Fat-Free Mass Index Controlled for Age and Sex and Malnutrition Are Predictors of Survival in Interstitial Lung Disease

Respiration ◽  
2021 ◽  
pp. 369-376
Author(s):  
Sylvia Rinaldi ◽  
Jason Gilliland ◽  
Colleen O’Connor ◽  
Jamie A. Seabrook ◽  
Marco Mura ◽  
...  
Keyword(s):  
Body Composition ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Disease Severity ◽  
Exercise Capacity ◽  
Fat Free Mass ◽  
Nutrition Status ◽  
Severe Malnutrition ◽  
Z Score ◽  
Age And Sex

Background: Literature focusing on nutritional variables and survival in interstitial lung disease (ILD) is limited by its focus on weight and BMI and has not considered body composition. Objectives: The primary objective of this study was to examine whether body composition measures, specifically fat-free mass index z-score (z-FFMI) and body fat mass index z-score (z-BFMI), were predictors of survival in fibrotic ILD patients. The second objective was to examine if nutrition status was a predictor of survival. Method: Seventy-eight outpatients diagnosed with fibrotic ILD were recruited in this cross-sectional study. Body composition data using dual frequency bioelectrical impedance analysis (BodyStat 1500MD; UK) and nutrition status using the subjective global assessment (SGA) were determined. To control for age and sex, z-FFMI and z-BFMI were calculated using population means. Participant charts were reviewed for diagnosis, age, disease severity, and exercise capacity. Results: Age (HR 1.08, 95% CI [1.03–1.13], p < 0.01), BMI (HR 0.90, 95% CI [0.84–0.97], p < 0.01]), z-FFMI (HR 0.70, 95% CI [0.56–0.87], p = 0.02), z-BFMI (HR 0.74, 95% CI [0.57–0.96], p < 0.01), 6-min walk distance (6MWD) (HR 0.99, 95% CI [0.99–1.00], p < 0.01), percent predicted diffusing capacity for carbon monoxide (%DLco) (HR 0.93, 95% CI [0.89–0.97], p < 0.01), and severe malnutrition (SGA-C) (HR 6.98, 95% CI [2.00–24.27], p < 0.01) were significant predictors of survival. When controlled for exercise capacity and disease severity, z-FFMI and severe malnutrition were significant predictors of survival independent of %DLco. Conclusion: z-FFMI and severe malnutrition were significant predictors of survival in fibrotic ILD patients independent of disease severity.

Exercise capacity and its relationship with body composition and nutrition status in patients with interstitial lung disease

2021 ◽  
Author(s):  
Sylvia Rinaldi ◽  
Jason Gilliland ◽  
Colleen O'Connor ◽  
Jamie A. Seabrook ◽  
Marco Mura ◽  
...  
Keyword(s):  
Body Composition ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Exercise Capacity ◽  
Nutrition Status

scholarly journals OP0009 DERIVATION AND VALIDATION OF THE SCLERODERMA LUNG 3-STAGE INDEX (SL3SI), A NEW FUNCTIONAL INDEX FOR INTERSTITIAL LUNG DISEASE WITH PROGNOSTIC IMPLICATIONS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 7.2-7
Author(s):  
A. Santaniello ◽  
C. Bellocchi ◽  
L. Bettolini ◽  
M. Cassavia ◽  
G. Montanelli ◽  
...  
Keyword(s):  
At Risk ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Disease Severity ◽  
Disease Duration ◽  
Functional Model ◽  
Severity Scale ◽  
Predictive Capability ◽  
Patients At Risk ◽  
Disease Severity Scale

Background:The staging of interstitial lung disease (ILD) is important to monitor disease progression and for prognostication. A disease severity scale of Systemic Sclerosis (SSc)-related lung disease has long been proposed (i.e. Medsger’s severity scale). This scale was mostly developed by discussion and consensus and stage thresholds were not computed by a data-driven approach. Hidden Markov models (HMM) are methods to estimate population quantities for chronic diseases with a staged interpretation which are diagnosed by markers measured at irregular intervals.Objectives:To build a SSc-ILD specific disease severity scale with prognostic relevance via HMM modeling.Methods:A total of 358 SSc patients at risk for or with ILD were enrolled in a discovery (207 cases, Milan1) and in a validation (151 cases, Milan2, Pavia and Rome) cohort. Patients were included if satisfied the following criteria: 1) Diagnosis of SSc according to the EULAR/ACR 2013 criteria, 2) absence of anticentromere antibodies, 3) dcSSc subset or 4) other subsets with either 4a) ILD-related antibodies (Scl70, PmScl, Ku) or 4b) evidence of ILD on HRCT, 5) disease duration < 5 years at the time of the first pulmonary function test (PFT). Serial PFTs were retrieved and the time up to the last available visit -if the patient alive-, or to death due to pulmonary complications, was recorded. HMM were used to estimate the threshold of a 3-stage model (SL3SI, Scleroderma Lung 3-Stage Index) based on PFT functional values (normal/mild, moderate, severe involvement) in the discovery cohort. Survival estimates of the SL3SI model were compared to Medsger’s severity classes estimates and their predictive capability evaluated via the explained residual variation (R2) of prediction errors (the higher the better). One-hundred random replicates were generated to simulate the prediction effort in patients with different disease duration and lung severity.Results:Patients characteristics are summarized in the Table. Fifteen-years survival estimates for Mesdger’s classes in the discovery set were: normal=0.88, mild=0.86, moderate=0.84 and severe=0.71. The SL3SI was defined by the following thresholds: normal/mild, FVC and DLco >=75%; moderate FVC or DLco 74-55%; severe, FVC or DLco <55%. SL3SI 15-yrs survival estimates were: normal/mild=0.89, moderate=0.82 and severe=0.63. Prediction analysis showed a higher R2values at 15 yrs for the SL3SI compared to Medsger’s classes, providing evidence for a better predictive capability of the former (discovery: 0.31 vs 0.25; validation: 0.28 vs 0.19).Conclusion:The SL3SI, a simplified 3-stage functional model of SSc-ILD, yields better survival estimates and long-term prognostic information than Medsger’s classes. Its reproducibility and ease of use make it a useful tool for the functional and prognostic evaluation of SSc patients at risk for or with ILD.Table:VariablesDiscovery (n=207)Replication (n=151)DcSSc62 (30%)98 (64%)Age at first PFR48.6±1249.1±14.4Disease duration at first PFR1.7±1.61.3±2.4FVC90.5±18.191.1±20.2DLco70.7±19.861.3±20.1ILD on HRCT179 (86%)125 (80%)Scl70157 (76%)153 (78%)SSA63 (30%)32 (21%)n of visits38571473Follow-up time, yrs11±5.610.6±5.7Deaths27 (13%)23 (15%)Disclosure of Interests:Alessandro Santaniello: None declared, Chiara Bellocchi: None declared, Luca Bettolini: None declared, Marcello Cassavia: None declared, Gaia Montanelli: None declared, Adriana Severino: None declared, Monica Caronni: None declared, Corrado Campochiaro Speakers bureau: Novartis, Pfizer, Roche, GSK, SOBI, Enrico De Lorenzis: None declared, Gerlando Natalello: None declared, Paolo Delvino: None declared, Claudio Tirelli: None declared, Lorenzo Cavagna: None declared, Giacomo De Luca Speakers bureau: SOBI, Novartis, Celgene, Pfizer, MSD, Silvia Laura Bosello: None declared, Lorenzo Beretta Grant/research support from: Pfizer

Pectoralis muscle area and its association with indices of disease severity in interstitial lung disease

2021 ◽  
pp. 106539
Author(s):  
Yannick Molgat-Seon ◽  
Sabina A. Guler ◽  
Carli M. Peters ◽  
Dragoş M. Vasilescu ◽  
Joseph H. Puyat ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Disease Severity ◽  
Pectoralis Muscle ◽  
Muscle Area

scholarly journals Telephone surveillance during 2019 novel coronavirus disease: Is it a helpful diagnostic tool for detecting acute pulmonary exacerbations in children with chronic lung disease?

2020 ◽  
pp. 1357633X2097200
Author(s):  
Beste Ozsezen ◽  
Nagehan Emiralioglu ◽  
Dilber A Tural ◽  
Birce Sunman ◽  
Halime N Buyuksahin ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Transmission Risk ◽  
Nutrition Status ◽  
Peak Time ◽  
Pulmonary Exacerbation ◽  
Pulmonary Exacerbations ◽  
The Times ◽  
Novel Coronavirus

Introduction The global burden of the 2019 novel coronavirus disease pandemic on the healthcare system, as well as the high transmission risk of coronavirus disease has led to the use of alternative strategies for evaluation of children with chronic conditions. In this context, telemedicine has become the effective and affordable choice. In this study we aimed to evaluate the efficiency of telephone visits to determine pulmonary exacerbations and hospitalization rates of children with cystic fibrosis and interstitial lung disease. Methods A total of 119 children with cystic fibrosis or interstitial lung disease were enrolled and provided cases in which telephone visits were applied during the peak time of the coronavirus disease pandemic in our country. The recordings of respiratory, gastrointestinal and other symptoms, nutrition status, rate of acute pulmonary exacerbation, treatments initiated by telephone visits, referral to hospital and hospitalization were established from the electronic health reports of the patients. Results Thirteen patients (10.9%) were symptomatic, 12 of them (10%) were diagnosed with acute pulmonary exacerbation. One patient was diagnosed with peripheral facial paralysis. Nine patients were recalled to the hospital and seven patients (5.8%) were hospitalised. Discussion Using telemedicine the health status of patients can be defined, and patients can be guided on proper healthcare that they need, especially during the times of pandemics which we are facing. Communication with patients while minimising the risk of exposure to coronavirus disease is an important advantage of telemedicine. Telemedicine will have to be implemented on our daily medical practice in the near future.

Neural Respiratory Drive, Breathlessness And Disease Severity In Interstitial Lung Disease

2012 ◽  
Author(s):  
Victoria MacBean ◽  
Mohammad A.F. Siddiqui ◽  
Amit S. Patel ◽  
Surinder S. Birring ◽  
John Moxham ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Disease Severity ◽  
Respiratory Drive

scholarly journals MON-104 The Relationship Between Metabolic Syndrome Indicators and Body Composition Measured by Bioelectrical Impedance Analysis Methods in Obese Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Seulki Kim ◽  
Yoonji Lee ◽  
Na-yeong Lee ◽  
Seonhwa Lee ◽  
Yujung Choi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Composition ◽  
Serum Insulin ◽  
Fat Free Mass ◽  
Model Assessment ◽  
Z Score ◽  
Good Tool ◽  
Prepubertal Children ◽  
Composition Data ◽  
The Relationship

Abstract Purpose: This study aimed to compare obesity indices with impedance analyzed body composition data, and to investigate the association between impedance analyzed body composition data and the prevalence of metabolic syndrome. Methods: 123 prepubertal children (49% girls 3-to-8- year-old, 51% boys 3-to-9-year-old) who are below or equal to body mass index (BMI, kg/m2) 85th percentile were retrospectively reviewed. Height, weight, waist circumference, blood pressure, serum lipid profiles, fasting plasma glucose and serum insulin were measured. Body fat percentile (BFP), fat-free mass (FFM) were measured by BIA and fat mass index (FMI), fat-free mass index (FFMI) were calculated. We investigated the relationship between metabolic syndrome indicators and body composition measured by BIA. Metabolic syndrome (MetS) was defined as including more than or equal to three of the metabolic abnormalities according to the modified National Cholesterol Education Program Adult Treatment Panel III. Results: The overall prevalence of MetS was found to be 15.4%(19/123). The prevalence of MetS, MetS indicators, and body composition measured by BIA were not significantly different between males and females. BMI z-score was positively correlated with BFP, FMI and FFMI (r=0.51, P=0.001; r=0.63, P=0.001; r=0.29, P=0.001, respectively), so was waist-to-height ratio (WHR) (r=0.57, P=0.001; r=0.70, P=0.001; r=0.33, P=0.001). Homeostatic model assessment for insulin resistance (HOMA-IR) index was associated to BFP, FFM, FMI, and FFMI (r=0.305, P=0.003; r=0.359, P=0.001; r=0.331, P=0.001; r=0.24, P=0.018, respectively). Regression analysis showed chronological age (CA) and BMI z-score affect HOMA-IR (β=0.61, P=0.001; β=0.93, P=0.002, respectively) and CA was considered as a potential risk factor of MetS (Odd ratio of 3.09 and 95 % confidence interval of 1.25–7.65). Conclusion: BIA seems to be a good tools for measuring obesity but not a good tool for predicting complications of obesity in prepubertal children. Further study is needed on the risk factors for complications of obesity in prepubertal children.

scholarly journals Are Body Composition Parameters Better than Conventional Anthropometric Measures in Predicting Pediatric Hypertension?

2020 ◽  
Vol 17 (16) ◽  
pp. 5771
Author(s):  
Chih-Yu Hsu ◽  
Rong-Ho Lin ◽  
Yu-Ching Lin ◽  
Jau-Yuan Chen ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Body Composition ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Fat Free Mass ◽  
Z Score ◽  
Pediatric Hypertension ◽  
Anthropometric Measures ◽  
Operating Characteristic Curve ◽  
Better Than

Body composition (BC) parameters are associated with cardiometabolic diseases in children; however, the importance of BC parameters for predicting pediatric hypertension is inconclusive. This cross-sectional study aimed to compare the difference in predictive values of BC parameters and conventional anthropometric measures for pediatric hypertension in school-aged children. A total of 340 children (177 girls and 163 boys) with a mean age of 8.8 ± 1.7 years and mean body mass index (BMI) z-score of 0.50 ± 1.24 were enrolled (102 hypertensive children and 238 normotensive children). Significantly higher values of anthropometric measures (BMI, BMI z-score, BMI percentile, waist-to-height ratio) and BC parameters (body-fat percentage, muscle weight, fat mass, fat-free mass) were observed among the hypertensive subgroup compared to their normotensive counterparts. A prediction model combining fat mass ≥ 3.65 kg and fat-free mass ≥ 34.65 kg (area under the receiver operating characteristic curve = 0.688; sensitivity = 66.7%; specificity = 89.9%) performed better than BMI alone (area under the receiver operating characteristic curve = 0.649; sensitivity = 55.9%; specificity = 73.9%) in predicting hypertension. In conclusion, BC parameters are better than anthropometric measures in predicting pediatric hypertension. BC measuring is a reasonable approach for risk stratification in pediatric hypertension.

Sign in / Sign up

Export Citation Format

Share Document