Lean Body Mass Values Research Articles

A pilot study of early PET and biomarker dynamics in patients with stage 2 and 3 triple negative breast cancer treated with neoadjuvant response-adapted chemotherapy with pembrolizumab (NeoADAPT).

TPS624 Background: In patients with triple negative breast cancer (TNBC) the addition of pembrolizumab to neoadjuvant chemotherapy has improved pathologic complete response rates (pCR) and 5-year event free survival (EFS). Patients with TNBC who achieve a pCR have a significantly lower risk of recurrence compared to those with residual disease (RD). However, pCR can only be assessed at the time of surgery after completion of 6 months of intensive chemo-immunotherapy, associated with up to 77% high-grade treatment-related toxicity. Identifying pCR early on is imperative in developing optimized and individualized treatments, however, there are no predictive biomarkers. Studies in HER2-positive breast cancer have shown that early fluorodeoxyglucose positron emission tomography (FDG-PET) changes soon after initiation of neoadjuvant treatment can help predict the pathological outcomes at the time of surgery and also the risk of recurrence. Emerging data also support that clearance of circulating tumor DNA (ctDNA) during neoadjuvant treatment may be associated with higher rates of pCR. We thus designed a study to determine the association of early FDG-PET changes and ctDNA clearance with pCR in early-stage TNBC. Methods: NeoADAPT is a phase 2, open label, single center clinical trial including adult patients with previously untreated clinical stage 2 or 3 TNBC. Participants will receive 4 cycles of neoadjuvant paclitaxel/carboplatin with pembrolizumab (TC/pembro), per standard-of-care (SOC). An FDG-PET will be performed at baseline and after 1 cycle. A breast MRI will be performed at baseline and after completion of 4 cycles of treatment. Patients with a complete clinical response (cCR) will proceed to surgery and will forgo more neoadjuvant treatment. Patients with clinical RD on MRI will complete SOC neoadjuvant therapy with 4 cycles of doxorubicin/cyclophosphamide (AC) with pembro prior to surgery. If RD is identified after surgery, adjuvant therapy will be determined by the treating oncologist, which may include pembro with AC (if not given prior), capecitabine, etc. The primary objective is to evaluate if lack of decrease in maximum FDG-PET standard uptake value of lean body mass (SULmax) by less than 40% after 1 cycle of neoadjuvant treatment correlates with RD at the time of surgery (i.e. determining the negative predictive value of FDG-PET). Additional key endpoints include ctDNA clearance, evaluation of pCR and cCR rates in the treatment population and EFS. Distributions of percent reduction in SULmax will be compared between pCR and no-pCR groups using the Wilcoxon rank sum test. Receiver operating characteristic (ROC) curve analysis will be performed to estimate the ability of FDG-PET SULmax reduction and cCR by MRI in predicting pCR at surgery. Clinical trial information: NCT06245889 .

Trans men can achieve adequate muscular development through low-dose testosterone therapy: A long-term study on body composition changes.

Transgender individuals undergo the gender-affirming hormone therapy (GAHT) to achieve physical changes consistent with their gender identity. Few studies are available on the long-term safety and efficacy of GAHT. To investigate the long-term physical effects and the safety of the testosterone therapy for trans men and to assess the impact of differential hormone dose. Trans men who initiated GAHT between May 2000 and December 2021 were included in this retrospective analysis. Physical findings (body mass index, body fat percentage (BFP), lean body mass (LBM), and grip strength), blood testing results (hemoglobin, hematocrit, uric acid, creatinine, total cholesterol, triglycerides, and total testosterone), and menstrual cessation were recorded. We assessed the effects of testosterone on body composition changes and laboratory parameters, comparing a low-dose group (≤ 62.5mg/wk) to a high-dose group(>62.5mg/wk). Of 291 participants, 188 patients (64.6%) were in the low-dose group and 103 (35.4%) in the high-dose group. Cumulative menstrual cessation rates up to 12 months were not significantly different between groups. Both groups showed a decrease in BFP and an increase in LBM during the first year of therapy, followed by a slight increase in both over the long term. The high-dose group exhibited greater LBM gains during the first year. Higher hormone doses and lower initial LBM values were associated with LBM increases at 3 and 6 months (3mo, P=0.006, P<0.001; 6mo, P=0.015, P<0.001). There were no long-term, dose-dependent side effects such as polycythemia or dyslipidemia. Long-term GAHT for trans men is safe and effective. Low-dose testosterone administration is sufficient to increase LBM in trans men. Higher testosterone doses can lead to an earlier increase in muscle mass.

The Utilization of Body Composition to Predict Cardiorespiratory Fitness and Determine Association with CKD Stage in Individuals with Mid-Spectrum CKD: A Pilot Study

Body composition (BC), a measure of body fat mass (FM), lean body mass (LBM), and bone mineral content (BMC), can be used as a predictor of cardiorespiratory fitness (CRF). Prior studies have established a relationship between BC and VO2max in healthy individuals over 35 years of age. However, this relationship is poorly understood in chronic disease populations. The focus of the study was to assess the relationship between BC, cardiorespiratory fitness, and chronic kidney disease (CKD). A cross-sectional analysis was conducted among 24 (9 males and 15 females) individuals diagnosed with mid-spectrum CKD (stages G2–G3b) who completed a health screening, dual-energy X-ray absorptiometry (DEXA) scan, and underwent a VO2max exercise test. Normality tests, descriptive statistics, Pearson’s correlations, t-tests, and ANOVAs were conducted in SAS v.9.4. The average percent body fat (%BF) was 36.28 ± 8.47%, LBM was 109.4 ± 29.1 lb, BMC was 2308.7 ± 735.1 g, and VO2max was 20.13 ± 5.04 mL/kg/min−1. BC was able to predict CRF via VO2max (R2 = 0.721, p &lt; 0.001) and CKD stage (R2 = 0.390, p &lt; 0.017). Positive correlations were observed in LBM (r = 0.750, p &lt; 0.0018) and BMC (r = 0.647, p &lt; 0.001), and negative correlations were observed with FM (r = −0.384, p &lt; 0.032) and %BF (r = −0.802, p &lt; 0.0001). BC was able to predict both CRF and CKD stages, with significant associations observed between BC, VO2max, and CKD stage. The progression of the CKD stage was associated with lower LBM, BMC, and VO2max values, indicating a graded effect of BC on CRF and CKD stage.

The Effects of Different Temperaments on Vascular Parameters: A Pilot Crossover Randomized Controlled Trial.

According to the Persian Medicine (PM) point of view, the function of the cardiovascular system and the risk of cardiovascular events would be different between subjects having warm and cold temperaments. Moreover, different foods in terms of temperament may lead to different acute and chronic effects on the body. We investigated the postprandial effects of PM-based warm and cold test meals on arterial stiffness indices in healthy men with warm and cold temperaments. Twenty-one eligible warm or cold temperament subjects with a similar range of age, weight, and heights were enrolled in this pilot cross-over randomized controlled trial study during February- October 2020. Two test meals (cold and warm PM-based temperament foods) were designed as different interventions. Pulse wave velocity (PWV) and pulse wave analysis (PWA) was obtained at the baseline state (following 12 hours fasting), 0.5, 2, and 4 hours after the test meal consumption during each test day. Warm temperament participants had higher values of lean body mass, total body water, and protein content (P = 0.03, 0.02, and 0.02, respectively). Cold temperament individuals had higher aortic heart rate (HR) following 12 hours of fasting (P <0.001). On the other hand, the augmentation pressure (AP) of warm temperament individuals was higher than the colds ( P = < 0.001). According to the results of the present study, although warm temperament individuals could have higher arterial stiffness at the fasting state, arterial stiffness indices had a greater reduction following warm-temperament meal intake compared to cold-temperament meal.

Body composition and nutrition in skiing

Special requirements, such as super-maximally filled glycogen stores, short regeneration times, correct meal timing or appropriate weight specifications for ski jumping are particularly useful for endurance athletes such as cross-country skiers. A deficiency could have a fatal effect on performance and possibly a negative influence on health.&#x0D; While cross-country skiing is clearly one of endurance sports, ski jumping and alpine skiing are considered to be fast-strength sports or technical (acrobatic) sports.&#x0D; The proven advantages of carbohydrate loading (supercompensation), a nutritional technique for classic endurance loads, also apply to cross-country skiing.&#x0D; A drop in performance, concentration and coordination disorders as well as overheating threaten if fluid loss exceeds 2% of the total body water. Vitamin additives or sweeteners in sports drinks are inefficient. Since the higher need is actually compensated by the increased food intake with a balanced mixed diet, there is, in principle, no over-proportional need for individual vitamins in athletes.&#x0D; As the maximum oxygen uptake is already 15% lower from 3000 m altitude, a drop in performance is clearly noticeable there.&#x0D; When skiing (snowshoeing, ski touring, etc.), it should be noted that an ascent of 100 meters in altitude alone requires an additional 100–150 kcal. At moderate activity, the additional energy requirement at high altitudes compared to the sea level is estimated to be 250–290 kcal per day for men and 180–200 kcal per day for women.&#x0D; Top athletes in cross-country skiing can liberate 170–210 kJ/min (40– 50 kcal/min) in a dominant anaerobic manner within 2–3 minutes. The respective energy consumption is modified by numerous personal as well as external factors (for cross-country skiing, for example, the outside temperature, the friction resistance of the snow, the technique, the height profile of the route and the headwind).&#x0D; In cross-country skiers, the average values of body fat range between 4.8 and 12.7% in males and from 10.6 to 22.7% in females, while the average values of lean body mass (LBM) vary between 58.2 and 68.8 kg in males and from 45.6 to 48.6 kg in females. In alpine skiers, the mean values of body fat are between 9.7 and 15.8% in males and from 16.2 to 26.7% in females, and the LBM values in males range between 59.9 and 74.7 kg, in females from 42.1 to 52.8 kg. The span of body fat in male ski jumpers ranges from 8.6 to 16% with an LBM of 59.7 kg. Since 2012, a BMI of at least 21 kg/m² including suit and shoes has been a condition for ski jumpers to be able to use full-length skis (145% of body height). Otherwise, shorter skis have to be used, which reduces the wing area and is intended to reduce the jump distance as a penalty. The average values of body fat in male athletes of Nordic Combined range between 8.9 and 11.2%, and the corresponding LBM values are between 62.0 and 64.1 kg. When comparing these parameters of body composition, it must always be remembered that different methods of determining the body fat percentage have been used in corresponding studies and that possible differences do not represent a development of the skiing somatotypes over time but could also have methodological reasons.

Combined Upper Limb Exercise and Creatine Monohydrate Supplementation Improved Musculoskeletal Function in NSCLC Patients

Background: Lung cancer is a chronic respiratory disease that causes muscle dysfunction. Giving creatine monohydrate supplementation combined with exercise has efficacy in increasing lean body mass (LBM), muscle strength, and physical function. This study aims to analyze the effect of a combination of creatine monohydrate supplementation and upper limb exercise on skeletal muscle dysfunction in NSCLC patients.Methods: A quasi-experimental study with a pretest-posttest study on NSCLC patients given epidermal growth factor receptor (EGFR) – tyrosine kinase inhibitors (TKIs) from outpatient at RSUD Dr. Moewardi Surakarta in September - October 2021. The combination group of creatine monohydrate supplementation with upper limb exercise (n=15), the group with creatine monohydrate supplementation only (n=16), and the control group (n=15). Lean body mass in kilograms and percentages, 6-minute walk test (6MWT), and quality of life were assessed after 8 weeks of treatment.Results: The increase in LBM in the combination group was 4.22±1.81kg and 6.38±2.48% (P=0.0001). The combination groups have a greater increase in the 6MWT was 104±20.07 meters. The increase in quality of life in the combined creatine monohydrate supplementation group with upper limb exercise was 20.80±10.75. Changes in the value of LBM, 6MWT, and quality of life (QoL) in the creatine monohydrate supplementation combined with upper limb exercise were significantly different compared to the creatine monohydrate supplementation only group and the control groups.Conclusion: There is a greater effect of giving a combination of creatine monohydrate supplementation and upper limb exercise on LBM, 6MWT, and QoL in NSCLC patients.

How Anthropometrics of Young and Adolescent Swimmers Influence Stroking Parameters and Performance? A Systematic Review.

The purpose of this systematic review was to investigate the relationship between anthropometric characteristics, biomechanical variables and performance in the conventional swimming techniques in young and adolescent swimmers. A database search from 1 January 2001 to 30 June 2021 was done according to the PRISMA statement, with 43 studies being selected for analysis. Those manuscripts were divided in butterfly, backstroke, breaststroke and front crawl techniques as main categories. The results showed the importance of the anthropometric variables for the performance of the young swimmer, although there was a lack of variables common to the studies that analysed the butterfly, backstroke and breaststroke techniques. For the front crawl technique there is a consensus among studies on the advantage of having higher height and arm span values, variables that concurrently with high body mass and lean body mass values, contribute positively to better stroke length and stoke index values.

Effects of whole-body electromyostimulation with two different frequencies and combined training on lipid profile and body composition in overweight women

IntroductionThe study aimed to investigate the effects of whole-body electromyostimulation (WB-EMS) and combined training on lipid profile and body composition in overweight women.MethodsOverall, 45 overweight (body mass index [BMI]: 27.73 ± 1.59 kg/m2) women (aged 32.89 ± 4.59 years) voluntarily participated in this study. They were randomly assigned to 3 groups: a WB-EMS group, who received WB-EMS (2 sessions/week, 20 min/session; first session each week: 85 Hz, 350 μs, 4 s pulse, 4 s rest; second session: 7–15 Hz, 350 μs, continuous pulse); a combined training group, who underwent aerobic and bodyweight resistance training (2 sessions/week, 20 min/session); and a control group. In all 3 groups, lipid profile and body composition were assessed before and after 8 weeks of intervention.ResultsIn the WB-EMS group, within-group comparison revealed significant differences in triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, body weight, BMI, waist-hip ratio, waist circumference, body fat percentage, body fat mass, and lean body mass values (&lt;i&gt;p&lt;/i&gt; ≤ 0.05); there was no significant difference only in fasting blood sugar. In the combined training group, a significant difference was only observed in BMI (&lt;i&gt;p&lt;/i&gt; ≤ 0.05). In the post-intervention between-group comparison, there were significant differences only in high-density lipoprotein and body fat percentage (&lt;i&gt;p&lt;/i&gt; ≤ 0.05).ConclusionsSince WB-EMS has positive effects on lipid profile and body composition, it may be a proper method for people who have limited time for exercise or are unable or unmotivated to practise conventional exercises.

Assessment of VO2 Max among Female Workers of Cotton Textile Industry at Visnagar, North Gujarat Region: A Cross-sectional Study

Introduction: Occupational lung illness is a significant problem among textile factory workers. Occupational cotton dust exposure has been linked to lung involvement in many epidemiological studies of cotton industry workers. The maximum oxygen intake is one of the measures used to estimate functional capacity (VO2 max) of cardiopulmonary efficiency. The integration of the ventilatory, cardiovascular and neuromuscular system is necessary for attainment of VO2 max. Aim: To assess the VO2 max among women employees in cotton textile industry and to study the correlation between VO2 max and anthropometric parameters like Body Mass Index (BMI), Body Surface Area (BSA), fat percent (fat %) and Lean Body Mass (LBM). Materials and Methods: This cross-sectional study was conducted from January 2021 to June 2021 at Nootan Medical College and Research Centre/Nootan General Hospital, Visnagar, Dt. Mehsana, North Gujarat, India, which included study and control group which comprised 50 female workers of cotton industry and 50 age matched females respectively (n=50 each) who had never worked in the cotton industry or been exposed to cotton dust. The labourers of cotton industry were chosen from the Mehsana district’s numerous cotton factories. Physical examinations (resting heart rate, resting systolic and diastolic blood pressure) and a standardised proforma were used to gather data. VO2 max and anthropometric measurements such as BMI, BSA, fat % and LBM were measured by standard procedure. The statistical analysis was done by using Student’s t-test and Pearson correlation test. The correlation between BMI, BSA, fat percent and LBM with maximal oxygen consumption (VO2 max) was assessed by using Karl-Pearson’s correlation with level of significance was considered statistically significant if p&lt;0.05. Results: The mean value of VO2 max in study and control group was 35.62±0.34 mL/kg/min and 36.80±0.58 mL/kg/min respectively. It was decreased significantly (p&lt;0.001) in study group. The r values of BMI, BSA, LBM and body fat % were 0.262, 0.132, 0.236, 0.224 respectively. In the present study correlation between BMI, BSA, LBM, body fat % with VO2 max was reported as weak positive correlation which was not statistically significant. Conclusion: VO2 max was significantly decreased in cotton industry workers compared to non exposed control subjects. More studies on the effects of cotton dust on VO2 max should be conducted in future in both genders.

The avian lightweights: Trans-Saharan migrants show lower lean body mass than short-/medium-distance migrants.

Avian trans-Saharan migrants travelling long distances and crossing ecological barriers experience different constraints in terms of time, energy and safety than short-/medium-distance migrants without barrier-crossings. As such, natural selection shapes the aerodynamic properties of these groups differently. Yet, to the best of our knowledge, we lack information on whether natural selection has contributed to reducing energetic flight costs through generally lower body mass in trans-Saharan migrants. To fill parts of this gap, we investigated this eco-morphological pattern in 5,410 individuals of 22 Palearctic songbird species ranging from short-/medium-distance to trans-Saharan migrants. We used individual size-independent scaled lean body mass values based on wing length as a measure of body size and, for the first time, precisely determined lean body mass values by direct measurements via quantitative magnetic resonance technology. Scaled lean body mass for a given body size was significantly higher in short-/medium-distance migrants than in trans-Saharan migrants. Although scaled lean body mass significantly decreased with increasing migration distance in short-/medium-distance migrants, no such effect was found in trans-Saharan migrants. Our results thus show an eco-morphological pattern relating species' lean body mass not only to migration distance but also to migration group. This suggests that selective effects of the presence/absence of ecological barriers and/or of a threshold level for migration distance on migrant birds may be more important than the linear continuum of migration distance per se.

Maternal Exposure to Electronic Cigarettes Causes Body Composition Alterations in Pups

Electronic cigarette (E‐cig) usage is promoted as a safe alternative to traditional smoking, even during pregnancy, but long‐term effects of vaping are still unknown. Maternal smoking during pregnancy has been well studied and shown to increase both body mass index and obesity within children later in life. However, the effects of vaping on the offspring of maternal E‐cig users remains poorly studied. We hypothesized that maternal vaping during pregnancy will also increase body mass and obesity in the mature offspring with E‐cig exposed rat dams.Pregnant Sprague Dawley dams were exposed to nicotine‐free E‐cig aerosol (E‐cig0), E‐cig aerosol containing 18 mg/ml of nicotine (E‐cig18), or ambient air (control). Maternal E‐cig exposure (Joyetech eGrip OLED using 5‐sec puff @ 17.5 W) consisted of 60 puffs over 1‐hour each day, 5 days/week, starting on gestational day 2 and continued until pups were weaned. Progeny themselves were never directly exposed to E‐cig aerosol. Dual energy X‐ray absorptiometry (DXA) was used for body composition analysis in male and female rat offspring at 31±1 weeks of age (Air n=16, E‐cig0 n=21, E‐cig18 n=19).In females, total body mass and lean body mass (LBM) was not different between the exposure groups, however fat mass (FM) was greater in E‐cig0 compared to air and E‐cig18 exposed groups (125±9 vs. 103±12 and 100±5 g, respectively, ANOVA p&lt;0.05). Percentage BF (%BF) was also greater in E‐cig0 compared to air and E‐cig18 (33±2 vs. 28±2 and 29±1 %, respectively, ANOVA p&lt;0.05). As expected, total body mass, LBM, and FM values were significantly lower in females than males (ANOVA p&lt;0.001), but no differences in body composition was observed within the males across the exposure groups.In conclusion, maternal vaping without nicotine may increase risk for elevated body fat in adult life and the development of obesity in female progeny with fetal exposure in utero.Support or Funding InformationWVU Cancer Institute Philip R Dino Innovative Research Grant (IMO), NIHGMS 5U54GM104942‐03 (PDC)

Association of predicted lean body mass and fat mass with cardiovascular events in patients with type 2 diabetes mellitus.

Previous studies have found that predicted fat mass and lean body mass may act differently on adverse events. However, the cardiovascular prognostic value of lean body mass and fat mass in patients with type 2 diabetes mellitus (T2DM) has not yet been investigated. We sought to investigate the relation between predicted lean body mass or fat mass and the risk of cardiovascular disease in patients with T2DM. We conducted a post hoc analysis of data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study to investigate the relation between the predicted lean body mass or fat mass and major adverse cardiovascular events in patients with T2DM. We used sex-specific quartiles of predicted lean body mass index (BMI; kg/m2) and fat mass index (kg/m2). We defined a major adverse cardiovascular event as a composite of nonfatal myocardial infarction, nonfatal stroke or death from cardiovascular causes. After a mean follow-up period of 8.8 years, we found that a major cardiovascular event occurred in 1801 of 10 251 patients (17.8%). Predicted lean BMI was not associated with major cardiovascular events (p = 0.34). Compared with patients in the first quartile (incidence rate 16.4%; 17.2%, 17.5% and 19.8% for the second, third and four quartiles, respectively) of predicted fat mass index, those in the fourth quartile had a hazard ratio of 1.53 (95% confidence interval 1.23-1.91). In patients with T2DM, we found that predicted fat mass had a strong positive association with a higher risk of a major adverse cardiovascular event. Increasing lean body mass did not have a protective role. Trial registration: ClinicalTrials.gov., no. NCT00000620.

Examination the Effects of Aerobic and Resistance Exercise on Body Compositions of Sedentary Male Individuals

The present study was conducted to determine the effects of 8-week aerobic and resistance training on body composition values of sedentary male individuals. A total of 30 healthy sedentary male subjects volunteered to participate in the study and were divided into two groups randomly: aerobic training group (n = 15, age = 34.0 ± 5.22 years), and resistance training group (n = 15, age = 34.2 ± 6.12). Body heights of the participants were measured and their body compositions body weight (BW), body mass index (BMI), basal metabolic rate (BMR), body fat percentage (BFP), body fat mass (BFM), lean body mass (LBM) were measured with bioelectric impedance analysis (BIA) device, and then evaluated. Their resting heart rates were determined, and maximum heart rates were calculated with the Karvonen formula. The Brzycki Equation was used to predict one-repetition maximum strength. There were statistically significant decreases in BW, BMI, BFP and BFM values of the aerobic training group (p&lt;0.05). There was no significant difference between pre- and post-test values of BMR and LBM (p&gt;0.05). BW and BMI values of the resistance training group did not show a significant difference in pre-test and post-test (p&gt;0.05). Significant decreases were found in BFP and BFM values (p&lt;0.05). The increase in BMR and LBM values were found to be statistically significant (p&lt;0.05). There were significant differences between BW, BMI, BMR, BFM and LBM values in the comparison of pre- and post-test values of the aerobic and resistance training groups (p&lt;0.05). However, there was no statistically significant difference in BFP (p&gt;0.05). In conclusion, it was found out that regular aerobic and resistance training caused positive effects on body composition of sedentary male individuals.

Association of ABO blood types and novel obesity markers in healthy adolescents.

INTRODUCTION:Association of ABO blood type with body mass index (BMI) was explored in the past studies, but literature on association of novel obesity markerssuch as total body fat and lean body mass (LBM) is scarce. The present study aimed to evaluate the relationship of ABO blood types with novel obesity markers in normal adolescents.MATERIALS AND METHODS:A cross-sectional study was done on 387 medical students. Bio-impedance analysis (BIA)-derived novel obesity markers such as body fat percent (BFP) and lean body mass (LBM) were recorded. Blood typing was done using slide-agglutination method. Mean and SD were calculated; analysis of variance and Chi-square (χ2) correlation were used to determine the relationship between ABO blood types and obesity markers.RESULTS:Highest propensity for BFP and LBM was seen in blood groups AB and B (25.09 ± 8.92 and 44.45 ± 6.91) respectively. Highly significant (P < 0.001) differences were observed in the values of BFP and LBM in normal and obese participants across ABO blood types. Prevalence of obesity did not show significant relationship (χ2 = 2.069; P = 0.913) with ABO blood types.CONCLUSIONS:Unlike BMI, novel obesity markers (BFP and LBM) significantly differ across ABO blood groups in normal and obese population. The findings suggest that ABO blood type might have role in determining body composition. This will be helpful in recognition of the participants at the risk of obesity on the basis of their blood groups.

In Patients We Trust: Reliability of Self-Reported Weight and Height in Nuclear Medicine Patients.

The aim of the study was to assess the reliability of the self-reported weight and height of nuclear medicine patients in view of recommendations for weight-dependent tracer application for imaging and therapy. Methods: In total, 824 patients (334 men and 490 women) were asked to report their weight and height before imaging or therapy and their level of confidence. Subsequently, the weight and height of each patient were measured, and body mass index, body surface area, and lean body mass were calculated. Differences between reported and true values were compared for statistically significant differences. Results: The average patient age was 60 ± 14 y (range, 17-91 y). An over- or underestimation of weight by at least 10% was observed in 2% of patients, and height was overestimated by 1% by the patients. The BMI calculation was affected by incorrect self-reported values. Conclusion: Most self-reported weights and heights of nuclear medicine patients are accurate. However, since over- and underestimation of weight and height lead to incorrect body mass index, body surface area, and lean body mass values, patient weights should be measured at least for patients receiving a weight-adapted therapy or if quantification in PET/CT is needed.

Lean body mass: reference values for Italian population between 18 to 88 years old.

Body's lean mass compartment is a strong predictor of morbidity and mortality risk in various clinical conditions. This paper proposes a simple and easily applied reference table for lean body mass (LBM) and lean body mass index (LBMI) for the Italian population. Retrospective analysis of a database containing anthropometric and DXA body composition measurements obtained from a cross-sectional study conducted between 2002 and 2009 with Italian individuals. Parametric and nonparametric tests were performed using R 3.1.1 and SPSS 22.0 software packages. The 3712 study participants, 37.3% men and 62.7% women, aging from 18 to 88 years. Individuals with normal weight, overweight and obesity were evenly distributed in the sample. LBM and LBMI measures were significantly higher in males. In both genders, there was a significant and progressive decline in these measures associated with aging. Significant differences in LBMI between genders were found in all age groups except for individuals over 75 years. Based on the participants LBM profile, a reference table for LBM values was proposed. This reference will be useful to detect changes in the LBM compartment of individuals from the South Central Region of Italy, supporting health professionals during the process of diagnosing sarcopenia.

The Retinol Circulating Complex Releases Hormonal Ligands During Acute Stress Disorders.

Intensive care workers actively participate in very hot debates aiming at defining the true metabolic, hormonal and nutritional requirements of critically ill patients, the contributory roles played by thyroid and retinoid ligands being largely underestimated. The present article makes up for redressing the balance on behalf of these last hormonal compounds. The retinol circulating complex is transported in the bloodstream in the form of a trimolecular edifice made up of transthyretin (TTR), retinol-binding protein (RBP) and its retinol ligand. TTR reflects the size of the lean body mass (LBM) and is one of the 3 carrier-proteins of thyroid hormones whereas RBP is the sole conveyor of retinol in human plasma. In acute inflammatory disorders, both TTR and RBP analytes experience abrupt cytokine-induced suppressed hepatic synthesis whose amplitude is dependent on the duration and severity of the inflammatory burden. The steep drop in TTR and RBP plasma values releases thyroxine and retinol ligands in their physiologically active forms, creating free pools estimated to be 10-20 times larger than those described in healthy subjects. The peak endocrine influence is reached on day 4 and the freed ligands undergo instant cellular overconsumption and urinary leakage of unmetabolized fractions. As a result of these transient hyperthyroid and hyperretinoid states, helpful stimulatory and/or inhibitory processes are set in motion, operating as second frontlines fine-tuning the impulses primarily initiated by cytokines. The data explain why preexisting protein malnutrition, as assessed by subnormal LBM and TTR values, impairs the development of appropriate recovery processes in critically ill patients. These findings have survival implications, emphasizing the need for more adapted therapeutic strategies in intensive care units.

Nutritional Status, Physical and Psychomotor Development of Premature Infants: A Prospective Observational Comparative Study

Background. The development of premature infants is slower than that of term ones, often due to nutritional status disorders in preterm infants. Objective. Our aim was to study the nutritional status, physical, and psychomotor development of infants. Methods. Nutritional status — the composition (the ratio of fat and fat-free tissues) and the value of lean body mass (LBM) — was assessed by plethysmography and densitometry; physical development — by measuring the mass and length of the body, the circumference of the head and chest, calculating the body mass index (BMI); psychomotor development — assessing compliance with the schedule of neuropsychological development of infants (GNOM). The examination was carried out at 12–14 and 16–18 weeks of the corrected age for preterm and actual age for full-term infants. Initially, the diet of infants was assessed by determining the amount, content of macronutrients and energy in the breast milk and/or milk formula and complementary food consumed. The diet was considered to be balanced if the diet parameters diverged not more than 10% of the norm. Results. The study included 23 preterm infants with extremely low (ELBW), 20 — with very low (VLBW), 34 — with low body weight (LBW), and 33 full-term infants. At 12–14 weeks of the corrected age, the magnitude of LBM in infants with ELBW — 3,397 (3,096; 3,608) and with VLBW — 3,824 (3,797; 3,899) was lower than in infants with LBW — 4,497 (4,034; 4,651) and full-term infants — 4,511 (3,887; 4,647) (Kruskal–Wallis test, p = 0.048). Protein balanced diet was in 2 (9%) infants with ELBW, energy balanced diet — in 1 (4%) infant. Among infants with ELBW, 17/23 (74%) referred to the risk group, 6/23 (26%) — to the developmental disorder group. Compared with infants with ELBW and VLBW, infants with LBW and full-term infants had a higher LBM and, correspondingly, higher body weight and BMI. Improvement of the nutritional status after 4–6 weeks due to correction of protein and energy consumption in infants with ELBW was accompanied by some increase in lean body mass, while its proportion was much higher and the proportion of fat mass was lower, which was accompanied by an improvement in the psychomotor development in individual infants: 5/23 (22%) became age-appropriate, and in the risk group of developmental disorders, the proportion of infants decreased from 17 (74%) to 13/23 (57%). The obtained results testify to the influence of nutritional status on the physical and psychomotor development of infants. Conclusion . The importance of dynamic assessment of the nutritional status of premature infants with individualized correction of their diet for improving the physical and psychomotor development of the child during the first year of life is shown.

Значение массы жировой ткани в клиническом течении пневмонии на фоне декомпенсации хронической сердечной недостаточности

Pneumonia is one of most important causes of in-hospital mortality in patients with decompensated chronic heart failure (CHF). To evaluate the effect of adipose tissue mass and body weight index (BWI) on prognosis for patients with communityacquired pneumonia and decompensated CHF. The study included 286 patients aged 53-90 with BWI 18.5-24.9 kg/m2 who were hospitalized in cardiology and therapy departments of an emergency care hospital for decompensated CHF and pneumonia, which was verified within the first day of admission. Body composition was analyzed using a bioimpedance analyzer of body water sectors (ABC-01, Medass); BWI was calculated for all patients. Sputum samples collected with proper observation of sterility rules were analyzed in a specialized microbiological laboratory. Statistical analysis was performed with methods of binary logistic regression, Kaplan-Meier, Cox regression, and two-step cluster analysis using the IBM SPSS Statistics 20 software. Assessing the body composition showed that groups with sputum Str. Pneumonia and mixed infection differed in indexes of lean body mass and adipose tissue mass but not in BWI. In-the mixed group, the in-hospital mortality was 38.71% and the one-year mortality - 95.16%. In the group with Str. Pneumonia in the sputum culture, the in-hospital mortality was 18.52% and the one-year mortality - 42.59%. The two-step cluster analysis allowed to isolate two clusters in the structure of the studied totality. All patients of the first cluster died during the first 9 months of the year following hospitalization. They were distinguished by lower values of lean body mass and BWI, older age, and the presence of mixed infection in the sputum culture in 39.1% of cases. In the structure of the studied totality, the most important risk factor for in-hospital mortality and one-year death was the value of adipose tissue mass.

ASSESSMENT OF THE LATE EFFECTS ON BONES AND ON BODY COMPOSITION OF CHILDREN AND ADOLESCENTS TREATED FOR ACUTE LYMPHOCYTIC LEUKEMIA ACCORDING TO BRAZILIAN PROTOCOLS.

ABSTRACTObjective: To evaluate the impact of therapy on bone mineral density (BMD) and body composition in survivors of acute lymphoblastic leukemia (ALL) treated in accordance with Brazilian protocols by the Brazilian Cooperative Group of Treatment of Lymphoblastic Leukemia in Childhood (GBTLI) LLA-93 and LLA-99. Methods: A cross-sectional study with 101 patients was performed. BMD and body composition were evaluated using bone densitometry and were interpreted according to the age group and the reference population. Values between -1.1 and -1.9 in the group of children under 20 years were considered as risk group for low BMD z-scores. BMD values were compared to clinical characteristics, treatment received and body composition. A chi-square test, Fisher’s exact test, likelihood ratio and Student’s t-test were applied, with a 5% significance level. Results: The patients presented a frequency of fractures of 2%, of osteonecrosis, 2%, and of low BMD, 2.9%. In the group of 79 patients under 20 years of age, three had low BMD. The 16 that presented risk for low BMD, demonstrated lower valutes in lumbar vertebrae L1-L4 (p=0.01) and whole body (p=0.005), and smaller values of lean body mass (p=0.03). In the group of 22 patients over 20 years of age, ten had osteopenia. Conclusions: The low impact of treatment on BMD of this study confirms the concept that the bone mass gain occurs with increasing age and that the treatment does not influence the process. The population at risk for low BMD values presented lower bone mass values and could benefit from a long-term monitoring for possible bone toxicity.