Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Anthropometric and Body Composition Parameters
2.2. Muscle Ultrasonography of the Quadriceps Rectus Femoris (QRF)
2.3. Assessment of Nutritional Status
2.4. Assessment of Respiratory Status
2.5. Statistical Analysis
2.6. Ethics
3. Results
3.1. Body Composition and Other Anthropometric Measurements
3.2. Correlation between Ultrasound and Other Anthropometric and Body Composition Measurements
3.3. Correlation between Ultrasound and Muscle Strength
3.4. Respiratory Variables
3.5. Nutritional Status
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall | Normo-Nourished | Malnourished | p-Value | ||
---|---|---|---|---|---|
n = 48 | n = 23 | n = 25 | |||
Age (years) | m ± SD | 34.1 ± 8.8 | 35 ± 8.8 | 32.9 ± 8.9 | 0.43 |
Gender | n (%) | ||||
Men | 24 (50) | 15 (62.2) | 9 (36) | ||
Women | 24 (50) | 8 (34.8) | 16 (64) | 0.02 | |
Mutation | n (%) | ||||
Homozygous for ΔF508 | 11 (22.9) | 6 (26.1) | 5 (20) | ||
Heterozygous for ΔF508 | 24 (50) | 9 (39.1) | 15 (60) | ||
Negative for ΔF508 | 13 (27.1) | 8 (34.8) | 5 (20) | 0.26 | |
Cystic fibrosis-related diabetes [34] | n (%) | 25 (52.1) | 11 (47.8) | 14 (56) | 0.68 |
Pancreatic insufficiency | n (%) | 37 (77.1) | 17 (73.9) | 20 (80) | 0.76 |
Bronchorrhea (mL) | m ± SD | 22 ± 22.5 | 20.5 ± 24.1 | 22.3 ± 20.3 | 0.81 |
Total exacerbations | m ± SD | 0.63 ± 0.93 | 0.73 ± 1.03 | 0.54 ± 0.83 | 0.51 |
Severe exacerbations | m ± SD | 0.13 ± 0.4 | 0.18 ± 0.5 | 0.08 ± 0.28 | 0.41 |
FEV 1 (%) | m ± SD | 59.4 ± 24.1 | 65.7 ± 22.6 | 52.5 ± 24.5 | 0.09 |
FVC (%) | m ± SD | 67.6 ± 19.8 | 70.3 ± 18.4 | 64.5 ± 21.3 | 0.38 |
FEV1/FVC (%) | m ± SD | 0.69 ± 0.11 | 0.73 ± 0.09 | 0.64 ± 0.11 | 0.01 |
Colonizations | n (%) | 41 (87.2) | 21 (91.3) | 20 (80) | 0.13 |
Pseudomonas aeruginosa | 37 (77.1) | 19 (82.6) | 18 (72) | 0.14 | |
Staphylococcus aureus | 38 (79.2) | 20 (86.9) | 18 (72) | 0.10 | |
Haemophilus influenzae | 23 (47.9) | 12 (52.2) | 11 (44) | 0.47 |
Men (n = 24) | Women (n = 24) | p-Value | ||
---|---|---|---|---|
BMI (kg/m2) | Mean ± SD | 23.2 ± 4.2 | 21.8 ± 3.4 | 0.21 |
Triceps skinfold (mm) | Mean ± SD | 9.26 ± 4.4 | 17.3 ± 5.6 | p < 0.001 |
Arm muscle circumference (cm) | Mean ± SD | 24.8 ± 2.4 | 20.5 ± 2.4 | p < 0.001 |
Fat-free mass (anthropometry) (kg) | Mean ± SD | 54.1 ± 7.1 | 39.1 ± 5.8 | p < 0.001 |
FFMI (anthropometry) (kg/m2) | Mean ± SD | 18.9 ± 1.9 | 15.6 ± 1.4 | p < 0.001 |
Phase angle (°) | Mean ± SD | 6.07 ± 0.6 | 5.02 ± 0.54 | p < 0.001 |
Fat-free mass (BIA) (kg) | Mean ± SD | 54.4 ± 8.1 | 38.6 ± 5.7 | p < 0.001 |
FFMI (BIA) (kg/m2) | Mean ± SD | 18.9 ± 2.2 | 15.4 ± 1.5 | p < 0.001 |
Fat-free mass (DXA) (kg) | Mean ± SD | 51.8 ± 6 | 37.3 ± 6 | p < 0.001 |
FFMI (DXA) (kg/m2) | Mean ± SD | 18.2 ± 1.4 | 14.6 ± 1.6 | p < 0.001 |
Handgrip strength (kg) | Mean ± SD | 38.3 ± 7.1 | 23.8 ± 5.5 | p < 0.001 |
Muscular area rectus anterior (MARA) (cm2) | Mean ± SD | 4.97 ± 1.4 | 3.11 ± 0.89 | p < 0.001 |
Muscular area index (MARAI) (cm2/m2) | Mean ± SD | 1.73 ± 0.48 | 1.24± 0.34 | p < 0.001 |
X-axis (cm) | Mean ± SD | 3.96 ± 0.52 | 3.1 ± 0.41 | p < 0.001 |
Y-axis (cm) | Mean ± SD | 1.47 ± 0.33 | 1.16 ± 0.31 | p < 0.001 |
Muscular circumference rectus (cm) | Mean ± SD | 9.93 ± 1.26 | 7.73 ± 1.03 | p < 0.001 |
Subcutaneous adipose tissue (SCAT) (cm) | Mean ± SD | 0.55 ± 0.28 | 1.11 ± 0.38 | p < 0.001 |
MARA (cm2) | MARAI (cm2/m2) | X-Axis (cm) | Y-Axis (cm) | Muscular Circumference (cm) | SCAT (cm) | |
---|---|---|---|---|---|---|
BMI (kg/m2) | r = 0.385 p = 0.008 | r = 0.339 p = 0.02 | r = 0.183 p = 0.217 | r = 0.380 p = 0.008 | r = 0.280 p = 0.057 | r = 0.330 p = 0.023 |
Fat-free mass (anthropometry) (kg) | r = 0.747 p < 0.001 | r = 0.574 p < 0.001 | r = 0.688 p < 0.001 | r = 0.554 p < 0.001 | r = 0.736 p < 0.001 | r = −0.381 p = 0.009 |
FFMI (anthropometry) (kg/m2) | r = 0.712 p < 0.001 | r = 0.642 p < 0.001 | r = 0.605 p < 0.001 | r = 0.568 p < 0.001 | r = 0.659 p < 0.001 | r = −0.286 p = 0.009 |
Fat-free mass (BIA) (kg) | r = 0.780 p < 0.001 | r = 0.612 p < 0.001 | r = 0.703 p < 0.001 | r = 0.607 p < 0.001 | r = 0.763 p < 0.001 | r = −0.405 p = 0.006 |
FFMI (BIA) (kg/m2) | r = 0.774 p < 0.001 | r = 0.710 p < 0.001 | r = 0.635 p < 0.001 | r = 0.660 p < 0.001 | r = 0.714 p < 0.001 | r = −0.325 p = 0.029 |
Phase angle (°) | r = 0.695 p < 0.001 | r = 0.675 p < 0.001 | r = 0.578 p < 0.001 | r = 0.623 p < 0.001 | r = 0.632 p < 0.001 | r = −0.589 p < 0.001 |
Fat-free mass (DXA) (kg) | r = 0.670 p < 0.001 | r = 0.505 p = 0.002 | r = 0.480 p = 0.004 | r = 0.616 p < 0.001 | r = 0.677 p < 0.001 | r = −0.570 p = 0.005 |
FFMI (DXA) (kg/m2) | r = 0.678 p < 0.001 | r = 0.567 p < 0.001 | r = 0.491 p = 0.003 | r = 0.576 p < 0.001 | r = 0.680 p < 0.001 | r = −0.610 p = 0.002 |
Handgrip strength (kg) | r = 0.790 p < 0.001 | r = 0.687 p < 0.001 | r = 0.718 p < 0.001 | r = 0.625 p < 0.001 | r = 0.779 p < 0.001 | r = −0.589 p < 0.001 |
Total Exacerbations | Severe Exacerbations | FEV1 (%) | FVC (%) | FEV1/FVC (%) | |
---|---|---|---|---|---|
Muscular area rectus anterior (MARA) (cm2) | r = 0.019 p = 0.89 | r = 0.161 p = 0.286 | r = 0.445 p = 0.005 | r = 0.376 p = 0.02 | r = 0.344 p = 0.037 |
Muscular area index (MARAI) (cm2/m2) | r = 0.052 p = 0.730 | r = 0.148 p = 0.326 | r = 0.328 p = 0.044 | r = 0.299 p = 0.068 | r = 0.234 p = 0.164 |
X-axis (cm) | r = 0.019 p = 0.899 | r = 0.092 p = 0.545 | r = 0.279 p = 0.090 | r = 0.270 p = 0.101 | r = 0.107 p = 0.530 |
Y-axis (cm) | r = −0.057 p = 0.708 | r = 0.038 p = 0.801 | r = 0.444 p = 0.005 | r = 0.398 p = 0.013 | r = 0.350 p = 0.034 |
Muscular circumference rectus (cm) | r = −0.016 p = 0.917 | r = 0.069 p = 0.646 | r = 0.348 p = 0.032 | r = 0.304 p = 0.064 | r = 0.214 p = 0.203 |
Subcutaneous adipose tissue (SCAT) (cm) | r = 0.122 p = 0.420 | r = 0.072 p = 0.634 | r = −0.065 p = 0.698 | r = −0.015 p = 0.931 | r = −0.224 p = 0.183 |
Normo-Nourished (n = 21) | Malnourished (n = 27) | p-Value | ||
---|---|---|---|---|
Muscular area rectus anterior (MARA) (cm2) | m ± SD | 4.75 ± 1.65 | 3.37 ± 1.04 | p = 0.014 |
Muscular area index (MARAI) (cm2/m2) | m ± SD | 1.71 ± 0.51 | 1.28 ± 0.36 | p = 0.016 |
X-axis (cm) | m ± SD | 3.74 ± 0.65 | 3.37 ± 0.61 | p = 0.279 |
Y-axis (cm) | m ± SD | 1.45 ± 0.36 | 1.17 ± 0.28 | p = 0.010 |
Muscular circumference rectus (cm) | m ± SD | 9.48 ± 1.69 | 8.26 ± 1.34 | p = 0.097 |
Subcutaneous adipose tissue (SCAT) (cm) | m ± SD | 0.73 ± 0.37 | 0.95 ± 0.46 | p = 0.872 |
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Sánchez-Torralvo, F.J.; Porras, N.; Ruiz-García, I.; Maldonado-Araque, C.; García-Olivares, M.; Girón, M.V.; Gonzalo-Marín, M.; Olveira, C.; Olveira, G. Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis. Nutrients 2022, 14, 3377. https://doi.org/10.3390/nu14163377
Sánchez-Torralvo FJ, Porras N, Ruiz-García I, Maldonado-Araque C, García-Olivares M, Girón MV, Gonzalo-Marín M, Olveira C, Olveira G. Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis. Nutrients. 2022; 14(16):3377. https://doi.org/10.3390/nu14163377
Chicago/Turabian StyleSánchez-Torralvo, Francisco José, Nuria Porras, Ignacio Ruiz-García, Cristina Maldonado-Araque, María García-Olivares, María Victoria Girón, Montserrat Gonzalo-Marín, Casilda Olveira, and Gabriel Olveira. 2022. "Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis" Nutrients 14, no. 16: 3377. https://doi.org/10.3390/nu14163377