Cláudia Porto Sabino Pinho

Anthropometric characteristics and muscle strength remain insufficiently characterized in adults with congenital heart disease (CHD). The aim of the study was to characterize anthropometric indicators and muscle strength in hospitalized adults with CHD and examine differences according to cardiac lesion complexity. Exploratory comparisons with adults without CHD were performed as secondary analyses. This cross‐sectional study included 109 hospitalized adults with CHD and an external convenience group of 115 adults without CHD. Body mass index (BMI), mid‐upper arm circumference (MUAC), triceps skinfold thickness (TSF), mid‐arm muscle circumference (MAMC), arm muscle area (AMA), corrected arm muscle area (cAMA), and handgrip strength (HGS) were assessed. Cardiac defects were classified as mild, moderate, or complex. Associations of lesion complexity and previous cardiac surgery with anthropometric indicators and HGS were examined using multivariable linear regression. Comparisons with adults without CHD were conducted as exploratory analyses using the same approach. Among adults with CHD, 57.8% had mild, 24.8% moderate, and 17.4% complex defects. Lesion complexity was associated with MAMC ( P = 0.032); participants with complex defects had lower MAMC than those with mild defects ( B = −2.44 cm; 95% CI: −4.26 to −0.63). Previous cardiac surgery was associated with higher BMI, MUAC, MAMC, and AMA. In adjusted exploratory comparisons, adults with CHD had lower weight, height, BMI, MUAC, MAMC, AMA, and HGS than adults without CHD, whereas TSF was similar. Values below reference ranges for BMI, MUAC, MAMC, cAMA, and HGS were more frequent in CHD. Greater lesion complexity was associated with lower MAMC, whereas previous cardiac surgery was associated with higher BMI, MUAC, MAMC, and AMA. Muscle‐related anthropometric measures and HGS may provide complementary information beyond body size and adiposity in adults with CHD.

Introduction: The potential effect of elevated parathyroid hormone (PTH) levels on nutritional status and sarcopenia in chronic kidney disease (CKD) patients undergoing hemodialysis (HD) has not yet been well established. Objective: The aim of this study was to evaluate the status of sarcopenia and nutritional aspects according to PTH levels in HD patients. Methods: This cross-sectional study evaluated consecutive patients attending three HD clinics in Northeast Brazil. Patients were stratified based on PTH levels: (1) 0–199 pg/mL, (2) 200–599 pg/mL, and (3) ≥ 600 pg/mL. Group 1 was excluded due to older age, and groups 2 and 3 were matched for age, sex, and presence of diabetes. Sarcopenia was defined according to the European consensus criteria, assessing muscle strength, muscle mass, muscle quality index, and body mass index. Results: A total of 238 individuals were evaluated (119 in each group), with a mean age of 49.3 ± 14.4 years. The prevalence of sarcopenia was 18.5%, and 66.7% exhibited low muscle quality. Underweight was observed in 6.3% of the sample, while 41.4% were overweight. There were no differences in rates of underweight, low muscle mass, low muscle strength, sarcopenia, and low muscle quality according to PTH status (p > 0.05). Conclusion: Patients undergoing HD with moderate to severe hyperparathyroidism (PTH ≥ 600 pg/mL) did not show higher nutritional impairment or sarcopenia compared to patients with PTH levels within the recommended range (200–599 pg/mL).

Resumo Introdução: Ainda não está estabelecido o potencial efeito de elevados níveis de paratormônio (PTH) no estado nutricional e no status de sarcopenia em pacientes com doença renal crônica (DRC) submetidos à (HD). Objetivo: Analisar o status de sarcopenia e aspectos nutricionais segundo os níveis de PTH em pacientes em HD. Métodos: Estudo transversal que avaliou pacientes regulados em três clínicas de HD no Nordeste do Brasil. Os pacientes foram estratificados segundo os níveis de PTH: (1) 0–199 pg/mL, (2) 200–599 pg/mL e (3) ≥ 600 pg/mL. O grupo 1 foi excluído por conter os pacientes com maior idade, e os grupos 2 e 3 foram pareados segundo idade, sexo e presença de diabetes. A sarcopenia foi estabelecida segundo critério europeu, sendo avaliados: força muscular, massa muscular, índice de qualidade muscular e índice de massa corporal. Resultados: Foram avaliados 238 indivíduos (119 em cada grupo), com média de idade de 49,3 ± 14,4 anos. A prevalência de sarcopenia foi de 18,5%, e 66,7% exibiram baixa qualidade muscular. A desnutrição foi observada em 6,3% da amostra, e 41,4% tinham excesso de peso. Não houve diferença nas taxas de desnutrição, baixa massa muscular, baixa força muscular, sarcopenia e baixa qualidade muscular segundo o status de PTH (p > 0,05). Conclusão: pacientes em HD com hiperparatireoidismo moderado e grave (PTH ≥ 600 pg/mL) não apresentaram maior comprometimento nutricional ou sarcopenia em comparação com pacientes com níveis de PTH dentro da faixa recomendada (200–599 pg/mL).

Introdução: As neoplasias hematológicas, associadas aos tratamentos antineoplásicos, podem desencadear alterações na composição corporal, aumentando o risco de sarcopenia e comprometimento da qualidade de vida. Objetivo: avaliar a associação entre sarcopenia e qualidade de vida em pacientes hospitalizados com neoplasias hematológicas. Método: Estudo transversal, com pacientes adultos e idosos, de ambos os sexos, internados no Hospital das Clínicas da Universidade Federal de Pernambuco, no ano de 2024, com diagnóstico de neoplasia hematológica. Foram coletadas variáveis demográficas, clínicas, nutricionais e de qualidade de vida. O diagnóstico de sarcopenia foi estabelecido quando os indivíduos apresentaram circunferência muscular do braço e força de preensão palmar reduzidas. Para avaliar a qualidade de vida foi utilizado o questionário específico para pacientes com câncer, o The Functional Assessment of Cancer Therapy – General, onde quanto maior foi a pontuação, melhor foi a qualidade de vida, sendo o grupo do menor tercil classificado como pior qualidade de vida. Resultados: a amostra foi composta por 35 pacientes, com média de idade 55,0±15,8. A sarcopenia foi encontrada em 28,6% dos indivíduos e a baixa qualidade de vida, por sua vez, foi observada em 34,3% dos pacientes, com mediana de 72,0 pontos. Houve associação no limiar da significância estatística entre a sarcopenia e qualidade de vida (p=0.053). Conclusão: A presença de sarcopenia e a baixa qualidade de vida foram achados importantes, fazendo-se necessário outros estudos, com caráter longitudinal e com amostras maiores para alcançar conclusões mais precisas sobre o papel da sarcopenia na qualidade de vida nessa população. Palavras chaves: sarcopenia; neoplasia; qualidade de vida; estado nutricional.

Growing evidence suggests that sarcopenic obesity (SO) may have a more pronounced effect on functionality compared with isolated sarcopenia, but research in this crucial area remains scarce. Therefore, this study aimed to evaluate whether the combination of sarcopenia and obesity is associated with increased functional impairment in hospitalized older adults. This is a cross‐sectional study involving hospitalized older patients. SO was defined as the simultaneous presence of obesity and sarcopenia. Obesity was determined based on a high body fat percentage obtained through bioelectrical impedance analysis, whereas both reduced muscle strength and mass identified sarcopenia. Functionality was evaluated using the Barthel Index and the gait speed test. Additional sociodemographic, clinical, nutrition, and behavioral data were assessed. A total of 176 patients were included in our study. The mean age was 69.8 ± 7.8 years. The frequency of sarcopenia was 37.5%, whereas SO was found in 17.6%. Barthel Index indicated that 64.2% of patients exhibited functional dependency, whereas 87.5% had a slow gait speed. Logistic regression analysis revealed that SO was independently associated with poor functionality by the Barthel Index (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.1–8.5) and slow gait speed (OR, 3.3; 95% CI, 1.1–9.8). Patients with SO showed poorer functional capacity compared with those with obesity alone ( P < 0.05), but not compared with those with sarcopenia alone ( P > 0.05). In conclusion, we observe that SO was associated with diminished functionality but did not elevate the risk compared with sarcopenia alone.

Wasting syndrome (WS), also known as unintentional weight loss, is defined as a 5% reduction in body weight over a period of 6–12 months. The mortality associated with WS in older adults has not been adequately explored. The objective of this study was to investigate this relationship in hospitalized older individuals over an 18‐month period. 175 older adults who were hospitalized were observed for 18 months to observe outcomes such as new hospitalizations within this timeframe, length of hospital stay, and death. Weight loss was defined as the difference between measured weight and self‐reported weight over the last 6–12 months. Outcomes were obtained through telephone tracking. WS was observed in 45.7% of older individuals at study baseline, with 46.8% experiencing hospital stays of ≥10 days. 26.9% of these patients died, and 43.4% were rehospitalized during the follow‐up. Deaths occurred earlier among patients with WS compared with unexposed individuals ( P = 0.028) according to the Kaplan‐Meier curve, but in the Cox regression WS was not significantly associated with mortality. In conclusion, a high prevalence of WS was observed in hospitalized older people, with a significant association with functional dependence. Although WS was not an independent predictor of mortality in the multivariate model, it was associated with earlier deaths in the unadjusted survival analysis.

Background: The prognostic significance of standardized phase angle (StPhA) and bioelectrical impedance vector analysis (BIVA) remains unclear among hospitalized older individuals. Our study aimed to investigate the prognostic significance of StPhA and BIVA patterns concerning overall survival in hospitalized older patients. Methods: A prospective cohort study was conducted among older adults hospitalized in medical or surgical wards. Single‐frequency bioelectrical impedance analysis (BIA) was conducted. Using the raw BIA measurements (resistance and reactance), BIVA plots were graphed and StPhA was calculated. In addition, patients underwent assessments for anthropometry, malnutrition, and muscle strength via handgrip strength test. Follow‐up was conducted for up to 24 months after the initial data collection to determine the incidence of mortality as the outcome. Results: A total of 168 patients were included in this analysis. They were mostly men, with a median age of 68 years. Onco‐hematological diagnoses were the most frequent. Patients with low StPhA exhibited significantly lower body mass index and fat mass (%) ( P < 0.05). Analysis of BIVA confidence showed that patients with low StPhA and nonsurvivors exhibited a significant downward shift along the y‐axis, indicating less cell mass. BIVA ellipses demonstrated that patients with low StPhA and nonsurvivors were mainly concentrated in the cachexia and anasarca quadrants. Low StPhA was an independent predictor of mortality (hazard ratio _adjusted = 2.28; 95% CI, 1.05–4.97). Conclusion: Our study highlights the prognostic significance of StPhA and demonstrates the clinical relevance of using BIVA to estimate body composition/nutrition phenotypes in hospitalized older patients.