement of ±1.14 L/min/m and a percentage error of 33%. Although the percentage error for overall data was higher than the acceptable limit of 30%, subgroup analysis during the postoperative phase showed better agreement (23% vs. 42% during the intraprocedure phase). Four-quadrant plot and polar plot analyses showed fair-to-poor trending abilities (concordance rate of 90% to 91%, angular bias of +17 degrees, radial limits of agreement between ±37 and ±40 degrees, and polar concordance rate of 72% to 75%), including the subgroup analysis. Absolute CI values obtained from EV and TPTD are not interchangeable with TPTD for perioperative use in subarachnoid hemorrhage patients. However, considering the moderate levels of agreement with marginal trending ability during the early postoperative phase, this user-friendly device can provide an attractive monitoring option during neurocritical care.

The Relationship Between The Electromyographic Activity Of Rectus And Oblique Abdominal Muscles And Bioimpedance Body Composition Analysis - A Pilot Observational Study.

PurposeMeasurements using surface electromyography (sEMG) may be more complicated when the different thickness of the subcutaneous tissue layer is observed, therefore it is important to show the influence of fat tissue on the results of sEMG measurements. The main aim of the study was to assess the relationship between the sEMG RMS value of rectus and external oblique muscles of the abdomen and the composition of the body, which was assessed using bioelectrical impedance analysis.Patients and methodsThe target group was made up of healthy people aged 20-30-year-old. The study visit protocol of the participants was as follows: a medical history, instructions on the purpose of measurements and examination procedures, obtaining consent for participation in the research, an analysis of the body weight composition by the electrical bioimpedance method, a fat tissue thickness measurement using body fat calipers, preparation of the subject for sEMG measurements (sEMG RMS value of rectus and external oblique abdominal muscles).ResultsTwenty-nine people were qualified for the study according to the inclusion and exclusion criteria. sEMG amplitudes decreased when the person had a higher fat content and had less water in the body. These results were related to the rectus abdominal muscle (mainly its upper part) during the active contraction of this muscle. In addition, it was observed that when actively bent their torsos forward people with a higher BMI and with a greater thickness of fat tissue had a lower sEMG RMS value of the rectus abdominal muscle.ConclusionIn order to conduct reliable examinations using sEMG, parameters concerning the amount of fat tissue, the thickness of fat tissue, BMI and amount of water in the body should be taken into account.

Endothelial and Autonomic Dysfunction at Early Stages of Glucose Intolerance and in Metabolic Syndrome.

This study evaluated sE-selectin, Endothelin-1, and cardiovascular autonomic neuropathy (CAN) at early stages of glucose intolerance and in metabolic syndrome (MetS). A total of 87 subjects - 39 males, of mean age 45.7±11.6 years and mean BMI 31.4±6.6 kg/m2, divided according to glucose tolerance and the presence of MetS were enrolled. Glucose tolerance was studied during OGTT. Anthropometric indices, blood pressure, HbA1c, lipids, hsCRP, sE-selectin, Endothelin-1, and immunoreactive insulin were measured. Body composition was assessed by a bioimpedance method (InBody 720, BioSpace). Tissue AGEs accumulation was evaluated by skin autofluorescence (AGE-Reader, DiagnOpticsTM). CAN was assessed by ANX-3.0 technology. In the groups, according to glucose tolerance, the prevalence of CAN was 5.7% in normal glucose tolerance (NGT), 8.6% in prediabetes, and 23.5% in newly diagnosed type 2 diabetes (NDD). In the groups, according to the presence of MetS, the prevalence of CAN was 12.3% in those with MetS and 4.8% in those without MetS. Parasympathetic activity was diminished at rest (p=0.048, 0.015, respectively) in NDD as compared to prediabetes and NGT; and there was a numerically elevated heart rate at rest in NDD in comparison to NGT. There was a negative correlation between parasympathetic tone and waist circumference, BMI, and visceral and total fat. There was no difference in the measured endothelial function markers in the groups according to glucose tolerance and MetS. sE-selectin correlated with HOMA-IR (r=0.275, p=0.048). No association between Endothelin-1 levels and assessed metabolic parameters was observed. There is a high prevalence of CAN at early stages of glucose intolerance and in MetS, due to decreased parasympathetic activity. Slight elevation of glycemia and MetS probably do not affect endothelial function, since sE-selectin seems to be related to insulin resistance.

Features of physical development and somatotype of girls and women involved in fitness

Purpose : Comparative analysis of the physical development features and somatotype of girls and women involved in fitness. Material : The experiment involved 95 girls and women, divided into 2 groups. Group 1 - 48 girls (36.04 ± 0.19) years, Group 2 - 47 women (43.26 ± 0.22) years, (p &lt;0.01). Participants practiced fitness 2-3 times a week. The duration of the training was 60 minutes. It was determined the body mass and body length, wrist circumference, waist and hips circumferences. The TANITA BC 587 analyzer was applied to determine muscle and fat mass, the specific weight of fat tissue, water content, percentage of visceral fat, basal metabolism value, bone mass mineralization. It was calculated the body mass index and the waist-to-hip ratio. The results were evaluated applying the Student's t-test (t) and Rosenbaum (Q) and Wilcoxon - Mann - Whitney (U) criteria. Results : There were no significant differences in body length and body mass. The girls confirmed a less value of hip circumference (t = 2.04, p &lt;0.05) and a tendency to less waist circumference (t = 1.97, p &lt;0.1) in comparison with group 2. The participants of group 2 had a larger wrist circumference (U = 891, p &lt;0.05). According to this parameter, persons with asthenic body type prevailed among participants. Their specific weight was (56.25 ± 7.16)% of group 1 and (53.19 ± 7.28)% of group 2. It was confirmed less absolute body fat content in group 1 (t = 2.09, p &lt;0.05). All participants were characterized by larger muscle mass. There were no differences in this parameter between groups. It was determined the high concentration of specific weight of fat tissue in comparison with age standards. The content of visceral fat was within the age norm. Its content was higher in group 2 (Q = 18, p &lt;0.01). The basal metabolic value was larger in group 2 (Q = 17, p &lt;0.01). The values of bone mass mineralization reflect the correspondence to the body mass of the participants. This parameter did not have significant differences in the groups. The body mass index value in group 1 was within the average interval. In group 2, this index was higher than the standard one. The body mass index in group 1 was significantly lower (t = 2.18, p &lt;0.05). The participants with a body mass index above the norm were (35.42 ± 6.90)% of group 1 and (59.57 ± 7.16)% of group 2. The prevalence of waist-to-hip ratio above the norm was (54.17 ± 7.19)% 1 group and (59.57 ± 7.17)% 2 group, (p&gt; 0.05). Conclusions : it was determined the proximity of the main anthropometric parameters (mass and body length). The girls have lower values of the hip circumference. Persons with asthenic body type prevailed among the participants. Analysis of the indices confirmed the high prevalence of overweight and high risk of developing metabolic syndrome. The application of bio-impedance method confirmed and clarified the results of anthropometric research. The participants demonstrated the increased content of subcutaneous and visceral fat, increasing with age. The water level in the body gradually decreases with age. This is considered as a reflection of age-related physiological changes in metabolism and should be considered in fitness training organizing. Studies have confirmed the informativeness and adequacy of the bio-impedance method.

A multi-center survey on hospital malnutrition and cachexia in Slovenia

BackgroundMalnutrition has become a prevalent condition, with European and international studies reporting rates of approximately 25–40% in hospitals. We set out to perform a multi-center cross-sectional study to assess malnutrition rates in Slovenian hospitals and to convert the findings into a mobile application suitable for use by nurses and staff at the bedside. In addition, we examined the association of the results of this mobile application with parameters for body composition measured by bioimpedance method, muscle strength, anthropometrics, and specific blood markers.MethodsWe selected the Nutritional Risk Screening 2002 (NRS-2002) method, the second version of the modified short-form of Mini-Nutritional Assessment (MNA-SF), and the diagnostic criteria for cachexia proposed by Evans (CDE) as evidence-based methods for estimating the risk of and prevalence of malnutrition or/and cachexia. The methods were converted into the Android mobile application named MalNut that was used in three Slovenian hospitals by nurses and dietitians.ResultsWe applied NRS-2002 and MNA-SF to screen for malnutrition risk and to assess malnutrition in 207 individuals aged 18 years and older, regardless of gender or reason for hospitalization during 1-week periods. Totally, 98% of these patients consider nutrition an important part of medical treatment care. NRS-2002 estimated the malnutrition risk to be 66.3%, which includes both patients to be at risk for malnutrition and patients that are truly malnourished. The malnutrition risk in the elderly (65+) estimated by MNA-SF was 39.6% and malnutrition 42.5%. When applying the CDE score in these two categories, 66.7% were identified as cachectic and 21.4% as pre-cachectic. In the patients assessed with the CDE score, malnutrition risk increased with higher extracellular water and decreased body mass index, hemoglobin, phase angle, and muscle strength. In all, 75% of patients assessed as high risk for malnutrition by NRS-2002, were identified as cachectic and 15.7% as pre-cachectic. In NRS-2002 assessed patients, this risk increased with higher C-reactive protein and lower phase angle.ConclusionsThe study showed that both malnutrition and cachexia are largely overlapping notions and are common in hospitalized adults in Slovenia. The MNA-SF and NRS-2002 tools showed that malnutrition risk was not significantly correlated with age, gender, serum albumin, but was correlated with lower phase angle, CRP, and muscle strength in elderly patients. The results have been used to develop further nutritional interventions in Slovenia.

DASH diet decreases CXCL4 plasma concentration in patients diagnosed with coronary atherosclerotic lesions

Background and aimsAim of this study involved assessment of the intensive intervention concerning lifestyle based on the DASH diet model on plasma concentration of CXCL4 chemokine among patients with coronary atherosclerosis. Methods and resultsThe Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography Study randomized patients with stable CAD to an interventional group (n = 41), where DASH diet was implemented and the control group (n = 40) without dietary intervention. Dietary counselling was provided to DASH group during all 6 control visits within 6 months of observation. During the study, body weight and body composition were controlled using the bioimpedance method. CXCL4 concentration was determined with the use of ELISA test.Within the DASH group, a significant decrease in body weight, a decrease in high sensitivity C-reactive protein concentration (−0.32 ± 2.8 mg/l; p < 0.05), as well as a decrease in CXCL4 concentration (−3.35 ± 3.4 ng/ml; p < 0.0001) were observed. Occurring changes were not statistically significant within the control group. ConclusionsDASH diet lessens CXCL4 concentration among patients with a stable CAD, however, further research is necessary in order to confirm aforementioned results and evaluate the impact on atherosclerotic plaque. This trial was registered atwww.clinicaltrials.gov as NCT02571803.

Resting Energy Expenditure and Substrate Oxidation in Malnourished Patients With Type 1 Glycogenosis.

Type 1a and 1b glycogenosis [glycogen storage disorder (GSD)1a, GSD1b] are rare diseases generally associated with malnutrition. Although abnormal substrate oxidation rates and elevated energy expenditures might contribute to malnutrition, this issue has not been investigated. To investigate whether abnormal resting energy expenditure (REE) and substrate oxidation rate characterize patients with GSD1. Cross-sectional study. Outpatient referral center for rare diseases and laboratory of clinical nutrition at the University Hospital of Palermo. Five consecutive patients with GSD1 (4 type a, 1 type b; 3 men, 2 women; age range, 19 to 49 years). The usual clinical procedures for patients with malnutrition, including REE and basal substrate oxidation rate (both indirect calorimetry), body composition (bioimpedance method), muscle strength (hand-grip test), and the usual laboratory tests, were performed. Malnutrition was clearly diagnosed in 2 patients (1 GSD1a and 1 GSD1b), with REE elevated in all five patients, and especially, in the two malnourished patients (+124% and +32.1% vs predictive values using Harris-Benedict equations). The two malnourished patients also exhibited lower basal protein oxidation rates (7.7% and 6.6%) than the nourished patients (range, 12.1% to 24.7%), with higher carbohydrate or lipid oxidation rates. Additionally, the two malnourished patients exhibited higher blood concentrations of lactic acid than the nourished patients. According to data obtained from our small sample of patients with GSD1, elevated REEs seem to be a common characteristic that might contribute to malnutrition. Low basal protein oxidation rates and elevated blood lactic acid concentrations appear to be associated with malnutrition.

HEMODYNAMIC PROFILES IN TREATMENT-NAIVE ARTERIAL HYPERTENSION AND THEIR CLINICAL IMPLICATION FOR CHOICE OF TREATMENT – A PILOT STUDY

Objective: Arterial Hypertension (AHT) is characterised by different hemodynamic modulators, which can be non-invasively assessed using the HOTMAN® System, a very low-current thoracic bioimpedance method to estimate modulators such as volemia, inotropy, chronotropy and vasoactivity, and express them as a hemodynamic map. The aim of the present study was to characterise hemodynamic patterns in newly diagnosed treatment-naive hypertensive patients and to assess the advantages of hemodynamic profiling in clinical decision making regarding choice of an antihypertensive therapy. Design and method: Between April 2015 and March 2018, 80 outpatients with newly diagnosed AHT were randomized to antihypertensive monotherapy with either an ACE inhibitor, an angiotensin receptor blocker, a calcium channel blocker, or hydrochlorothiazide. Hemodynamic profiles and 24h-blood pressure (BP) measurements were done at baseline and after one month of treatment. Three hypertension experts (blinded to treatment assignment) retrospectively determined the most appropriate treatment according to the hemodynamic maps at baseline. The randomized patients were post-hoc categorised as having received concordant or discordant treatment. Three hemodynamic profiles could not be analyzed due to technical problems. Results: Mean age, body mass index and gender proportion were 48.9(±14.3) years, 26.5(±3.7) kg/m2 and 74% males, respectively. The mean 24 h average BP at baseline was 141.8(±9.1)/87.7(±7.6) mmHg. The predominant hemodynamic profiles at baseline were 45% hypervolemia without vasoconstriction and 48% hypervolemia with vasoconstriction (mixed) (Figure 1).After one month of treatment, the BP control rate was 53.7%(43/80) among all, 57.7%(30/52) in the discordant group and 48%(12/25) in the concordant group. The overall 24 h average BP was 131.3(±11.3)/82.2(±8.3) mmHg, respectively with a BP reduction of −10.5(±11.7)/−5.6(±6.5) mmHg. The average 24 h BP systolic and diastolic reductions in the concordant treatment group (n = 25) and the discordant group (n = 52) were −12.4(±14.8)/−6.9 (±6.9) mmHg and −9.7(±10.1)/−5.0(±6.2) mmHg, respectively. The differences were statistically not significant (p = 0.496 and 0.322) (Figure 2). Conclusions: Our data does not support the hypothesis that treatment initiation based on hemodynamic patterns improves blood pressure control in newly diagnosed hypertensive outpatients.

SPECIFIC FEATURES OF OVARIAN FUNCTION IN WOMEN WITH METABOLIC SYNDROME DIAGNOSED ACCORDING TO 2009 HARMONIZED CRITERIA

The prevalence of metabolic syndrome (MS) continues to grow, among women of reproductive age as well. According to the 2009 MS diagnostic criteria (harmonized), increased waist circumference is not an obligatory criterion. Thus the concept of MS with a normal BMI appeared. The influence of metabolic disturbances on ovarian function is extensively studied in PCOS while in other cases this aspect remains understudied.The aim of the work was to study the specific features of ovarian function in women of early/active reproductive age with MS and obesity, with MS without obesity and women with obesity without MS compared with healthy women (PCOS was excluded in all studied groups).Methods. This was a case-control study that involved 38 women with BMI> 30, 30 women with MS and BMI 30 without MS, and 30 healthy women. The percentage of visceral fat was determined by bioimpedance method. AMH and FSH were evaluated with chemiluminescent and solid phase enzyme immunoassays respectively. The study was approved by the Ethics committee of the Centre of Innovation Medical Technologies NAMS of Ukraine. Authors claim the absence of the conflict of interest.Results: in women with MS with obesity and without, statistically lower levels of AMH were recorded compared with the control group and women with normal weight MS: 2,4+0,8ng/ml and 1.8+0,5ng/ml compared with 4.2+1,5ng/ml and 5.6+3,2ng/ml, respectively. At the same time, in women with MS without obesity, a decrease in AMH was accompanied by high levels of FSH, and with obesity – with low levels. The strong side of our study is the comparability of the examined women on reproductive age, which reduces the range of AMH variability, and the size of the group of women with obesity without MS (BMI <30, n-30), a contingent that is seldom investigated as a separate group. Features of ovarian dysfunction in women of reproductive age with MS in the context of BMI <30 require a more detailed investigation in the aspect of interaction with visceral obesity, gonadotoxic factors and genetic factors determining ovarian reserve.Conclusion. The study showed significant differences in the effect of different phenotypic forms of MS on the function of the ovaries in women of early/active reproductive age. In particular, women with MS and obesity have hypogonadotropic dysfunction, whereas in women with MS with BMI <30 there was a more pronounced decrease in ovarian reserve, which most likely resulted in an increase in FSH. Thus, a more detailed study of the mechanisms of ovarian disfunction in different phenotypic forms of MS distinct from PCOS is required.