Visceral Adiposity in Relation to Body Adiposity and Nutritional Status in Elderly Patients with Stable Coronary Artery Disease

Autor: Bartosz Hudzik, Janusz Szkodzinski, Barbara Zubelewicz-Szkodzińska, Justyna Nowak
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
obesity
CONUT score
Nutritional Status
030209 endocrinology & metabolism
Context (language use)
Coronary Artery Disease
030204 cardiovascular system & hematology
Body adiposity index
Intra-Abdominal Fat
Gastroenterology
Article
Body Mass Index
Coronary artery disease
03 medical and health sciences
BMI
0302 clinical medicine
Internal medicine
Electric Impedance
Medicine
Humans
TX341-641
Geriatric Assessment
Abdominal obesity
visceral adiposity
Adiposity
Aged
Geriatrics
Aged
80 and over
Inpatients
Nutrition and Dietetics
Anthropometry
Nutrition. Foods and food supply
business.industry
Surrogate endpoint
Reproducibility of Results
medicine.disease
Obesity
VAI
Nutrition Assessment
Obesity
Abdominal
Population study
Female
medicine.symptom
business
Biomarkers
Food Science
Zdroj: Nutrients
Volume 13
Issue 7
Nutrients, Vol 13, Iss 2351, p 2351 (2021)
ISSN: 2072-6643
Popis: Introduction: The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities. There are numerous factors that make the body-mass index (BMI) a suboptimal measure of adiposity. The visceral adiposity index (VAI) may be considered a simple surrogate marker of visceral adipose tissue dysfunction. However, the evidence comparing general to visceral adiposity in CAD is scarce. Therefore, we have set out to investigate visceral adiposity in relation to general adiposity in patients with stable CAD. Material and methods: A total of 204 patients with stable CAD hospitalized in the Department of Medicine and the Department of Geriatrics entered the study. Based on the VAI-defined adipose tissue dysfunction (ATD) types, the study population (N = 204) was divided into four groups: (1) no ATD (N = 66), (2) mild ATD (N = 50), (3) moderate ATD (N = 48), and (4) severe ATD (N = 40). Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score. Results: Patients with moderate and severe ATD were the youngest (median 67 years), yet their metabolic age was the oldest (median 80 and 84 years, respectively). CONUT scores were similar across all four study groups. The VAI had only a modest positive correlation with BMI (r = 0.59 p <
0.01) and body adiposity index (BAI) (r = 0.40 p <
0.01). There was no correlation between VAI and CONUT scores. There was high variability in the distribution of BMI-defined weight categories across all four types of ATD. A total of 75% of patients with normal nutritional status had some form of ATD, and one-third of patients with moderate or severe malnutrition did not have any ATD (p = 0.008). In contrast, 55–60% of patients with mild, moderate, or severe ATD had normal nutritional status (p = 0.008). ROC analysis demonstrated that BMI and BAI have poor predictive value in determining no ATD. Both BMI (AUC 0.78 p <
0.0001) and BAI (AUC 0.66 p = 0.003) had strong predictive value for determining severe ATD (the difference between AUC 0.12 being p = 0.0002). However, BMI predicted mild ATD and severe ATD better than BAI. Conclusions: ATD and malnutrition were common in patients with CAD. Notably, this study has shown a high rate of misclassification of visceral ATD via BMI and BAI. In addition, we demonstrated that the majority of patients with normal nutritional status had some form of ATD and as much as one-third of patients with moderate or severe malnutrition did not have any ATD. These findings have important clinical ramifications for everyday practice regarding the line between health and disease in the context of malnutrition in terms of body composition and visceral ATD, which are significant for developing an accurate definition of the standards for the intensity of clinical interventions.
Databáze: OpenAIRE
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