Miopenia e mioesteatose em pacientes hospitalizados com sobrepeso e obesidade
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Resumo
Objetivo: Avaliar a composição corporal, presença de miopenia e mioesteatose em população com excesso de peso hospitalizada e identificar preditores para longo tempo de internamento. Métodos: Estudo observacional, do tipo longitudinal, realizado com pacientes com sobrepeso e obesidade internados em instituição terciária pública. Foram coletadas variáveis sociodemograficas, clínicas e nutricionais. A hospitalização ≥16 dias foi considerada longa. A composição corporal foi definida pelas imagens de tomografia computadorizada, sendo obtidas as áreas e índices da massa muscular esquelética (MME) e tecidos adiposos; e, presença de miopenia e mioesteatose. Resultados: A amostra foi constituída por 158 pacientes e a longa permanência hospitalar foi verificada em 43,0%. A frequência de miopenia e mioesteatose foi de 24,7% e 63,3%, respectivamente. Pacientes com mioesteatose e aqueles que tinham, ambos, miopenia e mioesteatose eram maioria feminina, mais velhos, neoplásicos, possuíam risco para sarcopenia, risco nutricional e desnutrição; além de apresentarem menos MME e maiores quantidades de tecido adiposo. Apenas mioesteatose foi considerada fator de risco independente para longa hospitalização, aumentando em cinco vezes a probabilidade de internação ≥16 dias. Conclusão: Mioesteatose é frequente em pacientes hospitalizados com excesso de peso, sendo um fator de risco independente para longa permanência hospitalar.
##plugins.themes.bootstrap3.article.details##
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Referências
2. ANANDAVADIVELAN P, et al. Sarcopenic obesity: a probable risk factor for dose limiting toxicity during neo-adjuvant chemotherapy in oesophageal cancer patients. Clin Nutr, 2016; 35(3): 724-730.
3. ARO R, et al. Sarcopenia and myosteatosis are associated with neutrophil to lymphocyte ratio but not glasgow prognostic score in colorectal cancer patients. J Clin Med, 2022; 9(11): 2656-2668.
4. BODY S, et al. Sarcopenia and Myosteatosis Predict Adverse Outcomes After Emergency Laparotomy: A Multi-center Observational Cohort Study. Ann Surg, 2022; 275(6): 1103-1111.
5. CEDERHOLM T, et al. GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community. J Cachexia Sarcopenia Muscle, 2019; 10(1); 207-217.
6. CHUMLEA WC, et al. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc, 1985; 33(2): 116-120.
7. CRUZ PLM, et al. Clinical and nutritional predictors of hospital readmission within 30 days. Eur J Clin Nutr, 2022; 76(2): 244-250.
8. CRUZ-JENTOFT AJ, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019; 48(1): 16-31.
9. CZAPLA M, et al. The association between nutritional status and length of hospital stay among patients with hypertension. Int J Environ Res Public Health, 2022; 19(10): 5827.
10. DETSKY AS, et al. What is subjective global assessment of nutritional status? J Parenter Enteral Nutr, 1987; 11(1): 8-13.
11. EBADI M, et al. Myosteatosis in cirrhosis: a review of diagnosis, pathophysiological mechanisms and potential interventions. Cells, 2022; 11(7): 1216.
12. ELLIOTT A, et al. Exploring Overnutrition, Overweight, and Obesity in the Hospital Setting—A Point Prevalence Study. Nutrients, 2023; 15(10): 2315.
13. FUJIOKA S, et al. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metab, 1987; 36(1): 54-59.
14. HEYMSFIELD S, et al. Human body composition: advances in models and methods. Ann Rev Nutr, 1997; 17(1): 527-558.
15. HOPKINS JJ, et al. The impact of muscle and adipose tissue on long-term survival in patients with stage I to III colorectal cancer. Dis. Colon Rectum, 2019; 62(5): 549-560.
16. IRWIN NE, et al. Myosteatosis, the more significant predictor of outcome: an analysis of the impact of myosteatosis, sarcopenia, and sarcopenic obesity on liver transplant outcomes in Johannesburg, South Africa. Exp Clin Transplant, 2021; 19: 948-955.
17. KIM HK e KIM CH. Quality matters as much as quantity of skeletal muscle: clinical implications of myosteatosis in cardiometabolic health. Endocrinol Metab, 2021; 36(6): 1161-1174.
18. KONDRUP J, et al. An ad hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003; 22(3): 321-336.
19. MARTIN L, et al. Assessment of computed tomography (CT)-defined muscle and adipose tissue features in relation to short-term outcomes after elective surgery for colorectal cancer: a multicenter approach. Ann. Surg. Oncol, 2018; 25(1): 2669–2680.
20. MARTIN L, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol, 2013; 31(12): 1539-1547.
21. MITSIOPOULOS N, et al. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol, 1998; 85(1): 115-122.
22. OPAS, W. (2002). XXXVI Reunión del Comité Asesor de Investigaciones en Salud. Encuesta Multicentrica: Salud, bien estar y envejecimiento (SABE) em America Latina y El Caribe. Washington.
23. PRADO CM, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol, 2008; 9(7): 629-635.
24. SOUZA NC, et al. Frailty is associated with myosteatosis in obese patients with colorectal cancer. Clin Nutr, 2020; 39(2): 484-491.
25. STRETCH C, et al. Sarcopenia and myosteatosis are accompanied by distinct biological profiles in patients with pancreatic and periampullary adenocarcinomas. PloS one, 2018; 13(5): 0196235.
26. TACHI Y, et al. Impact of myosteatosis on skeletal muscle volume loss in patients with chronic liver disease. J Gastroenterol Hepatol, 2018; 33(9): 1659-1666.
27. UEMURA Y, et al. Utility of the nutritional screening in predicting adverse outcome of patients with overweight/obesity and acute heart failure. J Card Fail, 2020; 26(7): 566-573.
28. WANG X, et al. Association of myosteatosis with various body composition abnormalities and longer length of hospitalization in patients with decompensated cirrhosis. Front Nutr, 2022; 9: 921181.
29. WORLD HEATH ORGANIZATION. (1998). Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity.
30. XU MC, et al. Obesity is associated with longer survival independent of sarcopenia and myosteatosis in metastatic and/or castrate-resistant prostate cancer. J Urol, 2021; 205(3): 800-805.