Bioelectrical Impedance Measurements Research Articles

Impact of volume indices in bioelectrical impedance measurement on the assessment of cardiac function indices by echocardiography in hemodialysis patients

Introduction Cardiovascular events resulting from volume overload are a primary cause of mortality in hemodialysis patients. Bioelectrical impedance analysis (BIA) is significantly valuable for assessing the volume status of hemodialysis (HD) patients. In this article, we explore the correlation between the volume index measured by BIA and the cardiac function index assessed by echocardiography (ECG) in HD patients. Methods Between April and November 2018, we conducted a cross-sectional study involving randomly selected 126 maintenance HD patients. Comprehensive data on medical history and laboratory test results were collected. Subsequently, we investigated the correlation between volume indices measured by BIA and cardiac function parameters by ECG. Results We discovered a significant correlation between the volume indices measured by BIA and various parameter of cardiac function. The Left Ventricular Hypertrophy (LVH) group exhibited higher levels of the percentage of Extracellular Water (ECW%) and the percentage of Total Body Water (TBW%) compared to the Non-LVH group. Extracellular Water (ECW) and Third Interstitial Fluid Volume (TSFV) were identified as independent risk factors for Left Ventricular Mass (LVM), and both demonstrated a high predictive value for LVM. ECW% emerged as an independent risk factor for the Left Ventricular Mass Index (LVMI), with a high predictive value for LVMI. Conclusion ECW and TSFV were found to be positively associated with cardiac function parameters in HD patients.

Asymmetry in Body Composition Variables of Youth Athletes

Assessing bilateral differences in paired anthropometric features is an important methodological problem in sports anthropology. The present study included 128 adolescent female athletes (59 rhythmic gymnasts, 58 tennis players, and 11 swimmers). Body composition components were determined using multi-frequency bioelectrical impedance measurements (analyzer InBody 170). Asymmetry coefficients of muscle and fat mass accumulation in the upper (AA) and lower (AL) limbs were calculated using the Nacheva` equation (1986). The percentiles method was applied to distribute the bilaterally studied anthropometric features according to the mean values of the units of asymmetry (UA). Wilkoxon-test was used to assess the statistically significant differences in paired variables. Kruskal-Wallis test was applied to determine the differences in UA between three assessed athlete groups, depending on their age. The differences in body composition components between rhythmic gymnasts (RG), tennis players (TP), and swimmers (SW) were well expressed in all assessed age groups. The most considerable inter-group differences were observed in terms of the asymmetry coefficient in the lean body mass (LBM) with a right direction and body fat mass with a left direction for upper limb fat mass (%, kg), which have signed the highest values in the tennis players group, followed by the RG on the same age. Swimmers had significantly the lowest values of UA for all body segments. A close relation was found between asymmetry in body composition variables and the type of sports activity. Tennis was found as a sport with more pronounced inter-limbs asymmetry.

Assessment of the correlation between the occurrence of fine movements of the hand, pre-frailty, and body composition in the elderly

PurposeThe main objective of the study was to evaluate the correlations between fine movements of the hand, the tissue composition of the upper limb, and the occurrence of frailty syndrome in elderly people in the Polish population.MethodsThe study included 998 individuals living alone aged 60 to 87 years. Anthropometric and bioelectrical impedance measurements were taken, tests of motor skills of the upper limbs and functional efficiency were performed, and the phenotype of physical weakness was assessed.ResultsParticipants identified as pre-frailty were observed to score less favourably in motor skills tests compared to other participants. The significance of the differences between the males and females was confirmed for most tests of precision, coordination, and speed of the upper limbs, in addition to the number of aiming errors. A correlation was observed between reduced fine movements of the hand and age, reduced functional efficiency, and low muscle mass of the upper limbs. Of all the included hand motor tests, only hand tremor scores in the stability test did not affect the risk of pre-frailty.ConclusionsThe study showed a significant, positive correlation between the fine movements of the hand, mainly with the weight and strength of the muscles of the upper limb, and negative in the case of the risk of frailty syndrome. It is advisable to focus on programs to raise awareness of the importance of physical activity, which translates into health and quality of life.

The effects of Phoniatric PREhabilitation in Head and Neck Cancer patients on Aspiration and Preservation of Swallowing (PREHAPS): study protocol of a monocentric prospective randomized interventional outcome-blinded trial

BackgroundDysphagia, with its negative impact on life expectancy and quality of life, is a major side effect of head and neck squamous cell carcinoma (HNSCC). In a typical Head and Neck Cancer Center, more than half of patients are affected. Improving treatment, and ideally prevention respectively prehabilitation, therefore seems more than desirable.MethodsThe study is planned as a monocentric, prospective, outcome-blinded, randomized interventional study comparing an advanced phoniatric-logopedic prehabilitation with a control (standard of care). Seventy patients (30 control group, 30 intervention group, 10 drop-out rate of 15%) with an initial diagnosis of invasive HNSCC and curative treatment intention will be included over a period of 17 months. In addition to the previous standard, both groups will undergo both detailed subjective assessment of swallowing function and quality of life by means of various questionnaires and objective analyses by bioelectrical impedance measurements and phoniatric endoscopic swallowing examinations. In the intervention group, risk-related nutritional counseling (face-to-face) and phoniatric-logopedic prehabilitation are provided: detailed counseling with video demonstration and exercises to strengthen and improve the range of motion of the oral, pharyngeal, and laryngeal muscles (guided by exercise diary). Controls are performed at 6 weeks, 3 and 6 months, and 9 or 12 months after the end of therapy during the regular tumor follow-up. Primary study endpoints are swallowing function and emotional distress at 6 weeks of control visit.DiscussionPrehabilitation measures have already proven successful in other patient groups, e.g., transplant patients. In the field of head and neck oncology, interest in such concepts has increased significantly in recent years. However, usually, only subgroups, e.g., patients with swallowing problems after radiochemotherapy alone, are in focus. Our study aims to investigate the general benefit of prehabilitation with regard to swallowing function, which is so important for protection of aspiration and quality of life.Trial registrationGerman Clinical Trials Register DRKS00029676. International Clinical Trials Registry Platform DRKS00029676. Registered on 19 July 2022.

Serum afamin and its implications in adult growth hormone deficiency: a prospective GH-withdrawal study.

Adult growth hormone deficiency (AGHD) is associated with a high prevalence of metabolic syndrome (MS), which contributes to the unfavorable cardiovascular risk profile in these patients. Insulin like growth factor-1 (IGF-1) is a widely used biomarker, however it does not always reflect the cardiometabolic risk and has a poor relationship with clinical efficacy endpoints. Consequently, there is an unmet need for biomarkers to monitor responses to GH-replacement. Afamin is a hormone-like glycoprotein, expressed in the liver. Higher afamin levels are strongly associated with MS and insulin resistance (IR). Although both MS and IR are very common in AGHD, afamin has not been investigated in these patients. To investigate afamin as a potential biomarker in patients with AGHD. Participants included 20 AGHD patients (11 GH-substituted and 9 GH-unsubstituted) and 37 healthy controls. Subjects underwent routine laboratory examinations, anthropometric measurements, body composition analysis using multi-frequency bioelectrical impedance analysis (InBody720) and measurement of serum afamin concentrations. In GH-substituted subjects, GH-substitution was withdrawn for 2 months. Measurements were carried out right before GH-withdrawal, at the end of the 2-month withdrawal period, and 1 month after reinstituting GH-replacement therapy (GHRT). GH-unsubstituted patients demonstrated higher afamin levels compared to controls (p=0.03). Afamin positively correlated with skeletal muscle mass, bone mineral content, total body water, extracellular- and intracellular water content, insulin (all, p<0.01), HOMA-IR (p=0.01) and C-peptide (p=0.03) levels in AGHD but not in healthy controls. In GH-substituted patients 2-month of GH-withdrawal caused significant changes in body composition, including decreased fat-free mass, skeletal muscle mass, total body water, and intracellular water content (all, p<0.01); but these changes almost fully recovered 1 month after reinstituting GHRT. Unexpectedly, afamin levels decreased after GH-withdrawal (p=0.03) and increased with reinstitution (p<0.01). Changes of afamin levels during GH-withdrawal positively correlated with changes of HOMA-IR (r=0.80; p<0.01) and changes of insulin (r=0.71; p=0.02). Higher afamin levels in unsubstituted AGHD patients might indicate severe metabolic dysregulation. Significant changes accompanying GH-withdrawal and reinstitution, along with strong correlations with measures of IR, suggest that afamin could be a promising biomarker to monitor GHRT-associated changes of insulin sensitivity.

BODY COMPOSITION USING DXA VERSUS BIA IN A MIXED COHORT OF COLLEGE STUDENTS

https://youtu.be/pzOWeEl1S_s BACKGROUND Body composition assessment is an important clinical and research tool. Dual energy x-ray absorptiometry (DXA) is the ‘gold standard’ and useful in the research environment, however, it is expensive, reliant on a trained technician, requires a large space, and is immoveable. Bioelectrical impedance (BIA) measurements have improved with the application of 8-electrode multifrequency units and could offer faster, cheaper, and portable alternative if measurements are comparable. The purpose of this study was to determine how well bone mineral content (BMC), lean body mass (LBM), and fat mass measurements made with BIA compared to those made with DXA. METHODS 46 (36 female) college students [avg 21.2 yr, 167.2 cm, 67.2 kg, 28.9% fat; 6 Asian, 4 Hispanic, 3 Black] had their BIA and DXA whole body composition measured within minutes of each other. Three compartments were compared BIA vs DXA: BMC, fat mass, and LBM. Pearson’s correlation coefficients were determined. RESULTS Absolute fat mass (r=0.95), lean mass (r=0.98), and BMC (r=0.91) were highly correlated between the assessment methods. CONCLUSIONS A quadripolar multifrequency BIA device can be a valid body composition surrogate in research environments using college students when a DXA machine is impractical to use.w

Predictors of sustained physical activity: behaviour, bodily health, and the living environment.

This study examined the determinants of sustained physical activity. Eighty-four participants undertook a 7-weeks walking regime (i.e., a 1-h biometrically-monitored walk, at least 5days/week), with bioelectrical impedance (BIA) and total cholesterol capillary blood measurements performed before and after programme. To investigate behavioural habit formation, 7weeks after walking termination, all participants were interviewed and (health) re-tested. Data were modelled with an artificial neural network (ANN) cascading algorithm. Our results highlight the successful prediction of continued physical activity by considering one's physical fitness state, the environmental living context, and risk for cardiovascular disease. Importantly, those artificial neural network models also taking body mass index (BMI) and blood cholesterol as predictors excel at predicting walking continuation (i.e., predictions with 93% predictability). These results are first to highlight the type and importance of available physiological drivers in maintaining a sustained physical activity regime such as walking. They are discussed within the framework of habit formation and the nowadays health and/or wellbeing focus.

Reduced skeletal muscle mass to visceral fat area ratio is independently associated with reduced cognitive function in type 2 diabetes mellitus

AimSkeletal muscle mass to visceral fat area ratio (SVR) has been recognised as an index of sarcopenic obesity. SVR is associated with type 2 diabetes mellitus (T2DM), metabolic syndrome and arterial stiffness which are known risk factors for cognitive dysfunction. We aimed to investigate association between SVR and cognitive function in patients with T2DM. MethodsThis was a cross-sectional study of 1326 patients with T2DM and mean age 61.3 ± 8.0 years. SVR was assessed based on bioelectrical impedance measurements of muscle mass and visceral fat area (VFA). Cognitive function was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Linear regression was used to examine the association between SVR in quartiles and RBANS score, adjusting for demographics, education, presence of depressive symptoms, clinical covariates and medications. ResultsThe lower SVR quartiles were negatively associated with RBANS total score in the unadjusted analysis. The corresponding coefficients for Quartiles 1 and 2 SVR were −3.79 (95 % CI −5.39 to −2.19; p < 0.001) and −1.47 (95 % CI −2.86 to −0.07; p = 0.039) in fully adjusted analysis. The negative association between Quartile 1 SVR and RBANS score was evident in immediate memory, delayed memory, visuo-spatial construction, language and attention domains. Muscle mass and VFA alone had weaker associations with RBANS scores. ConclusionOur study demonstrated, for the first time, an independent association between reduced SVR and lower cognitive function. This is evident in global and multiple cognitive domains. The synergistic effects of reduced muscle mass and visceral obesity may be more pronounced than their independent effects on cognitive function.

A differentiated approach to the diagnosis of overweight and obesity in children based on bioimpedance analysis of body composition.

Aim: The current study introduces a novel diagnostic algorithm employing bioimpedance analysis to comprehensively evaluate body composition in children, assessing fat content, skeletal muscle content, and fat distribution. Materials and Methods: Bioelectrical impedance measurements were obtained using the TANITA MC-780 MA analyzer. Indicators such as body weight, BMI, total fat content, absolute limb muscle mass, skeletal muscle strength, and waist-to-hip ratio (WHR) were assessed. A sample of 101 children aged 9 to 14 were studied using the proposed algorithm, refining BMI-based classifications. Results: The algorithm comprises three steps, categorizing children based on fat content, presence of sarcopenia, and central fat distribution. It identified diverse somatotypes within the groups classified by BMI. Notably, it revealed prognostically unfavorable somatotypes, such as sarcopenic obesity with central fat distribution, highlighting potential health risks. Current BMI-centric diagnoses may misclassify cardiometabolic risks, making early detection challenging. The algorithm enables a detailed evaluation, unmasking metabolically unfavorable conditions like sarcopenic obesity. The incorporation of functional tests, such as a standardized hand-grip test, enhances diagnostic accuracy. The proposed WHR indicator for characterizing fat distribution provides a practical method for determining somatotypes in children. Conclusions: This comprehensive algorithm offers an alternative to BMI-based classifications, enabling early detection of obesity and associated risks. Further validation through large-scale epidemiological studies is essential to establish correlations between somatotypes and cardiometabolic risks, fostering a more nuanced and individualized approach to pediatric obesity management.

Sensitivity study of a locally developed six electrode focused impedance method.

The Focused Impedance Method (FIM) is a new technique of electrical bioimpedance measurements in the human body. The idea originated in Bangladesh and provides an opportunity for localized measurement of bioimpedance down to reasonable depths from the body surface using skin surface electrodes. This has potential applications for physiological studies of targeted organs in the body and in detecting or diagnosing diseases and disorders. FIM is based on the age-old Tetra-Polar Impedance Measurement (TPIM) but provides a few significant improvements. Technology must be developed indigenously to obtain long-term benefits, particularly in Low and Medium Income countries (LMIC). This paper presents an experimental sensitivity study of the six-electrode version of the Focused Impedance method (FIM-6) with the circuit and phantom indigenously designed in Nepal. The work involved sensitivity studies of both FIM-6 and TPIM with the necessary circuit blocks developed through experimental validation. The sensitivity studies were performed on a simple 2D phantom with different electrode arrangements for FIM-6 and linear TPIM. A cylindrical object was placed at different positions for this study. The FIM-6 gave a high sensitivity in the central part, which remained almost constant within a small region that may be termed as the focused region. On the other hand, TPIM results fell off sharply away from the central point, making it unsuitable for practical measurements on target organs. Besides, there were areas with large negative sensitivities in TPIM, which were much smaller in FIM. The results obtained through this work clearly show the improvement offered by FIM over TPIM.

Factors associated with the dietary patterns of children with precocious puberty

Objectives To investigate the nutritional status and factors associated with dietary patterns, sociodemographic variables and physical activity practice in children diagnosed with central precocious puberty (CPP). Methods Cross-sectional study with 85 female children aged 10 years with a diagnosis of CPP. Nutritional assessment was performed through body mass index (BMI), waist circumference (WC) and body composition by measurements of skinfolds (SF) and bioelectrical impedance (BIA). The Principal Component Analysis (PCA) was used, followed by varimax orthogonal rotation to identify dietary patterns, and Poisson regression to verify associations between variables, using a significance level of 5%. Results The group had a mean age of 8.4 years (1.30) and lived mostly in urban areas (52 – 61.2%). Excess weight was observed in 64.7% according to the BMI, 32.9% according to the WC and 63.5% according to body fat%. Two main dietary patterns were identified: the “western” and the “healthy” patterns. The identified dietary patterns were not associated with nutritional status, assessed according to all considered indicators. WC and body fat% were inversely associated with physical activity practice (PR=1.96, CI=1.12-3.43) and directly associated with the individuals’ urban area of residence (PR=0.63, CI= 0. 42-0.94), respectively. Conclusion: The results showed a high prevalence of excess weight, which was inversely associated with physical activity practice and directly with urban area of residence, although nutritional status is not associated with the identified dietary patterns. These results highlight the need for educational and informative measures to fight obesity.

Having breakfast has no clinically relevant effect on bioelectrical impedance measurements in healthy adults

Having breakfast has no clinically relevant effect on bioelectrical impedance measurements in healthy adults

Analysis of the suitable thawing endpoint of the frozen chicken breast using video recording analysis, shear force, and bioelectrical impedance measurement.

This study focuses on analyzing the texture properties and bioelectrical impedance characteristics of frozen chicken breasts during low-temperature thawing, meanwhile, we also compared the differences in physiochemical properties. Frozen chicken breasts were thawed at 4 ± 2°C for 2, 4, 6, 8, and 10 h separately, then the physiochemical properties (color, pH, water-holding capacity, water distribution), the texture properties (easy-to-cut level), and the bioelectrical impedance were determined and analyzed. The easy-to-cut level of the samples was evaluated by the sensory panel and two indexes, one is Warner-Bratzler shear force measured by texture analysis machine, and the other is cutting speed value calculated by the consumer-oriented cutting behavior analysis using frame-by-frame video recording analysis method. These two methods were used to characterize the easy-to-cut level of the frozen samples during thawing from the industrial processing and home cooking standpoint. Strong correlations were observed between the easy-to-cut level and the bioelectrical impedance of the frozen chicken breasts during thawing. The impedance magnitude at 100 kHz showed a high correlation coefficient (R2 = .9417) with Warner-Bratzler shear force, and the impedance magnitude at 50 Hz showed a high correlation coefficient (R2 = .8658) with cutting speed. Our results indicated the acceptability of using bioelectrical impedance to evaluate the easy-to-cut thawing endpoint for both industry processing and home cooking.

Having breakfast has no clinically relevant effect on bioelectrical impedance measurements in healthy adults

BackgroundBioelectrical impedance analysis (BIA) is commonly used to evaluate body composition as part of nutritional assessment. Current guidelines recommend performing BIA measurements in a fasting state of at least 2 h in a clinical setting and 8 h in a research setting. However, since asking patients with malnutrition or sarcopenia to fast is not desirable and literature to support the strategy in the guidelines is lacking, this study aimed to assess the impact of breakfast on BIA measurements.MethodsWe performed an explorative, prospective study in healthy volunteers aged between 18 and 70 years, with a normal fluid balance and a body mass index between 18.5 and 30 kg/m2. BIA measurements were performed according to the standard operating procedure in the fasting state, and 1, 2, 3, and 4 h after ingesting a standardized breakfast meal of about 400 kcal with a 150 mL drink, using the hand-to-food single-frequency BIA (Bodystat500 ®). The Kyle formula was used to calculate the primary outcome, i.e. fat-free mass (FFM, kg). A linear mixed model was used to compare baseline values with other time points. A difference of 1 kg in FFM was considered clinically relevant.ResultsThirty-nine (85% female) volunteers were included, with a median age of 28 years (IQR 24–38). In 90% of the participants, having breakfast had no clinically relevant impact on the estimated FFM. For the group, the most pronounced mean difference, a statistically but not clinically significant higher value of 0.2 kg (0.4%), was observed after 3 h of fasting compared to baseline. No statistically significant differences were found at the other time points.ConclusionEating affects single-frequency BIA measurements, but differences in FFM remain below clinical relevance for most participants when using a standardized breakfast. Thus, the current study suggests performing a BIA measurement in a fasting state is not required.

Protective effect of MitoTEMPO against cardiac dysfunction caused by ischemia–reperfusion: MCAO stroke model study

Purpose Neurological impairments are the leading cause of post-stroke mortality, while stroke-related cardiovascular diseases rank second in significance. This study investigates the potential protective effects of MitoTEMPO (2,2,6,6-tetramethyl-4-[[2-(triphenylphosphonio) acetyl] amino]-1-piperidinyloxy, monochloride, monohydrate), a mitochondria-specific antioxidant, against cardiac and neurological complications following stroke. The objective is to assess whether MitoTEMPO can be utilized as a protective agent for individuals with a high risk of stroke. Materials and methods Seventeen-week-old male Wistar Albino rats were randomly assigned to three groups: SHAM, ischemia–reperfusion and MitoTEMPO + ischemia–reperfusion (MitoTEMPO injection 0.7 mg/kg/day for 14 days). The SHAM group underwent a sham operation, while the ischemia–reperfusion group underwent 1-h middle cerebral artery occlusion followed by three days of reperfusion. Afterwards, noninvasive thoracic electrical bioimpedance and electrocardiography measurements were taken, and sample collection was performed for histological and biochemical examinations. Results Our thoracic electrical bioimpedance and electrocardiography findings demonstrated that MitoTEMPO exhibited a protective effect on most parameters affected by ischemia–reperfusion compared to the SHAM group. Furthermore, our biochemical and histological data revealed a significant protective effect of MitoTEMPO against oxidative damage. Conclusions The findings suggest that both ischemia–reperfusion-induced cardiovascular abnormalities and the protective effect of MitoTEMPO may involve G-protein coupled receptor-mediated signaling mechanisms. This study was conducted with limitations including a single gender, a uniform age group, a specific stroke model limited to middle cerebral artery, and pre-scheduled only one ischemia–reperfusion period. In future studies, addressing these limitations may enable the implementation of preventive measures for individuals at high risk of stroke.

Design of a Tomato Sorting Device Based on the Multisine-FSR Composite Measurement

The ripeness of tomatoes is crucial to determining their shelf life and quality. Most of the current methods for picking and sorting tomatoes take a long time, so this paper aims to design a device for sorting tomatoes based on force and bioelectrical impedance measurement. A force sensor installed on each of its four fingers may be used as an impedance measurement electrode. When picking tomatoes, the electrical impedance analysis circuit is first connected for pre-grasping. By applying a certain pre-tightening force, the FSR sensor on the end effector finger can be tightly attached to the tomato and establish an electric current pathway. Then, the electrical parameters of the tomato are measured to determine its maturity, and some of the electrical parameters are used for force monitoring compensation. Then, a force analysis is conducted to consider the resistance of the FSR under current stress. According to the principle of complex impedance circuit voltage division, the voltage signal on the tomato is determined. At the same time, the specific value of the grasping force at this time is determined based on the calibration of the pre-experiment and the compensation during the detection process, achieving real-time detection of the grasping force. The bioelectricity parameters of tomatoes can not only judge the ripeness of tomatoes, but also compensate for the force measurement stage to achieve more accurate non-destructive sorting. The experimental results showed that within 0.6 s of stable grasping, this system could complete tomato ripeness detection, improve the overall tomato sorting efficiency, and achieve 95% accuracy in identifying ripeness through impedance.

Electrical bioimpedance measurement and near-infrared spectroscopy in pediatric postoperative neurocritical care: a prospective observational study.

To investigate the clinical significance of the disturbance coefficient (DC) and regional cerebral oxygen saturation (rSO2) as obtained through the use of electrical bioimpedance and near-infrared spectroscopy (NIRS) in pediatric neurocritical care. We enrolled 45 pediatric patients as the injury group and 70 healthy children as the control group. DC was derived from impedance analysis of 0.1 mA-50 kHz current via temporal electrodes. rSO2 was the percentage of oxyhemoglobin measured from reflected NIR light on the forehead. DC and rSO2 were obtained at 6, 12, 24, 48 and 72 h after surgery for the injury group and during the health screening clinic visit for the control group. We compared DC and rSO2 between the groups, their changes over time within the injury group and their correlation with intracranial pressure (ICP), cerebral perfusion pressure (CPP), Glasgow coma scale (GCS) score, Glasgow outcome scale (GOS) score, and their ability to diagnose postoperative cerebral edema and predict poor prognosis. DC and rSO2 were significantly lower in the injury group than in the control group. In the injury group, ICP increased over the monitoring period, while DC, CPP and rSO2 decreased. DC was negatively correlated with ICP and positively correlated with GCS score and GOS score. Additionally, lower DC values were observed in patients with signs of cerebral edema, with a DC value of 86.5 or below suggesting the presence of brain edema in patients aged 6-16 years. On the other hand, rSO2 was positively correlated with CPP, GCS score, and GOS score, with a value of 64.4% or below indicating a poor prognosis. Decreased CPP is an independent risk factor for decreased rSO2. DC and rSO2 monitoring based on electrical bioimpedance and near-infrared spectroscopy not only reflect the degree of brain edema and oxygenation, but also reflect the severity of the disease and predict the prognosis of the patients. This approach offers a real-time, bedside, and accurate method for assessing brain function and detecting postoperative cerebral edema and poor prognosis.

1101-P: Glycemia after Pediatric Bariatric Surgery—Outcomes and Predictors

Background: Metabolic and bariatric surgery (MBS) is a safe and efficacious treatment for children and adolescents with severe forms of obesity. However, there are few data on the effects of pre-surgical fasting insulin homeostasis measures on post-surgical weight loss or glycemia. Methods: We analyzed data from n=216/242 individuals with ≥ Class 2 obesity prospectively enrolled in the multi-center, Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study for up to eight years. Individuals who had type 1 diabetes, a gastric band procedure, or lacked baseline data for insulin homeostasis measurements were excluded, leaving 216 individuals for analysis. Body composition was assessed through bioelectrical impedance measurements. An analysis of fasting markers of insulin homeostasis using homeostatic model of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), or HOMA-β and outcomes following MBS was performed. Results: Our cohort had a baseline mean age of 16.5 years, BMI of 52.7 kg/m2, and was 75.4% female. At 8-year follow up, participants had a mean BMI of 43.0 kg/m2. Pre-surgical measures of insulin homeostasis did not predict change in BMI or fat mass over eight years. However, larger improvements in HbA1c were positively associated with younger baseline age, higher baseline HOMA-IR and HOMA-β, and lower baseline HbA1c. Conclusion: Baseline markers of insulin homeostasis were not significantly associated with weight loss outcomes, but did predict glycemia 8 years after MBS. Disclosure S.Sisley: Speaker's Bureau; Rhythm Pharmaceuticals, Inc. A.S.Shah: None. K.J.Nadeau: None. M.M.Kelsey: Other Relationship; Boehringer Ingelheim Inc., Janssen Pharmaceuticals, Inc., Rhythm Pharmaceuticals, Inc., Lilly. T.Gu: None. M.Michalsky: Advisory Panel; Lilly, Other Relationship; Intuitive Surgical, Stock/Shareholder; Intuitive Surgical. T.M.Jenkins: None. T.Inge: None. Funding National Institutes of Health (U01DK072493); U.S. Department of Agriculture-Agricultural Research Service (3092-5100-065)

Prevalence of sarcopenia in patients older than 75 years admitted for hip fracture

BackgroundHip fracture in the population aged 75 years and older is one of the most disabling pathologies. Likewise, disease related malnutrition (DRM) and sarcopenia are two frequent diagnoses in this age group, whose prevalence may be increased in patients with hip fracture. AimsTo determine the prevalence of malnutrition and/or sarcopenia in patients admitted for hip fracture and evaluate the existence of malnutrition related to disease and sarcopenia, and the differences between the sarcopenic and non-sarcopenic group. Methods186 patients aged 75 years or over, hospitalised for hip fracture from March 2018 to June 2019 were included. Demographic, nutritional and biochemical variables were collected. Nutritional screening was carried out with the Mini-Nutritional Assessment (MNA), the presence of DRM was established with The Global Leadership Initiative on Malnutrition (GLIM) criteria. For sarcopenia screening, the Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls (SARC-F) was used and the diagnosis of sarcopenia was made using the criteria from the European Working Group on Sarcopenia in Older People (EWGSOP) reviewed in 2019 (EWGSOP2). Muscle strength was determined by hand-grip strength, body composition by measurement of bioelectrical impedance. ResultsThe mean age was 86.2 years, most of the patients were women (81.7%). 37.1% of patients were at nutritional risk (MNA 17−23.5) and 16.7% were malnourished (MNA < 17). 72.4% of women and 79.4% of men, were diagnosed with DRM. 77.6% of the women and 73.5% of the men had low muscle strength. The appendicular muscle mass index was below the cut-off points for sarcopenia in 72.4% of the women and 79.4% of the men. Patients with sarcopenia had a lower body mass index, older age, poorer previous functional status and higher disease burden. The relationship between weight loss and hand grip strength (HGS) was significant (p = 0.007). Conclusions53.8% of patients admitted for hip fracture present malnutrition or are at risk after screening with MNA. Sarcopenia and DRM affects at least three out of four patients older than 75 years admitted for hip fracture. Older age, worse functional status, lower body mass index and high number of comorbidities, are associated with these two entities. There is a relationship between DRM and sarcopenia.

Relationship between thyroid function tests and bioelectrical impedance measurement parameters according to degree of obesity

Aims: This study aimed to investigate the relationship between thyroid function tests and bioelectrical impedance measurement parameters showing body composition in groups of patients with varying degrees of obesity as determined by body mass index (BMI). Methods: A total of 120 people between the ages of 18 and 65 years were enrolled in the study, including 20 individuals with stage 1 obesity, 20 with Stage 2 obesity, 20 with Stage 3 obesity, and 40 with normal body weights. In the collection of data, a case report form prepared by the researcher for gathering information about the participants and the results of blood tests and bioelectrical impedance measurements made with a Tanita device were used. Blood samples were taken from the antecubital vein between 09:00 and 10:00 in the morning after at least 8 hours of fasting. HOMA-IR values were calculated by measuring fasting plasma glucose and insulin. Results: No significant correlation was found between median BMI and TSH, fT3 and fT4 levels in the whole population. While a negative correlation was found between median TSH and BMI in the group with normal body weight (r=-0.430, p=0.006), a positive correlation was found in the Stage 1 obese group (r=0.553, p=0.011). This relationship was not significant in the Stage 2 and morbidly obese groups. There was no significant correlation between BMI and fT4 and fT3 in all groups. A positive correlation was found between fat percentage and TSH (r=0.391, p=0.014) and fT3 (r=0.333, p=0.038) levels in the group with normal body weight, while no correlation was found with T4 levels. Conclusion: No statistically significant differenceswere found in terms of thyroid functions in different obesity classes as determined by BMI. Elevations of thyroid-stimulating hormone in obese patients are thought to be a result of obesity, not the cause.