The recent publication in Clinical Nutrition ESPEN shines a spotlight on the crucial issue of muscle mass (MM) evaluation in hospitalized patients, particularly those recovering from acute cardiac events. The original study, titled “Muscle mass evaluation in hospitalized patients: Comparison between doubly indirect methods,” presents findings that underscore the significance of assessing muscle mass for patient outcomes and the potential relationship between calf circumference (CC) and bioelectrical impedance analysis (BIA) in estimating MM.
The research, appearing in the February 2024 issue of the journal, is a collaborative work by Viviane Andrade Alves and colleagues from several Brazilian universities. The full citation for the article is: Alves, V. A., Fayh, A. P. T., Queiroz, S. A., Gonzalez, M. C., de Sousa, I. M. (2024). Muscle mass evaluation in hospitalized patients: Comparison between doubly indirect methods. Clinical Nutrition ESPEN, 59, 188-193. https://doi.org/10.1016/j.clnesp.2023.11.022
The study engaged a cohort of 177 patients with a mean age of 60.5 ± 12.4 years, predominantly males (75%), who were recuperating from cardiac incidents. It went beyond the mere measurement of muscle mass, delving into sociodemographic, clinical, and anthropometric factors to enrich its analysis. Notably, calf circumference was adjusted for body mass index (BMI), an innovative approach given that BMI alone is often an insufficient measure of body composition.
Findings revealed that raw values of fat-free mass (FFM)—often used as a proxy for muscle mass—obtained through BIA exhibited a weak to moderate correlation with calf circumference measurements in cardiac patients. This correlation suggests that changes in muscle mass reflected by one method could potentially affect, or be indicative of, alterations detected by the other method.
The study’s results are significant for several reasons. The loss of muscle mass is a common issue among hospitalized patients, particularly those with prolonged inactivity or critical illness. This deterioration can lead to adverse outcomes, including decreased mobility, longer hospital stays, increased healthcare costs, and higher mortality rates. Therefore, accurate assessment and timely intervention to preserve or restore muscle mass are essential components of patient care.
The article’s focus on two indirectly used methods for evaluating muscle mass is notable. Calf circumference is a simple anthropometric measure that reflects the size of the calf muscles and, by extension, the overall muscle mass of an individual. On the other hand, bioelectrical impedance analysis is a more technologically reliant method that gauges body composition, including fat-free mass, by sending a low-level electrical current through the body and measuring the resistance to that current.
By comparing these two methods, the research addresses an essential gap in understanding how different measures of muscle mass may be interrelated, offering a potentially more comprehensive picture of the patient’s condition. Moreover, the adjustments for BMI in calf circumference measurements highlight the nuances of body composition assessment and the complexity of reliably estimating muscle mass in varied populations.
The study does not declare any conflict of interest, which supports the integrity and credibility of the findings. Furthermore, the research contributes to a growing body of literature that emphasizes the significance of muscle mass in clinical settings, especially in the context of cardiovascular health.
Regarding the article’s publication details, it was first received on April 18, 2023, and went through robust peer review and revision processes before being accepted on November 28, 2023. The final version was published online on January 16, 2024, in Clinical Nutrition ESPEN, a well-regarded journal that disseminates critical research in the field of clinical nutrition and metabolism.
The study’s findings are of particular interest to healthcare professionals specializing in nutrition, cardiology, geriatrics, and rehabilitation. It also holds implications for those involved in healthcare policy and hospital administration, as the impact of muscle mass on patient outcomes can shape treatment protocols and resource allocation.
References
1. Alves, V. A., Fayh, A. P. T., Queiroz, S. A., Gonzalez, M. C., & de Sousa, I. M. (2024). Muscle mass evaluation in hospitalized patients: Comparison between doubly indirect methods. Clinical Nutrition ESPEN, 59, 188-193. https://doi.org/10.1016/j.clnesp.2023.11.022
2. Norman, K., Stobäus, N., Gonzalez, M. C., Schulzke, J. D., & Pirlich, M. (2011). Hand grip strength: outcome predictor and marker of nutritional status. Clinical Nutrition, 30(2), 135-142.
3. Kyle, U. G., Bosaeus, I., De Lorenzo, A. D., Deurenberg, P., Elia, M., Gómez, J. M., … & Heitmann, B. L. (2004). Bioelectrical impedance analysis—Part I: Review of principles and methods. Clinical Nutrition, 23(5), 1226-1243.
4. Rolland, Y., Lauwers-Cances, V., Cournot, M., Nourhashémi, F., Reynish, W., Rivière, D., … & Andrieu, S. (2003). Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. Journal of the American Geriatrics Society, 51(8), 1120-1124.
5. Janssen, I., Heymsfield, S. B., Baumgartner, R. N., & Ross, R. (2000). Estimation of skeletal muscle mass by bioelectrical impedance analysis. Journal of Applied Physiology, 89(2), 465-471.
Keywords
1. Muscle Mass Evaluation
2. Bioelectrical Impedance Analysis
3. Calf Circumference Measurement
4. Hospitalized Cardiac Patients
5. Body Composition Assessment