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Multicenter Study Journal Article Epublish 11 citations

PubMed: 37892547 DOI: 10.3390/nu15204473

Rectus Femoris Cross-Sectional Area and Phase Angle asPredictors of 12-Month Mortality in Idiopathic Pulmonary Fibrosis Patients.

Nutrients 15(20)

Authors: Rocío Fernández-Jiménez, Eva Cabrera Cesar, Ana Sánchez García, Francisco Espíldora Hernández, Isabel M Vegas-Aguilar, Maria Del Mar Amaya-Campos, Isabel Cornejo-Pareja, Patricia Guirado-Peláez, Victor Simón-Frapolli, Mora Murri, Lourdes Garrido-Sánchez, Alvaro Martínez Mesa, Lorena Piñel-Jimenez, Miguel Benítez-Cano Gamonoso, Lara Dalla-Rovere, Maria García Olivares, Jose Luis Velasco-Garrido, Francisco Tinahones-Madueño, José Manuel García-Almeida

Affiliations

  • Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain.
  • IBIMA, Málaga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain.
  • Department of Medicine and Dermatology, Málaga University, 29016 Malaga, Spain.
  • Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain.
  • Department of Neumology, Virgen de la Victoria University Hospital, 29010 Malaga, Spain.
  • Department of Neumology, Regional University Hospital, 29010 Malaga, Spain.
  • Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, CIBEROBN, Carlos III Health Institute (ISCIII), University of Málaga, 29016 Malaga, Spain.
  • Heart Area Clinical Management Unit, Virgen de la Victoria University Hospital, 29010 Malaga, Spain.
  • Department of Medicine and Dermatology, Málaga University, 29016 Malaga, Spain. Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain.
  • Department of Endocrinology and Nutrition, Carlos de Haya Regional University Hospital, 29010 Malaga, Spain.
  • Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, Spain. IBIMA, Málaga Biomedical Research Institute and BIONAND Platform, 29010 Malaga, Spain. Department of Endocrinology and Nutrition, Quironsalud Málaga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain. Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, CIBEROBN, Carlos III Health Institute (ISCIII), University of Málaga, 29016 Malaga, Spain.

Abstract

BACKGROUND

The value of the phase angle (PhA), measured via bioelectrical impedance analysis (BIA), could be considered a good marker of the cell mass and the cell damage of a patient; however, there are new techniques, such as muscle ultrasonography, that allow the quantity and quality of muscle to be assessed in a minimally invasive way. The aim of this study is to determine the prognostic value of morphofunctional techniques in the prognosis of mortality in patients with idiopathic pulmonary fibrosis (IPF).

METHODS

This multicenter, cross-sectional study included 86 patients with idiopathic pulmonary fibrosis with a mean age of 71 years, 82.7% of whom were male. The nutritional risk of the patients was assessed by means of questionnaires, such as the Subjective Global Assessment (SGA), and non-invasive functional techniques, including BIA, nutritional ultrasound, and hand grip strength (HGS). Statistical analysis of the sample was performed using JAMOVI version 2.3.22.

RESULTS

Correlations were made between the RF-CSA techniques with PhA (r = 0.48, < 0.001), BCM (r = 0.70, < 0.001), SMI (r = 0.64, < 0.001), and HGS (r = 0.54, < 0.001). The cut-off points for 12-month mortality were PhA = 4.5° (AUC = 0.722, sensitivity of 72.7% and specificity of 66.6%), BCM = 28.8 kg (AUC = 0.609, sensitivity of 32.4% and specificity of 100.0%), RF-CSA = 3.00 cm (AUC = 0.857, sensitivity of 64.4% and specificity of 100.0%), 6MMW = 420 m (AUC = 0.830, sensitivity of 63.27% and specificity of 100.0%), and TUG = 7.2 s (AUC = 0.771, sensitivity of 100.0% and specificity of 56.67%). In addition, a multivariate analysis was performed with RF-CSA, HR = 8.11 (1.39-47.16, = 0.020), and PhA of 6.35 (1.29-31.15, = 0.023), taking into account age, sex, and BMI to determine mortality. Finally, a Kaplan-Meier survival analysis was conducted with low or normal values for classical parameters (GAP and T6MM) and new parameters (PhA, BCM, RF-CSA, and TUG).

CONCLUSION

RF-CSA and PhA were shown to be good prognostic markers of 12-month mortality and could, therefore, be useful screening tools to complement the nutritional assessment of IPF patients.

MeSH

Cells, Idiopathic Pulmonary Fibrosis, Mortality, Muscles, Fibrosis, Food, Pulmonary Fibrosis, Hand Strength

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