Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain.
Centro de Investigación Endocrinología y Nutrición, Universidad de Valladolid, 47003 Valladolid, Spain.
Nutrients. 2023 Sep 9;15(18):3923. doi: 10.3390/nu15183923.
Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM).
A cross-sectional study was developed on 144 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional evaluation was assessed with anthropometric variables, handgrip strength and bioelectrical impedanciometry (BIA). Nutritional ultrasonography of quadriceps rectus femoris (QRF) was made (muscle mass (Muscle Area of Rectus Femoris index (MARFI)), Y axis and muscle quality (X-Y index and echogenicity).
The mean age of patients was 61.4 (17.34) years. The prevalence of sarcopenia in the sample was 33.3%. Patients with sarcopenia (S) had lower values of MARFI [(S: 1.09 (0.39) cm/m; NoS: 1.27 (0.45); = 0.02), Y axis (S: 0.88 (0.27); NoS: 1.19 (0.60); < 0.01) and X-Y index (S: 1.52 (0.61); NoS: 1.30 (0.53); < 0.01)]. There was a correlation between BIA parameters (phase angle) and muscle mass ultrasonographic variables (MARFI) (r = 0.35; < 0.01); there was an inverse correlation between muscle quality ultrasonographic variables (echogenicity) and handgrip strength (r = -0.36; < 0.01). In the multivariate analysis adjusted by age, the highest quartile of the X-Y index had more risk of death OR: 4.54 CI95% (1.11-18.47).
In patients with DRM and sarcopenia, standardized muscle mass and muscle quality parameters determined by ultrasonography of QRF are worse than in patients without sarcopenia. Muscle quality parameters had an inverse correlation with electric parameters from BIA and muscle strength. The highest quartile of the X-Y index determined by ultrasonography was associated with increased mortality risk.
评估与疾病相关的营养不良 (DRM) 患者的人体测量和质量超声参数与其他形态功能评估参数之间的关系。
对根据全球营养倡议 (GLIM) 标准诊断为 DRM 的 144 名患者进行横断面研究。形态功能评估通过人体测量变量、握力和生物电阻抗法 (BIA) 进行评估。对股四头肌直肌进行营养超声检查 (肌肉质量 (股直肌的肌肉区域指数 (MARFI))、Y 轴和肌肉质量 (X-Y 指数和回声性))。
患者的平均年龄为 61.4(17.34)岁。样本中肌少症的患病率为 33.3%。肌少症患者 (S) 的 MARFI 值较低 [(S：1.09(0.39)cm/m；NoS：1.27(0.45)； = 0.02)，Y 轴 (S：0.88(0.27)；NoS：1.19(0.60)；<0.01)和 X-Y 指数 (S：1.52(0.61)；NoS：1.30(0.53)；<0.01)]。BIA 参数 (相位角) 与肌肉质量超声变量 (MARFI) 之间存在相关性 (r = 0.35；<0.01)；肌肉质量超声变量 (回声性) 与握力呈负相关 (r = -0.36；<0.01)。在年龄调整的多变量分析中，X-Y 指数的最高四分位数死亡风险更高 OR：4.54CI95% (1.11-18.47)。
在患有 DRM 和肌少症的患者中，股四头肌直肌超声确定的标准化肌肉质量和肌肉质量参数比没有肌少症的患者差。肌肉质量参数与 BIA 和肌肉力量的电参数呈负相关。超声确定的 X-Y 指数的最高四分位数与死亡率增加的风险相关。
