Nutritional Status and Body Composition in Female Patients with Interstitial Lung Diseases

BACKGROUND: Body composition (BC) techniques, including bioelectrical impedance
analysis (BIVA), nutritional ultrasound® (NU), and computed tomography (CT), can
detect nutritional diagnoses such as sarcopenia (Sc). Sc in idiopathic pulmonary
fibrosis (IPF) is associated with greater severity and lower survival. Our aim
was to explore the correlation of BIVA, NU and functional parameters with BC at
T12 level CT scans in patients with IPF but also its relationship with degree of
Sc, malnutrition and mortality.
METHODS: This bicentric cross-sectional study included 60 IPF patients (85.2%
male, 70.9 ± 7.8 years). Morphofunctional assessment (MFA) techniques included
BIVA, NU, CT at T12 level (T12-CT), handgrip strength, and timed up and go. CT
data were obtained using FocusedON®. Statistical analysis was conducted using
JAMOVI version 2.3.22 to determine the cutoff points for Sc in T12-CT and to
analyze correlations with other MFA techniques.
RESULTS: the cutoff for muscle area in T12-CT was ≤77.44 cm2 (area under the
curve (AUC) = 0.734, sensitivity = 41.7%, specificity = 100%). The skeletal
muscle index (SMI_T12CT) cutoff was ≤24.5 cm2/m2 (AUC = 0.689, sensitivity =
66.7%, specificity = 66.7%). Low SMI_T12CT exhibited significantly reduced
median survival and higher risk of mortality compared to those with normal
muscle mass (SMI cut off ≥ 28.8 cm/m2). SMI_T12CT was highly correlated with
body cell mass from BIVA (r = 0.681) and rectus femoris cross-sectional area
(RF-CSA) from NU (r = 0.599). Cronbach’s α for muscle parameters across
different MFA techniques and CT was 0.735, confirming their validity for
evaluating muscle composition.
CONCLUSIONS: T12-CT scan is a reliable technique for measuring low muscle mass
in patients with IPF, specifically when the L3 vertebrae are not captured. An
SMI value of <28.8 is a good predictor of low lean mass and 12-month mortality in IPF patients. DOI: 10.3390/nu16172885 PMCID: PMC11396836 PMID: 39275202 [Indexed for MEDLINE] Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.