Kg For Males Research Articles

An evaluation of the prevalence of probable sarcopenia in older adults in a single centre in Trinidad and Tobago

Objectives To assess the prevalence of probable sarcopenia, defined as weak handgrip strength, in community dwelling older adults, for a cohort in Trinidad and Tobago, using guidelines issued by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Secondly, to investigate the association between probable sarcopenia and factors such as sex, age, ethnicity, diabetes, metformin usage, protein intake, multiple comorbidities, level of alcohol consumption and physical activity. Method This was a cross-sectional cohort study comprising of adults aged ≥ 60 years. SARC-F scores ≥ 4 were used to screen for probable sarcopenia and the EWGSOP2 criteria, low grip strength (< 27 kg for males and < 16 kg for females) were used for assessment. Statistically significant associations were determined using both Chi Squared and Logistic Regression analysis. Results A total of 143 adults were enrolled. The prevalence of probable sarcopenia within the cohort was 30.8% overall. In females it was 22.6% [n=84, mean age 75.9 years, standard deviation (8.07)] and in males 42.4% [n =59, mean age 75.7 years (6.28)]. Factors associated with probable sarcopenia were female sex (p = 0.01), age (p = 0.001), East Indian ethnicity (p = 0.001), SARC-F score >4 (p<0.001), number of diseases (p = 0.04), and minimal physical activity (p=0.01). In multivariate analyses, only socio-demographic variables and SARC-F but no lifestyle factors were significantly associated with probable sarcopenia. Conclusion This study found that almost 1 in every 3 persons of age above 60 years had probable sarcopenia, which was more common in males than in females. Age, sex, race, and SARC-F were significantly associated with probable sarcopenia in adjusted analyses.

Low Handgrip Strength (Possible Sarcopenia) With Insulin Resistance Is Associated With Type 2 Diabetes Mellitus.

Older adults with sarcopenic obesity are at high risk for type 2 diabetes mellitus (T2DM). However, few East Asians have sarcopenic obesity. Since many East Asians have insulin resistance (IR) without obesity, it is possible that older East Asians with sarcopenia and IR might be at high risk for T2DM. However, this relationship has not been studied. This cross-sectional study included 1629 older adults aged 65 to 84 years registered in the Bunkyo Health Study. All underwent a 75-g oral glucose tolerance test and handgrip strength measurement. Participants were classified into 4 groups by possible sarcopenia (handgrip strength <28 kg in men and <18 kg in women) and IR status (triglyceride glucose [TyG] index ≥8.79 for men and ≥8.62 for women [third quartile]). Modified Poisson regression was used to estimate relative risk (RR) and 95%CIs for T2DM with adjustment for confounding factors. The mean age was 73.1 ± 5.4 years. T2DM was diagnosed in 212 (13.0%) participants. After adjusting for age, sex, body mass index, use of lipid-lowering medications, hypertension, and cardiovascular disease, possible sarcopenia and IR were associated with T2DM, with their coexistence showing a notably stronger association (control: RR, 1.00 [Reference]; possible sarcopenia: RR, 1.55 [95% CI, 1.04-2.30]; IR: RR, 2.69 [95% CI, 1.99-3.65]; and IR possible sarcopenia: RR, 4.76 [95% CI, 3.34-6.79]). Possible sarcopenia based on low handgrip strength and IR based on the TyG index are independently associated with T2DM in older Japanese individuals. Their coexistence shows a particularly strong association with T2DM.

Skeletal muscle mass and function are affected by pancreatic atrophy, pancreatic exocrine insufficiency and poor nutritional status in patients with chronic pancreatitis

Background/ObjectivePrevious studies have demonstrated that sarcopenia is frequently observed in patients with chronic pancreatitis (CP). However, most studies have defined sarcopenia solely based on skeletal muscle (SM) loss, and muscle weakness such as grip strength (GS) reduction has not been considered. We aimed to clarify whether SM loss and reduced GS have different associations with clinical characteristics and pancreatic imaging findings in patients with CP. MethodsOne hundred two patients with CP were enrolled. We defined SM loss by the SM index at the third lumbar vertebra on CT (<42 cm2/m2 for males and <38 cm2/m2 for females), and reduced GS by < 28 kg for males and <18 kg for females. ResultsFifty-seven (55.9 %) patients had SM loss, 21 (20.6 %) had reduced GS, and 17 (16.7 %) had both. Patients with SM loss had lower body mass index, weaker GS, higher Controlling Nutritional Status score, lower serum lipase level, and lower urinary para-aminobenzoic acid excretion rate, suggesting worse nutritional status and pancreatic exocrine insufficiency. On CT, main pancreatic duct dilatation and parenchymal atrophy were more frequent in patients with SM loss than in those without it. Patients with reduced GS were older and had worse nutritional status than those without it. ConclusionsSM loss was associated with pancreatic exocrine insufficiency, low nutritional status, and pancreatic imaging findings such as parenchymal atrophy and main pancreatic duct dilatation, whereas older age and low nutritional status led to additional reduced GS.

Influence of sarcopenia on surgical efficacy and mortality of percutaneous kyphoplasty in the treatment of older adults with osteoporotic thoracolumbar fracture

BackgroundSarcopenia is an age-related condition that causes loss of skeletal muscle mass and disability. Sarcopenia is closely related to the prognosis of patients suffering osteoporotic thoraco-lumbar compression fractures (OTLCF). The purpose of this study was to investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty (PKP) in the treatment of older adults with OTLCF surgery and postoperative mortality. MethodsFrom February 2016 to June 2019, 101 patients who met the inclusion and exclusion criteria were included in this study. The grip strength of the dominant hand was measured using an electronic grip tester. The diagnostic cutoff value of grip strength for sarcopenia was <27 kg for males and <16 kg for females. The cross-sectional area (cm2) of the musculature at the level of the pedicle of the thoracic 12th vertebra (T12) was measured by chest CT. The skeletal muscle index (SMI) was calculated by dividing the muscle cross-sectional area at the T12 pedicle level by the square of the height. The diagnostic cut-off value of SMI at T12 level is 42.6 cm2/m2 for males and 30.6 cm2/m2 for females. Sarcopenia was diagnosed when the grip strength and SMI values were both lower than the diagnostic cut-off value. All included patients received PKP treatment for OTLCF. The age, gender, operation time, bleeding volume, time to ground, length of hospital stay, visual analog scale (VAS) score before operation and one month after operation, Oswestry Disability Index (ODI) one month after operation and the incidence of refracture within 36 months after operation were compared between the two groups. The survival curves of the two groups were analyzed by Kaplan Meier. Chi-square test was used to compare the differences in survival rates between the two groups at 12, 24, and 36 months after operation. Univariate and multivariate Cox regression analysis compared multivariate factors on OTLCF postoperative mortality. ResultsThere was no significant difference in gender, operation time, blood loss and preoperative VAS score between the two groups (χ2 = 1.750, p = 0.186; t = 1.195, p = 0.235; t = −0.582, p = 0.562; t = −1.513, p = 0.133), respectively. The patients in the sarcopenia group were older (t = 3.708, p = 0.000), and had longer postoperative grounding time and hospitalization time (t = 4.360, p = 0.000; t = 6.458, p = 0.000). The VAS scores and ODI scores one month postoperatively were also higher in sarcopenia group (t = 5.900, p = 0.000; t = 7.294, p = 0.000), and there was a statistical difference between the two groups. Interestingly, there was no significant difference in the incidence of spinal refracture within 36 months between the two groups (χ2 = 1.510, p = 0.219). The sarcopenia group had a higher mortality rate at 36 months after operation, and the difference was statistically significant (p = 0.002). Sarcopenia is an independent risk factor for long-term mortality in OTLCF patients received PKP surgery. ConclusionsPatients with sarcopenia combined with OTLCF have poor postoperative recovery of limb function and a high risk of death in the long-term (36 months) after surgery. Active and effective intervention for sarcopenia is required during treatment.

Complementary information on the biology of Bactrian camels (Camelus bactrianus) in the Mangistau region of Kazakhstan

The morphometric body parameters of male and female Bactrian camels, Kazakh Bactrian, were studied. Compared to camels of other breeds, the Kazakh Bactrian turned out to be one of the largest camels, having up to 750 kg for males and 690 kg for females, as well as powerful musculature and thick fur. Sexual dimorphism in body size and weight of males and females has been shown. The height at the withers of males was higher than in females by about 3.2 %, oblique length of the trunk by 4.5 %, chest girth by 1.3 %, and tibia girth by 6.6 % higher than in females. The greatest difference was in the live weight of the animals - 23,4 %. A histological study of one of the important internal organs - kidneys - was carried out, which allow camels to adapt to the conditions of waterless deserts. As a result of histological study of the kidneys of Kazakh Bactrians, the following characteristics of camel kidneys were established: the kidney capsule is rather thick (470±12 μm) and is made up of two layers: a layer of collagen fibres (400 μm) and thin (70 μm) inner smooth muscle cells. The relative thickness of the capsule and the presence of the smooth muscle cell layer within it appear to be related to the kidney’s ability to hold high intrarenal pressure while producing highly concentrated urine. The second feature of the Bactrian kidney was that the medullary layer was much thicker than the cortical layer. Their ratio was 1:4. The thick cerebral layer in camels provides relatively long renal tubules and loops of Henle, which are essential for the excretion of concentrated urine.

Equations for smartphone prediction of adiposity and appendicular lean mass in youth soccer players

Digital anthropometry by three-dimensional optical imaging systems and smartphones has recently been shown to provide non-invasive, precise, and accurate anthropometric and body composition measurements. To our knowledge, no previous study performed smartphone-based digital anthropometric assessments in young athletes. The aim of this study was to investigate the reproducibly and validity of smartphone-based estimation of anthropometric and body composition parameters in youth soccer players. A convenience sample of 124 male players and 69 female players (median ages of 16.2 and 15.5 years, respectively) was recruited. Measurements of body weight and height, one whole-body Dual-Energy X-ray Absorptiometry (DXA) scan, and acquisition of optical images (performed in duplicate by the Mobile Fit app to obtain two avatars for each player) were performed. The reproducibility analysis showed percent standard error of measurement values < 10% for all anthropometric and body composition measurements, thus indicating high agreement between the measurements obtained for the two avatars. Mobile Fit app overestimated the body fat percentage with respect to DXA (average overestimation of + 3.7% in males and + 4.6% in females), while it underestimated the total lean mass (− 2.6 kg in males and − 2.5 kg in females) and the appendicular lean mass (− 10.5 kg in males and − 5.5 kg in females). Using data of the soccer players, we reparameterized the equations previously proposed to estimate the body fat percentage and the appendicular lean mass and we obtained new equations that can be used in youth athletes for body composition assessment through conventional anthropometrics-based prediction models.

Canonical discriminant analysis on the characterization of the goat carcass

The objective of this work is to identify which carcass and cut characteristics have the best discriminatory power, between sexes and slaughter weights, through discriminant analysis. Were used 32 goats, with initial average weights of 3.11 kg for males and 3.06 kg, for females, for animals slaughtered at 70 days; 3.65 kg for males and 3.25 kg for females for animals slaughtered at 100 days of weight. Objective assessments consisted of morphometric measurements: external carcass length (ECL); internal carcass length (ICL); leg length (LEL); chest width (CHW); croup width (CRW); thigh perimeter (THP); croup perimeter (CRP); chest perimeter (CHP); chest depth (CHD); internal chest depth (ICD) using the hypsometer and flexible tape (Truper®). In the total of 18 primary variables evaluated, the following variables were included in the discriminant model, using the stepwise method: empty body weight, chest depth, chest width, thigh circumference, neck, loin, leg length, and rump width. The discriminant analysis was efficient to discriminate and identify the carcass and cut characteristics with better discriminatory power between the sex and slaughter weight of the animals.

Outcomes of Dolutegravir-Based Antiretroviral Therapy in Thai Youth Aged 18 to 24 Years Living with HIV in Bangkok: A Retrospective Cohort Study

Objective: Dolutegravir (DTG) is recommended globally for people living with HIV. The present study aimed to describe the efficacy and safety of DTG-based regimens among youth aged 18 to 24 years. Materials and Methods: A retrospective cohort study was conducted among youth aged 18 to 24 years living with HIV at Chulalongkorn Hospital. Participants were divided into antiretroviral naïve (AN), antiretroviral experienced with treatment failure (AETF), and antiretroviral experienced and virally suppressed (AEVS). DTG was prescribed as a daily individual tablet or as part of a fixed-dose combination. The primary outcome was virological suppression defined as VL of less than 200 copies/mL within 12 months after DTG initiation. Secondary outcomes included body weight and lipid profile changes. Results: Between 2017 and 2022, 87 youth with a median age of 20.6 (IQR 19.6 to 21.9) years were initiated on DTG. Fifty-six (64.3%) were male. Twelve participants were AN, 18 were AETF, and 57 were AEVS. HIV viral suppression was 100% and 96.2% among those AN and AEVS, but only 54.5% amongst the AETF group (p&lt;0.001). CD4 lymphocyte counts increased in all groups at follow-up. Median body weight change was +0.4 (IQR –1.8 to 3.6) kg in males and +0.5 (IQR –2.8 to 1.7) kg in females. Median total cholesterol declined from 167 (IQR 142 to 186) to 152 (IQR 135 to 170) mg/dL, p=0.003. Median triglycerides declined from 83 (IQR 60 to 129) to 66 (IQR 46 to 78), p&lt;0.001. No hospitalizations or mortalities were observed in the study. Conclusion: DTG was effective and well-tolerated in youth living with HIV, with no significant weight gain and improved lipid profiles. DTG implementation among youth living with HIV should be continued. Keywords: Dolutegravir; Antiretroviral therapy; Adolescents living with HIV

Decreased intracellular water is associated with sarcopenic obesity in chronic haemodialysis patients

ObjectiveTo explore the association between intracellular water (ICW) and sarcopenic obesity in patients undergoing chronic haemodialysis (HD).MethodsA multicentre, cross-sectional study of 3354 adult chronic HD patients was conducted in 20 haemodialysis centres from June 1, 2021, to August 30, 2021. The diagnosis of sarcopenic obesity was made according to the revised Asian Working Group’s definition of sarcopenia combined with obesity per the body fat percentage definition. Body composition was evaluated by a body composition monitor using bioimpedance spectroscopy. Multiple logistic regression models, stratified analyses, interactive analyses, and receiver-operating characteristic analyses were conducted.ResultsA total of 752 patients were diagnosed with sarcopenic obesity among 3354 participants. The patients were grouped by sex-specific ICW median levels, and the prevalence of sarcopenic obesity was significantly higher in the low ICW group than in the high ICW group (41.3%vs 3.0%). Decreased ICW was significantly associated with sarcopenic obesity. The association remained statistically significant even after adjusting for dialysis vintage, age, body mass index, biochemical indicators, and various medical histories. The odds ratios of the low ICW group were much higher than those of the high ICW group in both males and females (P for trend < 0.001). The association was stable across subgroups, and the interaction analysis showed that age, body mass index and history of diabetes had interactive roles in the association between ICW and sarcopenic obesity (P for interaction < 0.05). Furthermore, the ICW cut-off values for identifying sarcopenic obesity were 19.1 kg and 14.5 kg for males and females, respectively.ConclusionDecreased ICW was an independent risk factor for sarcopenic obesity in chronic HD patients. The measurement of ICW by bioimpedance spectroscopy might be a non-invasive and valid means for identifying the risk of future sarcopenic obesity in HD patients.

Effects of Different Rearing Systems on Growth and Fattening Performance of American Bronze Turkeys

Aim: This study was carried out to investigate the effect of different rearing conditions on the growth and fattening performance of American bronze turkeys Materials and Methods: In the study, data from a total of 123 American bronze turkeys were analyzed. The hatchlings, whose hatching weight was measured, were reared together for the first 10 weeks, and then divided into the experimental groups. The intensive rearing system group (control group) was fed only with concentrated ad libitum. Pasture groups are semi-intensive and extensive rearing systems. The semi-intensive group was subjected to 75% restricted feeding of the concentrate that the intensive group should consume. The turkey flock in the extensive rearing system was fed 50% of the feed that the turkeys in the intensive rearing system group should consume. Pasture groups benefited from the pasture between 09:00-17:00. The growth and fattening performances of the turkeys were examined by regular weighing and measurements every two weeks as they were being reared in these growing conditions between the ages of 10-32 weeks. Results: The 32-week live weights of turkeys were found to be 4.60-4.70 and 4.52 kg in females and 7.58-7.79 and 6.71 kg in males, in intensive, semi-intensive, and extensive systems, respectively. The effect of the rearing system was significant in males at 12-32 weeks, moreover, a difference was determined among groups in females at 14-28 weeks. Conclusion: As a result of, American bronze turkeys can be suitable breed for pasture conditions. Based on the live weight gain and feed efficiency values of the study groups, this breed can continue to grow for longer than 32 weeks when quality pastures are provided.

Nutrition Risk Is Associated with 3-Year Strength and Performance Indicators among Older Adults in the Canadian Longitudinal Study on Aging.

Determine if nutrition risk, as measured by SCREEN-8 is predictive of 3-year strength and performance indicators among community-living older adults after adjusting for key demographic and health variables. Sex-stratified analyses were also determined. Cohort study with baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging (CLSA). Participants 55 years and older at baseline were included (n = 22,502); those who reported nasogastric or abdominal tube feeding at either timepoint were excluded (n = 26). The final sample of participants available for analyses slightly varied depending on completion of the three outcome variables. List-wise deletion was used for nutrition risk and covariates to arrive at the sample available for analysis (n = 17,250). The valid and reliable SCREEN-8 tool was used to measure nutrition risk. The minimum and maximum score of SCREEN-8 is 0 and 48, respectively, with lower scores indicating greater nutrition risk. Baseline SCREEN-8 score was used in analyses. Grip strength, chair rise test time and gait speed assessed at the 3-year follow-up were the strength and performance outcomes. Criteria outlined by the European Working Group on Sarcopenia in Older People 2 were used to determine low performance for grip strength (<27 kg for males and <16 kg for females), chair rise test time (>15 seconds) and gait speed (≤0.8 m/s). Half of participants were female (49.4%) and mean age was 66.7 years (SD 7.9). Mean SCREEN-8 score was 39.2 (SD 6.0). Low grip strength, chair rise test performance and gait speed were found in 18.5%, 19.6% and 29.3% of participants, respectively. After adjusting for covariates (e.g., sex, age, education), SCREEN-8 score was significantly associated with grip strength (F = 11.21, p = .001; OR = 0.98, CI [0.97, 0.99]), chair rise time (F = 5.97, p = .015; OR = 0.99, CI [0.97, 0.997]), and gait speed (F = 9.99, p = .002; OR = 0.98, CI [0.97, 0.99]). Similar interpretation was seen in sex-stratified analyses, although chair rise time was not significant. Age, body mass index, Life Space Index Score and self-rated health were consistently associated with all outcome measures. Nutrition risk, as measured by SCREEN-8, significantly predicted 3-year strength and performance measures. Greater nutrition risk is associated with an increased odds of low performance on grip strength, chair rise test, and gait speed. Future research should implement nutrition risk screening in primary care settings with subsequent assessment and treatment for at risk clients to determine if nutrition interventions implemented post screening can delay age-related losses in strength and performance.

Response to Selection for Body weight and Linear Body Traits in Breeds of Rabbit

An assessment of the selection response of body weight and linear body traits in breeds of rabbit in Zaria, Kaduna State, Nigeria was conducted. A population of 48 matured rabbits consisting of three breeds; New Zealand white, Chinchilla and Dutch was used in the experiment. Each breed represented a treatment group and was used to generate 288 rabbits in a nested design. The populations were selected at six weeks of age in all the generations. The growth traits considered were; body weight, ear length, nose to shoulder, body length, length of back leg, thigh length, and heart girth and thigh circumference. Data generated were subjected to analysis of variance using the SAS software. The New Zealand White had a higher body weight of 1157.92±22.75g and 1229.35±24.07g in generations one and two respectively, and heart girth of 20.09±0.14cm, thigh length of 15.93±0.09cm, body length of 44.52±0.48cm and thigh circumference 10.96±0.09cm in generation one. The length of back legs and heart girth in generation two were better expressed in Chinchilla and Dutch breeds, respectively. The selection response range was 19.45 - 22.20kg and 13.59 - 14.95kg in males and females respectively for body weight while the linear body traits ranged from 0.01 - 0.30cm and 0.01 - 0.28cm for males and females respectively in New Zealand white. For chinchilla, responses to selection for body weight were 9.45-10.33kg and 1.85 - 14.54kg for males and females respectively while linear body traits ranged from 0.01- 0.33cm for both males and females. The response to selection for body weight in Dutch ranged from 7.48 - 27.40kg and 18.38 - 18.66kg for males and females respectively, whereas for the linear body traits the range was 0.01 - 0.34cm and 0.02 - 0.40cm for males and females respectively. It was observed that the Dutch genotype had the best selection progress for body weight and linear body traits and therefore recommended for improvement of body weight and linear body traits

Reproductive performance and kid growth in Hair goats raised under farmer conditions in Adana Province of Türkiye

This study was carried out to examine the growth and survival characteristics between birth and weaning (90th day) in kids born in 2020-2022, within the scope of the "National Sheep Breeding and Improvement Project under Farm Conditions" in the villages of the districts of Adana. A total of 15200 Hair goat kids’ data were used in the study. After birth, the kid’s birth weight, sex, and date of birth were recorded, and on the 90th day, weaning weights were determined. All kids sucked their mothers in the morning and evening and stayed in the pen rest of the day. From the age of about 2 weeks, the kids were fed with oak branches and straw pulp. The kids were fed with oak branches, cotton seed and wheat straw at around two weeks of age. The average birth weight of kids was 3.10 kg in males and 2.98 kg in females; The average weaning weights were found to be 16.05 kg for females and 17.50 kg for males. In terms of live weights at birth and weaning, differences across the birth year, sex, birth type, and maternal age groups were shown to be statistically significant (P &amp;lt; 0.001). The survivability of kids was 97.20%, significant by years (P &amp;lt; 0.05), but it was not significant in terms of sex, birth type and maternal age (P &amp;gt; 0.05). As a result, it has been determined that there is a significant variation among the herds in terms of the fertility of Hair goats and the developmental characteristics of kids, and it has been determined that developmental characteristics are affected by environmental factors.

A potential correlation between adipokines, skeletal muscle function and bone mineral density in middle-aged and elderly individuals

BackgroundEvidence exists of a strong association between inflammation and a decrease in skeletal muscle function and bone mineral density (BMD); however, the specific mechanisms of these associations remain unclear. Adipokines, as key regulators of the inflammatory response, may be implicated in these processes. The objective of this study was to explore the potential correlation between adipokines, skeletal muscle function and BMD in middle-aged and elderly individuals.MethodsA comparative cross-sectional study was carried out at the Huadong Hospital Affiliated with Fudan University (Shanghai, China). A total of 460 middle-aged and elderly individuals were recruited, and 125 were enrolled in the analysis. Their biochemical indices, body composition, skeletal muscle function and BMD were measured. Bioinformatic analysis was also employed to identify potential adipokine targets linked to skeletal muscle function and BMD. To validate these targets, plasma and peripheral blood mononuclear cells (PBMCs) were harvested from these individuals and subjected to western blotting (WB) and enzyme-linked immunosorbent assay (ELISA).ResultsIndividuals in this cross-sectional study were categorized into 2 groups according to their median skeletal muscle mass (SMM) (28.8 kg for males and 20.6 kg for females). Individuals with lower SMM exhibited poorer grip strength (P = 0.017), longer 5-Times-Sit-to-Stand Test (FTSST) duration (P = 0.029), lower total hip BMD (P = 0.043), lower femoral neck BMD (P = 0.011) and higher levels of inflammatory markers in comparison with individuals with higher SMM. Bioinformatics analysis identified LEP, ADIPOQ, RBP4, and DPP4 as potential adipokine targets associated with skeletal muscle function and BMD. In vitro experiments demonstrated that individuals with decreased skeletal muscle function and BMD expressed higher levels of these adipokines.ConclusionsSkeletal muscle function is positively correlated with BMD and negatively correlated with levels of inflammatory markers among middle-aged and elderly individuals. Those with lower skeletal muscle function and BMD tend to have a higher expression of LEP, ADIPOQ, RBP4 and DPP4.

Clinical profiles of individuals with orofacial clefts: Results from fourteen Eastern African countries.

BackgroundMore than 100,000 cleft lip and palate patients have benefited from reconstructive surgeries in Africa because of surgical support from non-governmental organizations such as Smile Train. The Smile Train Express is the largest cleft-centered patient registry with over a million records of clinical records, globally. In this study, we reviewed data from the Eastern African patient registry to analyze and understand the clinical profiles of cleft lip and palate patients operated at Smile Train partner hospitals in East Africa. MethodA cross-sectional study design was undertaken through a retrospective database review in fourteen Eastern African countries. The study population included all patients who had cleft lip and palate surgeries recorded in the Smile Train database between 2001 and 2019. Findings86,683 patient records from 14 Eastern African countries were included in this study. The mean age was (8.8), the mean weight was 22.3 kg and 20.8 kg for males and females, respectively, and 61.9% of the surgeries were performed on male patients. Left cleft lip and palate (21,062, 24.62%) and left cleft lip only (17,155, 20.05%) were the most common types of clefts, with bilateral cleft lip only (3958, 4.63%) being the least frequent. complete left cleft lip with complete left alveolus was the most frequent cleft combination observed (n = 21,746) and Cleft lip to cleft lip and palate to cleft palate ratio (CL:CLP: CP) was 4.73:7.1:1. Unilateral primary lip-nose repairs were the most common surgeries (66%). General anesthesia was used for 74,783 (86.2%) of the procedures. InterpretationMost children with cleft lip and/or palate were underweight, possibly due to malnutrition or related to socioeconomic status. There were more male patients compared to females, which could be related to gender disparities. Access to surgical care for children born with congenital defects needs to be improved, and inequities need to be addressed via more evidence-based collaborative intervention strategies. FundingNone

Morphologic and Morphometric Study of Lungs in Adult Indigenous Peafowl ‎‎(Pavo cristatus)

&#x0D; &#x0D; &#x0D; &#x0D; Peafowl are a species of bird for which there is limited scientific research, despite the ‎importance of the respiratory system on bird health. This study aimed to provide a detailed ‎anatomical examination and comparative description of the lungs in adult male and female ‎indigenous peafowl (Pavo cristatus) to further our understanding of the respiratory system in ‎this species. Sixteen healthy adult peafowl (8 peacocks and 8 peahens) were obtained from ‎commercial markets in Dyalla, and Baghdad, Iraq. The birds had a mean live weight of 3.5±0.59 kg for females ‎and 3.0±0.39 kg for males. After being anesthetized, the birds were sacrificed by cutting off major ‎blood vessels in the neck. Subsequently, the lungs were carefully dissected and examined to ‎identify their shape, color, position, dimensions, and overall structure. Detailed photographs of ‎the lungs were taken, and various measurements were recorded for each lung in male and ‎female peafowl. The lungs of the peafowl were found to have an elongated, triangular shape, ‎extending from the first to the sixth vertebral ribs. Each lung exhibited two borders (medial and ‎lateral) and three surfaces (vertebral, costal or dorsal, and septal). Notably, the lateral border ‎and dorsal surface of each lung had four deep grooves resulting from the embedding of the ‎second to fifth ribs, which led to the division of the lung into five lobes in both peacocks and ‎peahens. To the best of our knowledge, this study represents the first scientific research on the ‎anatomical features of the lungs in indigenous peafowl. The findings from this study contribute ‎to a better understanding of the lung structure in this bird species, which can be valuable for ‎future studies on avian respiratory physiology and health.‎‎‎&#x0D; &#x0D; &#x0D; &#x0D;

Hand grip strength in patients with advanced cancer: A prospective study.

Hand grip strength (HGS) is a widely used functional test for the assessment of strength and functional status in patients with cancer, in particular with cancer cachexia. The aim was to prospectively evaluate the prognostic value of HGS in patients with mostly advanced cancer with and without cachexia and to establish reference values for a European-based population. In this prospective study, 333 patients with cancer (85% stage III/IV) and 65 healthy controls of similar age and sex were enrolled. None of the study participants had significant cardiovascular disease or active infection at baseline. Repetitive HGS assessment was performed using a hand dynamometer to measure the maximal HGS (kilograms). Presence of cancer cachexia was defined when patients had ≥5% weight loss within 6months or when body mass index was <20.0kg/m2 with ≥2% weight loss (Fearon's criteria). Cox proportional hazard analyses were performed to assess the relationship of maximal HGS to all-cause mortality and to determine cut-offs for HGS with the best predictive power. We also assessed associations with additional relevant clinical and functional outcome measures at baseline, including anthropometric measures, physical function (Karnofsky Performance Status and Eastern Cooperative of Oncology Group), physical activity (4-m gait speed test and 6-min walk test), patient-reported outcomes (EQ-5D-5L and Visual Analogue Scale appetite/pain) and nutrition status (Mini Nutritional Assessment). The mean age was 60±14years; 163 (51%) were female, and 148 (44%) had cachexia at baseline. Patients with cancer showed 18% lower HGS than healthy controls (31.2±11.9 vs. 37.9±11.6kg, P<0.001). Patients with cancer cachexia had 16% lower HGS than those without cachexia (28.3±10.1 vs. 33.6±12.3kg, P<0.001). Patients with cancer were followed for a mean of 17months (range 6-50), and 182 (55%) patients died during follow-up (2-year mortality rate 53%) (95% confidence interval 48-59%). Reduced maximal HGS was associated with increased mortality (per -5kg; hazard ratio [HR] 1.19; 1.10-1.28; P<0.0001; independently of age, sex, cancer stage, cancer entity and presence of cachexia). HGS was also a predictor of mortality in patients with cachexia (per -5kg; HR 1.20; 1.08-1.33; P=0.001) and without cachexia (per -5kg; HR 1.18; 1.04-1.34; P=0.010). The cut-off for maximal HGS with the best predictive power for poor survival was <25.1kg for females (sensitivity 54%, specificity 63%) and <40.2kg for males (sensitivity 69%, specificity 68%). Reduced maximal HGS was associated with higher all-cause mortality, reduced overall functional status and decreased physical performance in patients with mostly advanced cancer. Similar results were found for patients with and without cancer cachexia.

#5269 THE NUTRITIONAL ASSESSMENT TOOLS TO IDENTIFY PATIENTS AT INCREASED SARCOPENIA RISK

Abstract Background and Aims Protein-energy wasting (PEW), debilitating nutritional and metabolic disorder marked by a systemic reduction in protein and energy store, is prevalent among patients with end stage renal disease (ESRD). The magnitude of malnutrition among patients undergoing hemodialysis has been positively associated with, the risk of all-cause mortality, particularly due to cardiovascular disease and infections. Additionally, inadequate nutritional status has been implicated in the development of sarcopenia, characterized by decreased muscle mass, weakened muscle strength, and impaired physical function. As such, routine management of nutritional status may be crucial aspect of care for these patients. In addition to the nutritional risk index for Japanese hemodialysis patients (NRI-JH), developed for the diagnosis of PEW, the geriatric nutritional risk index (GNRI) and mini nutritional assessment short-form (MNA-SF) are frequently utilized as nutritional indices in patients on hemodialysis. However, few studies have compared the magnitude of associations between these nutritional measure and sarcopenia in patients undergoing hemodialysis. This study aimed to evaluate the degree of association between nutritional assessments and sarcopenia in this patient population. Method The current cross-sectional study recruited outpatients receiving maintenance hemodialysis between June 2019 and December 2021. The study collected patient information, including age, gender, body mass index, dialysis duration, primary kidney diseases, 11 comorbid conditions, and laboratory parameters (such as serum albumin, serum creatinine, and total cholesterol), from medical records. Physical therapists assessed muscle mass (skeletal muscle index [SMI]), muscle strength (handgrip strength), and physical performance (short physical performance battery [SPPB]), and sarcopenia was diagnosed when patients presented with low muscle mass (SMI &amp;lt;7.0 kg/m2 for males, &amp;lt;5.7 kg/m2 for females) and low muscle strength (handgrip strength &amp;lt;28.0kg for males, &amp;lt;18 kg for females) or low physical performance (SPPB ≤9) based on the Asian Working Group for Sarcopenia 2019 criteria. The study employed the NRI-JH, GNRI, and MNA-SF as markers of nutritional status. The NRI-JH was calculated based on body mass index, serum albumin, serum creatinine, and total cholesterol. Logistic regression analysis was performed to examine the associations of NRI-JH, GNRI, and MNA-SF with sarcopenia among patients on hemodialysis. Results Sixty-five patients undergoing hemodialysis were analyzed in this study. The mean age of the patients was 78.3 ± 10.7 years, with 36.9% being female. The average duration of dialysis was 6.4 ± 3.9 years. The most frequently observed underlying kidney disease was diabetes mellitus, followed by hypertension. The prevalence of sarcopenia was found to be 60.0%. After adjustment for the effects of age, gender, dialysis duration, and comorbidity index, patients with a lower score on the NRI-JH were significantly more prone to sarcopenia (odds ratio per 1-point increase, 1.33; 95% confidence interval, 1.04–1.69). The NRI-JH was demonstrated to have a stronger association with sarcopenia compared to the others (Table 1). Conclusion The NRI-JH and GNRI were significantly associated with risk of sarcopenia. The NRI-JH demonstrated a stronger association with the risk of sarcopenia compared to the GNRI.

#3246 THE ASSOCIATION OF THE CO-OCCURRENCE OF MALNUTRITION AND SARCOPENIA WITH MORTALITY IN HEMODIALYSIS PATIENTS: A MULTICENTER PROSPECTIVE COHORT STUDY

Abstract Background and Aims Frailty is widely acknowledged as an age-related fragile state characterized by physiological vulnerability to stress, and it is prevalent among patients undergoing maintenance hemodialysis therapy. Various factors are interconnected and can be theoretically consolidated into a cycle of frailty, with malnutrition and sarcopenia at the core. These can result in numerous negative health outcomes in patients on hemodialysis and prompt identification and treatment are necessary. However, limited research has investigated the impact of the overlap between malnutrition and sarcopenia on mortality in this patient population. In this study, we examined the association of the overlap between malnutrition and sarcopenia with all-cause mortality in patients undergoing maintenance hemodialysis. Method The present prospective cohort study recruited outpatients on hemodialysis from three facilities in Japan. At the study baseline, data on patients' characteristics including age, gender, body mass index, duration of dialysis, primary kidney diseases, 11 comorbid conditions, and laboratory parameters (including serum albumin level) were collected from medical records. In addition, muscle mass (skeletal muscle index [SMI]), muscle strength (handgrip strength), and physical performance (short physical performance battery [SPPB]) were measured by physical therapists. A comorbidity index was used to quantify the severity of comorbid illnesses, which was calculated based on primary kidney diseases and the 11 comorbidities. Malnutrition was identified based on geriatric nutritional risk index &amp;lt;98, which was calculated using the serum albumin level and body weight. Sarcopenia was diagnosed when patients had low muscle mass (SMI &amp;lt;7.0 kg/m2 for males and &amp;lt;5.7 kg/m2 for females) and low muscle strength (handgrip strength &amp;lt;28.0kg for males and &amp;lt;18 kg for females) or low physical performance (SPPB ≤9), in accordance with the Asian Working Group for Sarcopenia 2019 criteria. After classifying the study participants into four groups based on the absence or presence of malnutrition and sarcopenia, the mortality risk was evaluated using the Kaplan-Meier method and Cox proportional hazard analysis. This study was approved by the Research Ethics Committee and conducted in accordance with the principles of the Declaration of Helsinki. Results A total of 379 patients on hemodialysis were included in the analysis. The mean age of the patients was 69.5±12.6 years, and 40.2% of the cohort being female. The mean duration of dialysis was 7.9±4.5 years. The most prevalent underlying kidney disease was diabetes mellitus. At baseline, the prevalence rates of malnutrition and sarcopenia were 32.7% and 28.2%, respectively. Over a mean follow-up period of 4.3 years, 23 patients died. The Kaplan-Meier analysis demonstrated a lower cumulative survival rate in patients with malnutrition and/or sarcopenia. After adjustment for the effect of age, gender, duration of dialysis, and comorbidity index, the hazard ratio in patients with both malnutrition and sarcopenia was significantly higher than in patients without both (hazard ratio [HR] 5.78, 95% confidence interval [CI] 1.86-17.94). However, the hazard ratios in patients suffering from either malnutrition or sarcopenia alone were not significantly different (Table 1). Conclusion The present study has demonstrated the strong association of a state of co-occurrence between malnutrition and sarcopenia, which implies starvation and muscle wasting, with a poor prognosis in patients undergoing hemodialysis. The findings of this study have accentuated the significance of addressing both malnutrition and sarcopenia in routine clinical practice for patients undergoing maintenance hemodialysis.

#3657 ASSOCIATION BETWEEN AGE, SARCOPENIA, AND MORTALITY IN PATIENTS UNDERGOING HEMODIALYSIS: A PROSPECTIVE COHORT STUDY

Abstract Background and Aims The mean age of Japanese patients undergoing hemodialysis at the end of 2018 was 68.75 years, demonstrating a 15-year increase since 1985. The healthcare management of the geriatric patients presents significant challenges, encompassing both clinical and societal aspects, as they often experience overlapping comorbidities while undergoing hemodialysis. A systematic review and meta-analysis published in 2022 reported that sarcopenia was associated with heightened mortality rates in patients undergoing dialysis therapy. However, only a limited number of studies have investigated this association among Asian populations, whose differences in body composition, nutritional status, and socio-economic background distinguish them from those in the United States and Europe. Notably, no studies have targeted the older demographic, who constitute the majority of Asian patients on hemodialysis and possess numerous risk factors for death. This study categorized Japanese patients undergoing hemodialysis by age, &amp;lt;75 and 75≤, and examined the impact of sarcopenia on mortality according to age. Method This multicenter prospective cohort study enrolled 404 outpatients undergoing hemodialysis from three facilities in Japan and followed them up for three years. At baseline, information on age, sex, dialysis vintage, body mass index, primary kidney diseases, comorbid conditions, and laboratory parameters (serum albumin, serum hemoglobin, and hematocrit) were collected from medical records. The geriatric nutritional risk index (GNRI) was calculated based on the patient's serum albumin level and body weight. Sarcopenia was diagnosed in patients who had low muscle mass (skeletal muscle mass index &amp;lt;7.0 kg/m² for males and &amp;lt;5.7 kg/m² for females) and low muscle strength (handgrip strength &amp;lt;28.0kg for males and &amp;lt;18 kg for females) or low physical performance (short physical performance battery score ≤9), according to the Asian Working Group for Sarcopenia 2019 criteria. The Kaplan-Meier method and Cox proportional hazard analysis were used to evaluate the independent association between sarcopenia and mortality after adjusting for baseline characteristics in patients aged &amp;lt;75 and ≥75 years. Results A total of 404 patients participated in this study, with a mean follow-up period of 30 months, during which 50 (12.4%) patients died. Participants had a mean age of 68.4 ± 12.6 years and 62.6% of them were male and the mean GNRI was 91.1 ± 21.2. Diabetes mellitus was the most prevalent underlying kidney disease among the study cohort (38.1%). The prevalence of sarcopenia in all patients, those under 75 years of age, and those 75 years and older was 37.6%, 22.7%, and 63.1%, respectively. Kaplan-Meier analyses indicated a higher mortality rate among patients with sarcopenia compared to those without. In the subgroup analysis for patients aged &amp;lt;75 years, sarcopenia was significantly associated with increased mortality risk after full adjustment (hazard ratio [HR], 2.50; 95% confidence interval [CI], 1.05–5.95). Conversely, in the subgroup of patients 75 years and older, sarcopenia was not significantly associated with all-cause mortality (HR, 0.69; 95% CI, 0.28–1.68), and only a low GNRI was independently associated with poor survival (HR, 0.98; 95% CI, 0.96–1.00). Conclusion This present study determined that the impact of sarcopenia on mortality among patients undergoing hemodialysis may be altered by their age. Specifically, among those aged 75 years and above, malnutrition was found to be a strong predictor of poor survival, rather than sarcopenia.