Body Cell Mass from Bioelectrical Impedance Analysis in Patients with Stroke Undergoing Rehabilitation

Objectives This study aimed to clarify the gender differences in nutritional status, food consumption and oxidative stress and in post-stroke patients during rehabilitation treatment. Design A longitudinal observational study. Methods Patients with first stroke were sequentially enrolled, evaluated at admission (T0), and again after a 6-week rehabilitation program (T1). The rehabilitation regimen included traditional and robotic physical therapy. Functional independence in Activity of Daily Living (ADL) was evaluated with modified Barthel Index assesment (mBI T0 and mBI T1) and calculating its change after rehabilitation (∆BI= mBIT1- mBI T0). Patients were screened for malnutrition at admission, following the GLIM criteria, by the Mini Nutritional Assessment Short-form (MNA-SF®) and the assessment of the nutritional status during the study was performed by means of: i) anthropometric measurements ii) the Geriatric Nutritional Risk assessment (GNRI), and iii) daily estimation of food consumption (plate waste). An Analysis of blood parameters at T0 and at T1 was performed including: albumin, glucose, lipidic panel, calcium, magnesium and iron. Systemic Oxidative stress status was evaluated at T0 and at T1 measuring: hydroperoxides (dROMs), total antioxidants (BAP), thiols (-SHp) and calculating the antioxidant capacity (OSI index). Results We finally included 87 patients in this study (42 women, 45 men mean age 69 ± 12 years). The sample was homogeneous and the whole group was at highly risk of malnutrition at admission with 44 subjects clearly malnurished (score lower than 7). Women wasted 23% of total plate consumed respect to 17% wasted from men. Hydroperoxides levels were very high in the whole groupat T0 and T1, but men after rehabilitation had lower values of dROMs, while women did not. Men reached higher value of mBI T1 respect to women (67.1 ± 21.9 vs 55.3 ±26.1; p = 0.032), moreover only 36% of women ameliorated their mBI of at least ten point, respect to 64% of men. MNA-SF® correlated with mBI T0, mBI T1 and ∆BI, but in women this correlation was higher [mBI T0 (rho = 0.506 p<0.001); with mBI T1 (rho = 0.527; p<0.001); with ∆BI (rho = 0.394; p = 0.001)], suggesting a relationship between their nutritional status at admission and their performance in functional recovery. Conclusions. Among subacute post stroke patients hospitalized for rehabilitation treatment, women appeared to have lower rehabilitation outcome, to waste more food and to have higher oxidative stress even after six-week of hospitalization. So, especially in consideration of the advanced age, women should be carefully monitored forn nutritional status during hospitalization for rehabilitation; future studies should clarify if a better nutrition, which includes the right dose of antioxidants, can improve their recovery after stroke.

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Bioelectrical Impedance Analysis Demonstrates Reliable Agreement with Dual-Energy X-ray Absorptiometry in Identifying Reduced Skeletal Muscle Mass in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Hypertension

Sheptulina,

Lyusina,

Mamutova

et al. 2024

Diagnostics

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Background/Objectives: Body composition (BC) affects the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension (HTN). Currently, dual-energy X-ray absorptiometry (DEXA) is considered the gold standard for assessing BC, even though it has some limitations, including immobility, ionizing radiation, and patient weight restrictions. The aim of the study was to evaluate the correlations of BC parameters measured by bioelectrical impedance analysis (BIA) with those measured by DEXA in patients with MASLD and HTN. Methods: Overall, 78 patients with MASLD and HTN underwent the following study procedures: compilation of an anamnesis, physical examination of a patient, laboratory tests, abdominal ultrasound, BIA, DEXA, and anthropometric measurements. Results: The agreement between BIA and DEXA in diagnosing reduced skeletal muscle mass (SMM) in patients with MASLD and HTN was moderate (kappa values were 0.440 and 0.404 in males and females, respectively). Significant strong direct correlations were found between fat mass (FM) and body fat percentage measured by BIA with corresponding measurements by DEXA (p < 0.001 for both). The area under the receiver operating characteristic curves (AUC) of SMM to body weight ratios calculated using BIA data were 0.834 and 0.929 for reduced appendicular SMM determined by DEXA in males and females with MASLD and HTN, respectively. Conclusions: In conclusion, BIA is an easy-to-use and widely available tool for assessing SMM and FM in patients with MASLD and HTN, demonstrating reliable agreement with DEXA measurement results and completely free of its limitations.

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Body Cell Mass from Bioelectrical Impedance Analysis in Patients with Stroke Undergoing Rehabilitation

Cited by 3 publications

References 46 publications

Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis

Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis

Gender differences in Nutritional Status, Food consumption and Oxidative Stress in Post-Stroke patients during Rehabilitation

Bioelectrical Impedance Analysis Demonstrates Reliable Agreement with Dual-Energy X-ray Absorptiometry in Identifying Reduced Skeletal Muscle Mass in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Hypertension

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