We aimed to investigate the relationship between the neutrophil to lymphocyte ratio (NLR) and nutritional parameters in chronic kidney disease (CKD) patients. In this cross-sectional study, 187 ...non-dialysis CKD patients were enrolled. Daily dietary energy intake (DEI) and daily dietary protein intake (DPI) were assessed by 3-d dietary records. Protein-energy wasting (PEW) was defined as Subjective Global Assessment (SGA) class B and C. Spearman correlation analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The median NLR was 2·51 (1·83, 3·83). Patients with CKD stage 5 had the highest NLR level. A total of 19·3 % (
36) of patients suffered from PEW. The NLR was positively correlated with SGA and serum P, and the NLR was negatively correlated with BMI, waist and hip circumference, triceps skinfold thickness, mid-arm muscle circumference, DPI and Hb. Multivariate logistic regression analysis adjusted for DPI, DEI, serum creatinine, blood urea nitrogen, uric acid and Hb showed that a high NLR was an independent risk factor for PEW (OR = 1·393, 95 % CI 1·078, 1·800,
= 0·011). ROC analysis showed that an NLR ≥ 2·62 had the ability to identify PEW among CKD patients, with a sensitivity of 77·8 %, a specificity of 62·3 % and an AUC of 0·71 (95 % CI 0·63, 0·81,
< 0·001). The NLR was closely associated with nutritional status. NLR may be an indicator of PEW in CKD patients.
•Malnutrition is very frequent in idiopathic pulmonary fibrosis (IPF) patients.•Low fat-free mass index (FFMI) assessed by bioimpedance analysis (BIA) is reported in 28% of patients.•Body mass index ...(BMI) and mid-arm circumference (MAC) are independently associated with low FFMI.•A two-step nutritional assessment based on BMI, MAC, and BIA should be routinely performed in IPF patients.
Little is known about the indicators to assess malnutrition in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to determine the following: 1) the prevalence of malnutrition in IPF patients; 2) the nutritional indicators predictive of low fat-free mass (FFM) as measured by bioimpedance analysis; 3) the IPF patients’ characteristics associated with low FFM.
The IPF patients were consecutively recruited in a referral center for rare pulmonary diseases. Malnutrition was defined as a fat-free mass index (FFMI) = FFM (kg) / (height m2) <17 (men) or <15 (women). Nutritional assessment included body mass index (BMI), mid-arm circumference (MAC), triceps skinfold thickness, analogue food intake scale, and serum albumin and transthyretin. The primary endpoint was FFMI. Area under the receiver operating characteristic curve (AUC) assessed low FFMI prediction from nutritional indicators. Multivariable logistic regression determined variables associated with low FFMI.
Eighty-one patients were consecutively recruited. Low FFMI prevalence was 28% (23 of 81). BMI AUC was 0.91 (95% confidence interval CI, 0.84‒0.97) and MAC AUC was 0.85 (0.76‒0.94). Multivariable analysis associated BMI (odds ratio OR 0.26 95% CI, 0.12–0.54, P = 0.0003), male sex (OR 0.02 0.00–0.33, P = 0.005), and smoking (OR 0.10 0.01–0.75, P = 0.024) with a lower risk of malnutrition.
Malnutrition occurred in nearly one-third of IPF patients. Malnutrition screening should become systematic based on BMI and MAC, which are good clinical indicators of low FFMI. We propose a practical approach to screen malnutrition in IPF patients.
Background To date, several studies have been published outlining reference percentiles for BMI in children and adolescents. In contrast, there are limited reference data on percent body fat (%BF) in ...U.S. youth. Purpose The purpose of this study was to derive smoothed percentile curves for %BF in a nationally representative sample of U.S. children and adolescents. Methods Percent fat was derived from the skinfold thicknesses of those aged 5–18 years from three cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES) IV (1999–2000, 2001–2002, and 2003–2004; N=8269). The LMS (L=skewness, M=median, and S=coefficient of variation) regression method was used to create age- and gender-specific smoothed percentile curves of %BF. Results Growth curves are similar between boys and girls until age 9 years. However, whereas %BF peaks for boys at about age 11 years, it continues to increase for girls throughout adolescence. Median %BF at age 18 years is 17.0% and 27.8% for boys and girls, respectively. Conclusions Growth charts and LMS values based on a nationally representative sample of U.S. children and adolescents are provided so that future research can identify appropriate cut-off values based on health-related outcomes. These percentiles are based on skinfolds, which are widely available and commonly used. Using %BF instead of BMI may offer additional information in epidemiologic research, fitness assessment, and clinical settings.
Caloric restriction (CR) is a cost-effective and easy-to-perform approach to counteracting surgical stress. The present study therefore evaluates the tissue-protective effects of a 30% CR in ...musculocutaneous flaps undergoing ischemia. For this purpose, a well-established murine dorsal skinfold chamber model, in combination with random pattern musculocutaneous flaps, was used. C57BL/6N mice were divided at random into a CR group (n = 8) and a control group with unrestricted access to standard chow (n = 8). The CR animals were subjected to a 30% reduction in caloric intake for 10 days before flap elevation. Intravital fluorescence microscopy was carried out on days 1, 3, 5, 7 and 10 after flap elevation to assess the nutritive blood perfusion, angiogenesis and flap necrosis. Subsequently, the flap tissue was harvested for additional histological and immunohistochemical analyses. The CR-treated animals exhibited a significantly higher functional capillary density and more newly formed microvessels within the flap tissue when compared to the controls; this was associated with a significantly higher flap survival rate. Immunohistochemical analyses showed a decreased invasion of myeloperoxidase-positive neutrophilic granulocytes into the flap tissue of the CR-treated mice. Moreover, the detection of cleaved caspase-3 revealed fewer cells undergoing apoptosis in the transition zone between the vital and necrotic tissue in the flaps of the CR-treated mice. These results demonstrate that a CR of 30% effectively prevents flap necrosis by maintaining microperfusion on a capillary level and inhibiting inflammation under ischemic stress. Hence, CR represents a promising novel conditioning strategy for improving the survival of musculocutaneous flaps with random pattern perfusion.
Abstract
Genetic selection for immune response has the potential to increase the sustainability of the beef industry by breeding cattle that are productive yet with an increased capacity to resist ...disease. Determining the optimal time to immunophenotype beef cattle is crucial for the accurate prediction of an animal’s immune response. The objective of this study was to determine the effect of time of immunophenotyping in relation to weaning on immune responses of beef calves. Antibody- (AMIR) and cell-mediated (CMIR) immune responses were measured on 97 calves on the day of weaning (WEANING, N = 56) or 2 mo post-weaning (POST-WEANING, N = 41). Within each period of immunophenotyping, on day 0, blood was collected, and calves received a 1.0 mL intramuscular injection of type 1 and 2 test antigens. On day 14, blood was collected, and baseline skinfold thickness (SFT) was measured. Calves received an intradermal injection of 0.1 mg of the type 1 antigen suspended in 0.1 mL phosphate buffered saline (PBS) in the right tail fold, and 0.1 mL of PBS in the left. Changes in SFT at 24 h was used to indicate CMIR. To assess AMIR, the titer of type 2 antigen-specific bovine immunoglobulin G in serum from blood collected on day 14 was determined by measuring optical density (OD) using an enzyme-linked immunosorbent assay (ELISA). Among heifers, AMIR was greater for the POST-WEANING group than for the WEANING group (P < 0.01). Among steers, AMIR was not different between the POST-WEANING group and the WEANING group (P = 1.0). Therefore, the AMIR of heifers may be more negatively affected by immunophenotyping at weaning than the AMIR of steers. For steers, CMIR was greater in the POST-WEANING group than the WEANING group (P < 0.001). For heifers, CMIR was not different between the POST-WEANING group and the WEANING group (P = 0.22). The CMIR of steers may be more negatively affected by immunophenotyping at weaning than the CMIR of heifers. Calf age was not associated with AMIR or CMIR for calves phenotyped at weaning or post-weaning. The effect of sire nested within dam age was significant for CMIR for calves in the POST-WEANING group (P < 0.01), but not for calves in the WEANING group (P = 0.67). The results suggest that measuring immunocompetence at weaning may not be representative of a calf’s genetic ability to mount an effective immune response, and immunophenotyping should be performed outside the weaning period.
Determining the most advantageous time to immunophenotype beef cattle is crucial to correctly assess an animal’s true genetic ability to mount an immune response for the purpose of selecting cattle with superior immunity. This study demonstrated that the immune responses of crossbred beef cattle are diminished when immune response testing is performed on the day of weaning, suggesting that immunophenotyping of beef calves at the time of weaning is not representative of an animal’s true immunocompetence.
Lay Summary
Understanding the optimal time to immunophenotype beef calves is important for the accurate estimation of their genetic ability to resist disease. The compound stressors experienced by a calf during weaning may have a similar impact on the immune system as chronic stress. Therefore, the immune response phenotype of a calf immunophenotyped during the weaning period may not truly reflect the animal’s genuine capacity for immune response. To accurately identify cattle with a superior capacity for immune response, with the goal of genetically selecting cattle for immunocompetence, immunophenotypes must be measured accurately. In this study, the effect of time of immunophenotyping in relation to weaning on immune responses of beef calves was determined. Calves immunophenotyped at weaning had lesser antibody-mediated and cell-mediated immune responses than calves immunophenotyped 2 mo post-weaning, this effect was influenced by sex. Sire affected immune responses when calves were immunophenotyped 2 mo post-weaning, but not when calves were immunophenotyped at weaning, indicating that when immunophenotyped post-weaning, the genetic component of a calf’s immune response is quantified without being obscured by other environmental factors.
The primary aim of this study was to evaluate the accuracy of skinfold thickness (SFT) measurements for the estimation of %Fat when compared to dual energy X-ray absorptiometry (DXA) in individuals ...with Down syndrome (DS). The secondary aim was to develop a new SFT-based body fat equation (SFT
). SFT-based %Fat was estimated using a body fat equation from González-Agüero (SFT
) and body density conversion formulas from Siri (SFT
) and Brozek (SFT
). Criterion %Fat was measured via DXA. SFT
, SFT
, and SFT
were significantly lower than DXA (mean differences ranged from -7.59 to -13.51%; all
< 0.001). The SEE values ranged from 3.47% (SFT
) to 8.60% (SFT
). The 95% limits of agreement were greater than ±10% for all comparisons. Mid-axilla and suprailium were significant predictors of %Fat (both
< 0.05). %Fat SFT
= 10.323 + (0.661 × mid-axilla) + (0.712 × suprailium). Age and all other skinfold sites were not statically significant in the regression model (all
> 0.05). Current findings indicate that SFT
, SFT
, and SFT
erroneously place an individual with excessive adiposity in a normal healthy range. Accordingly, the current study developed a new equation (SFT
) that can easily be administered in people with DS in a quick and efficient time frame. However, further research is warranted in this area.
Cutrufello, PT, Landram, MJ, Venezia, AC, and Dixon, CB. A comparison of methods used to determine percent body fat, minimum wrestling weight, and lowest allowable weight class. J Strength Cond Res ...35(3): 633-637, 2021-The National Collegiate Athletic Association's weight management program allows for the use of skinfold measurements (SF), air displacement plethysmography (ADP), and hydrostatic weighing in the assessment of percent body fat (%BF) and determination of a wrestler's minimum wrestling weight (MWW). Dual energy x-ray absorptiometry (DXA) and ultrasound (US) may offer alternative assessment methods. The purpose of this study was to examine %BF, MWW, and the lowest allowable weight class as determined by SF, ADP, DXA, and US. Thirty-three college-aged men (20.8 ± 1.1 years) participated. Urine specific gravity (Usg) was assessed to ensure proper hydration (1.006 ± 0.006). Percent body fat and MWW were then determined using the 4 assessment methods. Each method was significantly different from one another (p < 0.05) with the exception of ADP compared with SF (17.6 ± 7.1% vs. 17.4 ± 6.3%, p = 1.000) and DXA compared with US (20.5 ± 6.2% vs. 19.2 ± 7.5%, p = 0.124). DXA (68.6 ± 7.1 kg) and US (69.3 ± 6.0 kg) determined the lowest MWW, whereas those determined by SF (70.8 ± 6.8 kg) and ADP (70.9 ± 6.6 kg) were significantly greater (p< 0.05). The SEEs for MWW when compared with SF were 3.2, 3.4, and 2.4 kg for ADP, DXA, and US, respectively. Compared with SF, DXA and US would allow wrestlers to certify at a lower weight class 64 and 33% of the time, respectively. When comparing the approved methods (SF and ADP), approximately 50% of subjects would certify at a different weight class depending on the method used. The use of different methods in assessing %BF offer a wide variability in the determination of MWW.
Abstract The purpose of this study was to determine the association between cardiometabolic risk with body mass index and skinfold independently or in combination in youth. This cross-sectional study ...comprised a convenience sample of 450 children and adolescents (255 girls), aged 10 to 18 years old. Indicators of body composition were measured, and hemodynamic assessment completed. The association between body mass index and/or sum of skinfolds and cardiometabolic risk (z score of the sum of triglycerides/high density lipoprotein cholesterol, waist circumference, and mean blood pressure), was calculated using Generalized Linear Models Regression. The results showed that youngsters classified as overweight or obese with the highest skinfold measurements had the strongest association with cardiometabolic risk (< beta >: 2.60; IC 95%: 2.25–3.0) when compared with those exhibiting normal skinfold thickness (< beta >: 1.78; IC 95%: 1.30–2.20). Body mass index was most strongly associated with cardiometabolic risk (< beta >: 1.78; IC 95%: 1.3–2.2), in comparison to skinfold thickness, which was associated to a lesser extent (< beta >: 0.41; IC 95%: 0.34–0.49). Results of this cross-sectional study indicate that body mass index is more strongly associated with cardiometabolic risk than skinfold thickness. However when these two measures of overweight/obesity are combined, prediction of cardiometabolic risk is further improved. It is therefore important that public health professionals consider both body mass index and sum of skinfolds to better predict cardiometabolic risk in overweight and obese youth. Implications for future research include the use of longitudinal designs and inclusion of children from other racial/ethnic groups.
Summary
Background
Excess adiposity and adiposity‐related inflammation are known risk factors for cardiovascular disease in adults; however, little is known regarding the determinants of ...adiposity‐related inflammation at birth.
Objectives
The aim of this study was to investigate the association between maternal pre‐pregnancy BMI and newborn adiposity and inflammation.
Methods
Paired maternal (28‐week gestation) and infant (umbilical cord) blood samples were collected from a population‐derived birth cohort (Barwon Infant Study, n = 1074). Data on maternal comorbidities and infant birth anthropomorphic measures were compiled, and infant aortic intima‐media thickness was measured by trans‐abdominal ultrasound. In a selected subgroup of term infants (n = 161), matched maternal and cord lipids, high‐sensitivity C‐reactive protein (hsCRP) and maternal soluble CD14 were measured. Analysis was completed by using pairwise correlation and linear regression. Because of their non‐normal distribution, pathology blood measures were log transformed prior to analysis.
Results
Maternal pre‐pregnancy BMI was positively associated with increased birth weight (mean difference 17.8 g per kg m−2, 95% CI 6.6 to 28.9; p = 0.002), newborn mean skin‐fold thickness (mean difference 0.1 mm per kg m−2, 95% CI 0.0 to 0.1; p < 0.001) and cord blood hsCRP (mean difference of 4.2% increase in hsCRP per kg m−2 increase in pre‐pregnancy BMI, 95% CI 0.6 to 7.7%, p = 0.02), but not cord blood soluble CD14. Inclusion of maternal hsCRP as a covariate attenuated the associations between pre‐pregnancy BMI and both newborn skin‐fold thickness and cord blood hsCRP.
Conclusion
Higher maternal pre‐pregnancy BMI is associated with increased newborn adiposity and inflammation. These associations may be partially mediated by maternal inflammation during pregnancy.
Introduction
Childhood obesity is associated with increased risk of adult obesity, cardiovascular disease, diabetes and cancer. Appropriate techniques for assessment of childhood adiposity are ...required to identify children at risk. The aim of this review was to examine core clinical measurements and more technical tools to assess paediatric adiposity.
Methods
The online databases PubMed, CINALH and EMBASE were searched and the abstracts identified were reviewed to determine appropriate studies. Their reference lists were also searched to identify further eligible studies. Publications were included if they described childhood measurement techniques or involved validation.
Results and Discussion
There are many body composition assessment tools available, none of which are direct. Each technique has limitations and a combination of methods may be used. The main clinical techniques are weight, height, body mass index (BMI) and circumferences which provide sufficient information to enable classification of overweight or obesity when growth centile charts and ratios are employed. Further investigation depends on resources available and examiner skill. Skinfold thicknesses are cost-effective but require technical training and only measure subcutaneous fat. Dual energy X-ray absorptiometry (DEXA), air displacement plethysmography (ADP), magnetic resonance imaging (MRI) and computed tomography (CT) are more costly and intensive, requiring the child to remain still for longer periods. DEXA and ADP are capable of accurately measuring adiposity but are unable to distinguish between fat depots. MRI and CT can distinguish intra-abdominal from subcutaneous adiposity and are considered gold standards, but CT is unsuitable for adiposity measurement in children due to high levels of radiation exposure. Ultrasound is a promising technique capable of measuring intra-abdominal adiposity in children but requires further validation.
Conclusion
The core clinical measurements of weight, height, BMI and circumferences are sufficient to enable diagnosis of paediatric overweight and obesity while more technical tools provide further insight.
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