Body Composition Parameters Research Articles

Antihypertensive effects and changes in extracellular water content by mineralocorticoid receptor antagonists in patients with primary aldosteronism.

In primary aldosteronism (PA), non-suppressible excessive aldosterone secretion due to dietary salt intake significantly contributes to hypertension and cardiovascular complications. Blocking the overactivation of mineralocorticoid receptors (MRs) with mineralocorticoid receptor antagonists (MRAs) is a cornerstone for the medical treatment of PA. However, the role of MRAs in controlling hypertension remains unclear. This study aimed to explore the relationship between changes in body composition parameters (determined by bioelectrical impedance analysis), blood pressure (BP) levels, serum potassium (K+) levels and Study 36-Item Short-Form Health Survey (SF-36) scores after MRA treatment in 50 patients with PA. Treatment with MRAs significantly decreased the systolic BP (SBP) and diastolic BP (DBP) levels and extracellular water (ECW) volume, while it increased the serum K+ levels, active renin concentrations (ARCs), and scores on several SF-36-based quality of life (QOL) subscales. ECW change (ΔECW) and serum K+ change were not significantly associated with changes in SBP and DBP levels. ΔECW showed a significant inverse correlation with ΔARC, suggesting that ARC increases with decreasing ECW volume due to renal MR activity blockade and that ARC is a highly sensitive indicator of ECW volume. In the stratified analysis of patients with PA, ECW volume was significantly decreased in those aged ≥60 years and those with a body mass index of ≥25 kg/m2. In conclusion, MRA treatment showed antihypertensive, biochemical, and QOL improvement effects in patients with PA. The antihypertensive effect may not be related to the decrease in ECW volume due to renal MR activity blockade. Evaluation of ECW using BIA in patients with PA treated with MRAs. Abbreviations: ARC, active renin concentration; BIA, bioelectrical impedance analysis; BMI, body mass index; BP, blood pressure; ECW, extracellular water; K+, serum potassium; MRA, mineralocorticoid receptor antagonist; PA, primary aldosteronism; QOL; quality of life; Δ, parameter changes after MRA treatment.

Integrating 18F-FDG PET/CT radiomics and body composition for enhanced prognostic assessment in patients with esophageal cancer.

This study aimed to develop a predictive model utilizing radiomics and body composition features derived from 18F-FDG PET/CT scans to forecast progression-free survival (PFS) and overall survival (OS) outcomes in patients with esophageal squamous cell carcinoma (ESCC). We analyzed data from 91 patients who underwent baseline 18F-FDG PET/CT imaging. Radiomic features extracted from PET and CT images and subsequent radiomics scores (Rad-scores) were calculated. Body composition metrics were also quantified, including muscle and fat distribution at the L3 level from CT scans. Multiparametric survival models were constructed using Cox regression analysis, and their performance was assessed using the area under the time-dependent receiver operating characteristic (ROC) curve (AUC) and concordance index (C-index). Multivariate analysis identified Rad-scorePFS (P = 0.003), sarcopenia (P < 0.001), and visceral adipose tissue index (VATI) (P < 0.001) as independent predictors of PFS. For OS, Rad-scoreOS (P = 0.001), sarcopenia (P = 0.002), VATI (P = 0.037), stage (P = 0.042), and body mass index (BMI) (P = 0.008) were confirmed as independent prognostic factors. Integration of the Rad-score with clinical variables and body composition parameters enhanced predictive accuracy, yielding C-indices of 0.810 (95% CI: 0.737-0.884) for PFS and 0.806 (95% CI: 0.720-0.891) for OS. This study underscored the potential of combining Rad-score with clinical and body composition data to refine prognostic assessment in ESCC patients.

Phase angle and body composition in long-term type 1 diabetes in adults: a comparative study in a Brazilian public reference outpatient clinic.

Type 1 Diabetes Mellitus (DM1) affects a small percentage of the population. Nevertheless, its prevalence is currently growing with alarming data on uncontrolled cases. The importance of body composition and Phase Angle (PA), assessed by Bioelectrical Impedance (BIA), in long- term DM1 patients lies in the fact that alterations in cellular integrity and body compartments may affect risk profiles and metabolic control. The objective of this study was to compare PA and body composition parameters between adults with DM1 and healthy controls. A comparative study was carried out in a public university outpatient clinic including a cohort of adult patients of both sexes diagnosed with DM1 and healthy controls matched by age and sex in a 2:1 ratio. Anthropometric measurements included weight, height and BMI. Using the raw BIA data of Resistance and Reactance, fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), fat mass index (FMI), PA and standardized PA (SPA) were calculated. Means or medians were compared between the groups. Regression models were used to identify distinguishing characteristics of the groups and associations within the DM1 group (i.e. glycated hemoglobin (HbA1c), disease duration, presence of microvascular complications, capillary blood glucose, BMI and FMI). 88 patients with DM1and 46 healthy controls were evaluated. PA (6.05 vs. 6.85, p = 0.000) and SPA (-1.47 vs. -0,37, p = 0.000) were lower in patients with DM1 compared to healthy controls. People with DM1 displayed higher adiposity (%FM = 29.6 vs. 27.6, p = 0.016; FMI = 7.00 vs. 6.33, p = 0.016) and lower %FFM compared to healthy controls. Most of the differences were maintained after sex stratification; however, men with DM1 showed a lower FFMI than male controls (18.2 vs. 20.16, p = 0.029). Patients with DM1 present lower PA than healthy controls, which may be related to worse cell membrane integrity. Significant body composition differences between the groups and between sexes were identified, with data showing greater adiposity in women with DM1 and men displaying lower muscle mass. These findings suggest the importance of including PA and body composition evaluations in the follow-up of patients with DM1. The ultimate goal is to obtain a better metabolic control and, consequently, a better prognosis.

AHP SO10 - A review of preoperative dietetic outcomes in patients with oesophagogastric (OG) cancer undergoing surgery

Abstract Background In line with NICE guidance (2018), all patients undergoing OG surgery at GSTT are offered a dietetic assessment by a specialist dietitian before their surgery. There is emerging evidence and interest in prehabilitation programmes to improve clinical and patient-centred outcomes. Nutritional optimisation is a key component of such programmes, although the optimal nutrition interventions are not fully elucidated, particularly within the preoperative period (Casey et al., 23). There is large national variation in dietetic interventions and minimal guidance on best practice to support this patient group. Method A retrospective review was undertaken to assess whether preoperative dietetic goals for patients with OG cancer undergoing surgery between August 2022 to January 2023 were achieved. Outcomes based on weight were reviewed given its routine use and availability. Dietetic goals were categorised according to the following aims: weight gain, weight stability and weight loss. Data was collected on 44 patients and excluded from analysis were those who were not assessed by a dietitian preoperatively. The length of intervention was defined in days. Results Table 1.0 Goal Weight Gain (n=11) (all ONS) Intervention length Achieved (&amp;gt;1kg weight gain) 7 (64%) 19-46 Not achieved (&amp;lt;1kg weight gain/ weight loss) 4 (36%) 26-40 Conclusion Overall, 52% patients did not achieve their weight goal before surgery. At present in our centre, patients receive one appointment with the specialist dietitian before their surgery due to limited resource. There is a recognition that additional support is required for many patients to prepare for surgery. Prehabilitation would address this and have the potential to improve dietetic outcomes. Weight is a readily available outcome measure but does not reflect body composition or other parameters of nutritional status. More comprehensive assessment of nutritional status would support further evaluation of dietetic outcomes and their impact on clinical and patient centred outcomes.

Tofogliflozin reduces sleep apnea severity in patients with type 2 diabetes mellitus and heart failure: a prospective study.

Sleep apnea (SA) is prevalent among patients with heart failure (HF) and contributes to a poor prognosis. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated efficacy in reducing the risk of serious clinical events in patients with HF. Additionally, SGLT2 inhibitors may reduce the risk of incident SA and mitigate its severity in patients with cardiovascular disease and T2DM. We aimed to investigate whether the SGLT2 inhibitor tofogliflozin reduced the severity of SA, as assessed using the apnea-hypopnea index (AHI), in patients with HF and T2DM and whether a decrease in AHI correlates with changes in body composition and cardiorenal function parameters. This is a single-arm, prospective pathophysiologic study involving patients with HF, T2DM, and SA, defined as having an AHI of 15 events/h and more. SA was assessed using polysomnography. Changes in AHI before and 6 months after starting oral administration of tofogliflozin (20 mg) were assessed. Additionally, body composition and cardiorenal functions were assessed before and 6 months after tofogliflozin administration. Ten patients with HF, T2DM, and SA were finally enrolled (60% men, 66.9 ± 13.4 years). Tofogliflozin reduced AHI from 43.2 [30.2] to 35.3 [13.1] events/h (p = 0.024) at 6 months. Hemoglobin A1c, body weight, and body water content decreased significantly. However, no significant changes were observed in the cardiorenal function parameters. A linear relationship was observed between the changes in body water content and AHI (r = 0.642, p = 0.045). Tofogliflozin reduced AHI, possibly associated with a reduction in body water content.

Feasibility of high intensity training protocol on body composition and bone mineral density in older individuals with central obesity – a preliminary study

Abstract Osteoporosis and body composition changes are prevalent musculoskeletal issues contributing to increased risk of frailty in older people. Weight bearing directly influences bone mineral density and body composition. Study aims to determine feasibility of high intensity interval training (HIIT) protocol on body composition parameters and bone mineral density (BMD) in older individuals. Twenty-four participants were randomly allocated to two study groups. The interventional group received supervised HIIT protocol while control group performed non-supervised brisk walking on alternate days over 3 months. Pre- and post-outcome measures were taken at baseline and 3 months which included, BMD using portable densitometer, body composition using a bioelectric impedance analyser, and basic anthropometry. Between group analysis demonstrated the interventional group to be significantly better than control group for all parameters (). In conclusion, HIIT protocol is feasible and effective method in improving body composition parameters and BMD in older individuals. Clinical Trials Registry-India with CTRI number CTRI/2022/01/039740.

Controlled Coffee Intake Enhances Erythrocyte Deformability, Na,K-ATPase Activity, and GSH/GSSG Ratio in Healthy Young Adults

Background: Published studies suggest that regular coffee consumption may reduce the risk of various diseases. However, many of these studies relied on questionnaire-based data, limiting their ability to identify the specific biological mechanisms behind the observed effects. This study focuses on controlled coffee consumption among healthy young adults to clarify its effects on erythrocyte properties. The functional condition of erythrocytes is important as it affects both macro- and microcirculation. Additionally, since erythrocytes are not true cells, they are particularly sensitive to biochemical and biophysical changes when exposed to biologically active substances. Methods: After a washout period, 33 healthy young volunteers were asked to consume a standardized dose of a coffee beverage daily for 3 weeks. Basic hematological and body composition parameters were recorded before and after the intervention. Erythrocyte functional status was evaluated based on the following measurements: deformability, osmotic resistance, Na,K-ATPase activity, and nitric oxide production, along with monitoring oxidative stress markers. Results: After a coffee consumption period, both erythrocyte count and hematocrit value increased, while body composition remained unchanged. Erythrocyte deformability improved across a range of shear stress values typical of human circulation. This improvement was accompanied with enhanced Na,K-ATPase activity in erythrocyte membranes in the wide range of sodium ion concentrations, as well as increased nitric oxide production by erythrocytes. Additionally, a higher GSH/GSSG ratio, indicating a shift towards a more favorable antioxidant balance, was observed in erythrocytes following the coffee intake period. Conclusions: The results of this study suggest that controlled coffee intake in healthy young adults can positively influence various indices of erythrocyte functional status. Although the observed statistically significant changes were modest, the findings consistently indicate a positive modulation of erythrocyte properties—cell deformability, oxidative resilience, and active membrane transport of cations—following coffee consumption.

Correlation Between Muscle Strength, Swing Speed, Batting Statistics, and Body Composition Parameters in High School Baseball Players: A Retrospective Observational Study.

Suzuki, K, Mizoguchi, Y, Kimura, F, Fujisaki, K, Yokoyama, D, Hall, T, and Akasaka, K. Correlation between muscle strength, swing speed, batting statistics, and body composition parameters in high school baseball players: a retrospective observational study. J Strength Cond Res XX(X): 000-000, 2024-Body composition has emerged as a pivotal factor influencing baseball player performance. The purpose of this study was to examine the relationships between muscle strength, swing speed, batting statistics, and body composition in high school baseball players. This retrospective study evaluated 29 high school baseball players included critical parameters related to body composition (body fat percentage, lean body mass [LBM], fat mass index [FMI], and fat-free mass index [FFMI]), muscle strength (bench press, squat, deadlift), batting statistics (batting average, on-base percentage, slugging percentage, on-base plus slugging), and swing speed. These metrics were gathered using a body composition analyzer (Omron HBF-701; Omron Healthcare Co., Kyoto, Japan). After the correlation analysis with body composition, a subsequent multivariate analysis was conducted. Multivariate regression analysis identified LBM (p < 0.05, p < 0.01) as a significant predictor for bench press and swing speed, FFMI for squat (p < 0.01), and FMI for deadlift (p < 0.05). No significant association was found between body composition and batting statistics. Lean body mass has been identified as an important contributing factor to swing speed, suggesting the need for body composition management among high school baseball players and coaches to enhance performance and functionality. However, no association was found between batting statistics and body composition. Therefore, it is suggested that high school baseball players prioritize the development of technical skills over swing speed and muscle strength to improve batting statistics.

A multidimensional analysis of the impact of obesity on immune checkpoint inhibitor therapy efficacy

BackgroundObesity is a well-known risk factor for developing malignant tumors and promoting tumor cell growth and spread. However, recent studies have shown that obese cancer patients, who typically have a worse prognosis than nonobese cancer patients, show a significant improvement in survival after receiving immune checkpoint inhibitor (ICI) therapy. This phenomenon is known as the “obesity paradox”. However, this phenomenon is influenced by tumor type and sex. Therefore, this study aimed to explore the impact of obesity on immunotherapy efficacy from multiple perspectives, aiming to verify this paradox and provide new scientific evidence on the effect of obesity on ICI efficacy.MethodsThis retrospective study evaluated the data of patients who received ICI therapy between June 2019 and August 2023. Automatic segmentation of skeletal muscle, subcutaneous fat, and visceral fat was performed using Slice-O-Matic software, and the corresponding skeletal muscle index (SMI), subcutaneous fat index (SFI) and visceral fat index (VFI) were calculated. The neutrophil-to-lymphocyte ratio (NLR) was determined by dividing the neutrophil count by the lymphocyte count. Univariate and multivariate Cox regression analyses were used to evaluate the correlation between body mass index (BMI), body composition parameters, and the NLR with overall survival (OS) and progression-free survival (PFS) in obese patients receiving ICI therapy.ResultsWe analyzed 219 patients with a median age of 60 years (IQR 53–69 years; 155 men and 64 women). Obese patients, particularly those with visceral fat accumulation, exhibited extended OS after ICI therapy (log­rank P = 0.027). Cox multivariate analysis revealed that the NLR (HR = 1.036; 95% CI: 0.996 to 1.078; P = 0.002) was independently associated with OS. Patients with a high NLR had worse OS than those with a low NLR.ConclusionsThis study corroborates the veracity of the "obesity paradox" under specific conditions and identifies NLR as an independent prognostic factor, with elevated NLR indicative of a poor prognosis.

Effects of a Six-Month Physical Activity Program on Health Risk Factors and Body Composition Among Overweight and Obese Middle-Aged Adults.

Introduction. Physical activity is vital for preventing and managing lifestyle-related diseases, which pose significant health and socio-economic challenges. This study aimed to evaluate the effects of a six-month supervised physical activity program on health risk factors and body composition in middle-aged individuals with overweight or obesity. Methods. The study involved 166 men and women aged 30 to 65 years, with a body mass index (BMI) ranging from 26 to 35 and moderate to severe health risks. Participants of the study were engaged in a six-month physical activity training program designed in accordance with World Health Organization guidelines. Comprehensive assessments were performed at baseline and after the intervention, including measurements of various anthropometric and body composition parameters, as well as evaluations of functional performance. Fitness tests were also conducted to assess participants' physical capacity and to monitor improvements throughout the training period. Results. Baseline measures of body mass composition and age demonstrated a strong positive correlation with visceral fat rating (VFR) in both men (r = 0.364, p < 0.001) and women (r = 0.420, p = 0.002). Following the six-month training program, participants exhibited an average improvement of 30% (p < 0.001) in their Cooper endurance test results. The physical activity intervention positively impacted body mass index (BMI) and various body composition metrics, including fat mass, VFR, and muscle mass, across all participants and most subgroups (gender, BMI, and age). In males, training at higher maximum heart rate (HRmax) zones significantly contributed to a reduction in the percentage of fat mass (80-89% HRmax) and an increase in the percentage of muscle mass (70-79% and 80-89% HRmax). Conclusions. The study indicates that a six-month supervised physical activity program significantly improves health risk factors and body composition (visceral fat reduction and improvement in percent of fat and muscle mass) among middle-aged individuals with overweight or obesity. Therefore, we advocate for the integration of structured physical activity interventions into healthcare practices to effectively enhance health outcomes in this population.

Effect of Fontan circulation on body composition and correlation with exercise capacity

Abstract Background There is growing attention to body composition in Fontan patients (FP) and preliminary results suggest that FP have an increased fat mass and a decreased muscle mass compared to the healthy population. FP also have reduced exercise capacity compared to health peers. However, data are still limited. Purpose The aim of our study was to compare the body composition (BC) of adult patients with Fontan circulation and healthy controls and to assess the correlation with functional capacity. Material and Methods Case control study on adult patients with Fontan circulation (FP) and age and gender matched healthy controls (HC). The following characteristics were recorded: age, gender, morphology of the systemic ventricle, type of Fontan circulation, level of physical activity (PAR, 0-7 points, 0 = sedentary - 7 = running &amp;gt; 3hours/week). S-score muscle, T-score bone, fat mass (FM%), intra-muscular adipose tissue (IMAT), abdominal adipose tissue (AAT), intracellular water (ICW), extracellular water (ECW), total body water (TBW), were measured through multi-frequency bioelectrical impedance technology in the FP and in the HC. Correlation was made for FP between body composition and oxygen consumption at peak exercise (VO2 peak), VE/VCO2 slope and NYHA class as indicator of functional capacity. Results Thirty Fontan patients (FP, mean age 24±6 yrs, 70% males) and 30 matched healthy controls (HC) were recruited in the study. The systemic ventricle was dominant left in 14 patients (47%), dominant right in 16 (53%). Four patients had atrio-pulmonary connection, the remaining were palliated with a lateral tunnel (n=26, 87%). The analysed parameters are summarised in Table 1. PAR was reduced in FP compared to HC (median 4.0 points in FP versus 7.0 points in HC, p 0.024). There was no difference in the BMI, fat mass, and body water between FP and HC. However, FP showed significantly lower S and T scores compared to the HC (S-score: -0,75 in FP versus 0,0 in HC, p 0.003. T-score: -0.9 in FP versus -0.25 in HC, p 0.001). In FP, NYHA Class was I in 28 patients (93%), II in 1 (3,5%) and III in 1 (3.5%) patient. The mean VO2 was 23.4±5.4mlO2/kg/min and mean VE/VCO2 slope 32±7. There was a direct correlation between VO2 peak and the PAR (rho 0.443, p 0.044). No correlation was found between the VO2 peak, the VE/VCO2 slope or the NYHA Class and the analysed parameters of body composition. Conclusion FP have reduced muscle mass, and bone density compared to HC. In addition to the known reduced efficiency of the cardiac pump during exercise in FP, the lower level of conditioning contributes to the reduced exercise capacity in this population. Programs aiming to encourage physical activity are key and should be part of patients’ care.

Impact of sarcopenia and fat distribution on outcomes in penile cancer

Sarcopenia, defined as age-associated loss of skeletal muscle function and muscle mass, is a negative prognostic marker for survival in several tumor entities. However, data evaluating the impact of sarcopenia and fat distribution on penile cancer are rarely described. We performed a retrospective study including 38 patients who were diagnosed with squamous cell carcinoma of the penis. By measuring skeletal muscle mass and fat distribution at axial abdominal computed tomography images at the third lumbar vertebra several body composition parameters including skeletal muscle index (SMI), psoas muscle index (PMI), visceral obesity and visceral-to-subcutaneous fat ratio were determined. Among 38 patients, 26% (n = 10) of the patients with penile cancer were identified as sarcopenic. SMI, age, lymph node metastases, distant metastases and penile cancer of the shaft were identified as significant risk factors for overall survival. PMI and distant metastases were significantly associated with cancer specific survival. None of the analysed adipose tissue parameters could be identified as risk factors for survival in this study. We showed that sarcopenia occurs in a relevant part of patients with penile cancer and is a significant risk factor for overall survival (p = 0.032) and cancer specific survival (p = 0.034) for patients with penile cancer. Regarding fat distribution further studies are needed to evaluate its impact on sarcopenia and survival.

Improving the nutritional evaluation in head neck cancer patients using bioelectrical impedance analysis: Not only the phase angle matters.

Malnutrition and sarcopenia are highly prevalent in patients with head neck cancer (HNC). An accurate early diagnosis is necessary for starting nutritional support, as both are clearly associated with clinical outcomes and mortality. We aimed to evaluate the applicability and accuracy of body composition analysis using electrical bioimpedance vectorial analysis (BIVA) for diagnosing malnutrition and sarcopenia in patients with HNC cancer undergoing systemic treatment with chemotherapy or radiotherapy. Cross-sectional, observational study that included 509 HNC patients. A comprehensive nutritional evaluation that included BIVA was performed. The prevalence of malnutrition was higher in patients that received treatment with chemotherapy (59.2% vs. 40.8%, P<0.001); increased mortality was observed in malnourished patients (33.3% vs. 20.1%; P<0.001); ECOG status (1-4) was also worse in malnourished patients (59.2% vs. 22.8% P<0.001). Body cell mass (BCM) and fat mass were the most significantly associated parameters with malnutrition [OR 0.88 (0.84-0.93) and 0.98 (0.95-1.01), respectively]; BCM and fat free mass index (FFMI) were associated with several aspects including (1) the patient-generated subjective global assessment [OR 0.93 (0.84-0.98) and 0.86 (0.76-0.97), respectively], (2) the presence of sarcopenia [OR 0.81 (0.76-0.87) and 0.78 (0.66-0.92), respectively]. A BCM index (BCMI)<7.8 in combination with other parameters including FFMI and BCM accurately predicted patients with malnutrition [accuracy 95% CI: 0.803 (0.763-0.839); kappa index: 0.486; AUC: 0.618 (P<0.01)]. A BCMI cutoff of 7.6 was enough for identifying males with malnutrition (P<0.001), while it should be combined with other parameters in females. Body composition parameters determined by BIVA accurately identify patients with HNC and malnutrition. Phase angle, but other parameters including BCMI, FFMI and BCM provide significant information about nutritional status in patients with HNC.

Relationship Between Mediterranean Diet Adherence and Body Composition Parameters in Older Adults from the Mediterranean Region.

In recent decades, the rapid spread of various communication media has led to changes in traditional eating habits. In the Mediterranean region, the classic (Mediterranean) dietary pattern has been lost as a result. This has led to a shift in eating habits towards unhealthy eating patterns, which in turn has resulted in an inadequate distribution of body composition. It is known that, among other things, the number of non-communicable diseases increases with the inadequate distribution of body composition. The aim of our study was to examine the level of adherence to the Mediterranean diet (MD) of older adults in the Mediterranean region in relation to specific body composition parameters. This study included 521 older adults with a mean age of 69.6 ± 6.3 years. Body composition was measured using the BIA 101 Anniversary device (Akern s.r.l., Florence, Italy) and adherence to the MD was assessed using the MEDLIFE index questionnaire. This study found significant differences in body composition between males and females. The mean adherence to the MD was 17.0 ± 3.3 points among the participants and there was higher adherence in females (p = 0.002, ηp2 = 0.019). A multiple linear regression was performed to assess the relationship between the body composition parameters and MD. Multiple linear regression models were significant for reactance, fat mass (%), fat-free mass (%), skeletal muscle index, and total body water (%), with specific individual MEDLIFE items such as the consumption of processed meat, meat, white meat, fruit, vegetables, olive oil and limiting snacks between meals. Moreover, promising correlations were found between certain MD characteristics and BIA parameters, but the overall health effects of the MD remain unclear.

Determining the Fitness Level of People with Down Syndrome Living in Kosovo Based on the ALPHA Protocol

Purpose: This study aimed to establish national norm values for body composition and fitness levels among individuals with Down syndrome. It also aimed to investigate gender differences in body composition features and fitness parameters, analyze the impact of the region where individuals with Down syndrome reside, and compare their fitness levels with international peers. Methods: The sample included 81 participants, 40 females (height: 146.6±4.88 cm, weight: 63.6±16.4 kg) and 41 males (height: 157.4±6.21 cm, weight: 66.8±14.8 kg). To assess the physical fitness levels of the participants with Down syndrome, a modified version of the ALPHA testing protocol was used. Findings: The results demonstrated significant gender differences (p&amp;lt;0.05) in body composition and fitness parameters, with males generally exhibiting better outcomes compared to females. Moreover, significant disparities (p&amp;lt;0.05) in body composition and fitness parameters were observed among individuals with Down syndrome residing in different regions of Kosovo. Noteworthy gender disparities exist in terms of body composition and physical fitness metrics, with male participants achieving superior results compared to their female counterparts. Furthermore, noticeable variations were observed among the regional Down syndrome centers, with participants from older centers displaying improved fitness metrics and body composition features compared to those from newly established facilities. Conclusion: Gender differences in body composition and fitness were evident, with males outperforming females, except in muscle mass. Future studies should explore fitness and health barriers in Kosovo's DS population, with a focus on improving physical activity through tailored strategies.

Body composition derangements in lung cancer patients treated with first-line pembrolizumab: A multicentre observational study.

While immune checkpoint inhibitors (ICIs) are increasingly reshaping the therapeutic landscape of non-small-cell lung cancer (NSCLC), only a limited proportion of patients achieve a relevant and long-lasting benefit with these treatments, calling for the identification of clinical and, ideally modifiable, predictors of efficacy. Body composition phenotypes may reflect aspects of patients' immunology and thereby their ability to respond to ICIs. This study aims to explore the possible association between pre-treatment body composition phenotypes, tumour response, and clinical outcomes in patients receiving first-line pembrolizumab monotherapy for advanced NSCLC. A retrospective review of consecutive patients with treatment-naïve NSCLC and PD-L1 expression ≥50% undergoing pembrolizumab at three academic institutions was performed. Pre-treatment body composition parameters were measured at the third lumbar vertebra level by computed tomography, defined using pre-established cut-offs. Primary endpoint was objective response rate (ORR), secondary endpoints progression-free survival and overall survival (PFS and OS), compared through the log-rank test and the Cox proportional hazards model. Data from 134 patients (93 males [69.4%] and 41 females [30.6%]) were collected. Median age was 69years (range 36-85), with a median follow-up of 12months (range 1-131). The median body mass index (BMI) was 24.5 (IQR 21.5; 26.1) kg/m2. Overall, 59.0% and 51.5% of patients met established radiographic criteria for evidence of sarcopenia and myosteatosis, respectively, which occur across the BMI spectrum. Multivariate regression analysis, adjusted for co-morbidities, revealed that sarcopenia (aOR 5.56, 95% CI. 2.46-12.6, P<0.0001) and low intermuscular adipose tissue (IMAT) area (aOR 1.83, 95% CI. 1.22-2.83, P=0.001) were associated with a lower rate of ORR (30.4% vs. 70.5%, P<0.0001 and 30.7% vs. 73.2%, P<0.0001, respectively). Moreover, both in univariate and multivariate analysis, adjusted for co-morbidities, low performance status according to the Eastern Cooperative Oncology Group scale (ECOG PS), sarcopenia and low IMAT were significantly related to short PFS (ECOG PS: aHR 2.73, 95% CI 1.60-4.66, P<0.0001; sarcopenia: aHR 2.24, 95% CI 1.37-3.67, P=0.001; IMAT depot: aHR 2.26, 95% 1.40-3.63, P=0.002) and OS (ECOG PS: aHR 3.44, 95% CI 1.96-6.01, P<0.0001; sarcopenia: aHR 4.68, 95% CI 2.44-8.99, P<0.0001; IMAT depot: aHR 3.18, 95% 1.72-5.88, P<0.0001). Skeletal muscle abnormalities, apparently frequent in NSCLC, potentially represent intriguing predictive markers of response to ICIs and survival outcomes. Large prospective trials are needed to validate ICIs responders' clinical biomarkers.

TMG Symmetry and Kinematic Analysis of the Impact of Different Plyometric Programs on Female Athletes’ Lower-Body Muscles

Asymmetries in sports are common and can lead to various issues; however, different training programs can facilitate change. This study aimed to assess the effects of opposing plyometric programs on tensiomyography lateral symmetry (TMG LS)/inter-limb asymmetry in female athletes’ lower-body muscles, alongside kinematic and body composition parameters. Twenty female subjects from basketball, volleyball, and track and field (sprinting disciplines) were divided into two experimental groups (n = 10 each). Two six-week plyometric programs (two sessions/week) were implemented: the first program (E1) focused on eccentric exercises, depth landings, while the second (E2) emphasized concentric exercises, squat jumps. TMG assessed LS in six muscles: vastus lateralis, vastus medialis, biceps femoris, semitendinosus, gastrocnemius lateralis, and gastrocnemius medialis. A kinematic analysis of the countermovement jump (CMJ) and body composition was conducted using “Kinovea; Version 0.9.4” software and InBody 770, respectively. The results showed significant increases in LS percentages (E1—VL 9.9%, BF 18.0%, GM 10.6% and E2—BF 22.5%, p &lt; 0.05), and a significant large effect in E1 for VL, and in E2 for BF, p &lt; 0.01). They also showed that E1 had a significant effect on VL, and that E2 had a significant large effect on BF (p &lt; 0.01). E1 also led to increased lean muscle mass in both legs (left: 1.88%, right: 2.74%) and decreased BMIs (−0.4, p &lt; 0.05). Both programs improved LS, with E1 enhancing muscle mass and lower-body positioning in CMJ. We recommend future studies use varied jump tests, incorporate 3D kinematic analysis, include male subjects, and examine more muscles to enhance TMG LS analysis.

Role of CT-based body composition parameters in the course of COVID-19.

A significant correlation is observed between the course of coronavirus disease 2019 (COVID-19) and body composition parameters including visceral fat quantification, muscle mass, and hepatic attenuation. The aim of the study was to investigate the correlation between the extent of lung involvement and various computed tomography (CT) parameters, as well as laboratory findings in COVID-19 patients. A retrospective analysis was conducted on 72 adult patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection who underwent two consecutive thorax CT scans at least 2 weeks apart. The patients were divided into two groups, as progressive and nonprogressive, based on the presence of two consecutive CT scans. Skeletal muscle area (SMA), subcutaneous fat area (SFA), visceral fat area (VFA), total fat area (TFA), liver-to-spleen (L/S) density ratio, and laboratory findings were compared between the groups. The correlation between the extent of lung involvement and CT parameters, as well as the laboratory findings were assessed. A total of 72 patients were included in the study, with 34 (47.2%) females and 38 (52.8%) males. Hemoglobin levels were significantly lower in the progressive group compared to the nonprogressive group. C-reactive protein (CRP) values were higher in the progressive group at follow-up. The nonprogressive group exhibited decreases in the SFA, VFA, and TFA, while liver density increased. The progressive group showed a decrease in the twelfth thoracic vertebra (T12) paravertebral muscle area and muscle index. In the comparison of the laboratory and radiological data in the course of COVID-19, white blood cell (WBC) and neutrophil counts increased, SMA T12, and the skeletal muscle index (SMI) decreased in the lung progressive group. Hemoglobin and CRP levels at admission may indicate disease progression. Future studies are warranted to increase the reliability with larger series.

Visceral Obesity and Its Association with Severe Coronary Artery Calcification in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease.

Background/Objectives: The role of body composition parameters in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) with presence and severity of coronary artery calcification (CAC) is still not fully elucidated. We aimed to evaluate the impact of computed tomography (CT)-based body composition parameters in patients with MASLD with CAC severity. Methods: In this multicenter study, 1870 individuals underwent cardiac CT for the detection of CAC as well as ultrasonography for the diagnosis of hepatic steatosis. The presence of CAC was defined by a CAC score threshold of >0, while severe CAC was defined by a threshold of >300. Using the abdominal cross-sectional CT images at the L3 vertebra level, we analyzed the skeletal muscle index, visceral to subcutaneous adipose tissue ratio, and muscle density using the Hounsfield unit. Results: Of 648 patients with MASLD, the proportions of presence of CAC and severe CAC were 45.2% and 9.9%, respectively. Visceral obesity was not associated with the presence of CAC after adjustment for age, sex, smoking, statin therapy, type 2 diabetes, and advanced fibrosis (adjusted odds ratio (aOR), 1.38; 95% confidence interval (CI), 0.86-2.23; p = 0.180). However, visceral obesity was independently associated with severe CAC after adjustment for several metabolic risk factors (aOR, 3.54; 95% CI, 1.25-14.90; p = 0.039), and adjustment for atherosclerotic cardiovascular disease risk scores (aOR, 3.74; 95% CI, 1.31-15.79; p = 0.032). Conclusions: Visceral obesity may serve as a novel prognostic CT-based radiological biomarker for patients with MASLD with severe CAC.

CHANGES IN BODY COMPOSITION INDUCED BY ORTHODOX RELIGIOUS FASTING ON HIGH SCHOOL STUDENTS

Scientific research in recent decades has increasingly focused on changes in body composition influenced by Orthodox religious fasting, which the Church has established before major holidays. The purpose of this study is to provide more information on how body composition parameters changed among high school students who followed the recommendations of Orthodox religious fasting for forty days (during Lent). A sample of twenty-eight students from Holy Cyril and Methodius High School in Niš was analyzed . The average age of all male participants was 17.4 ± 1.2 years. Anthropometric measures were taken both before and after the 40-day fast. The Omron BF 511 device, which provided information on body weight, BMI (body mass index), percentage of body fat, percentage of skeletal muscle, and basal metabolic rate, was used to measure body composition values. The acquired data were subjected to statistical analyses, including ANOVA and MANOVA for repeated measures. The results show a statistically significant difference (p = 0.012) between the initial and final measurements based on the MANOVA analysis. This study indicates that students interested in reducing weight while maintaining their muscle mass could benefit from practicing Orthodox religious fasting for 40 days. Further research is needed to confirm these results and explore the long-term effects of religious fasting and the post-fasting period, particularly for this participant sample.