Annals of Clinical Nutrition and Metabolism

Jae-myeong Lee

3 Articles

Validity of Bioelectrical Impedance Analysis for Older Amputees with Leprosy: Jihyun Lee, Seorin Doo, Yeonhee Lee, Jaeyoung Ahn, Yookyoung Park, Hyun Joo Shin, Jae-myeong Lee; Surg Metab Nutr 2021;12(1):7-15. Published online June 30, 2021; DOI: https://doi.org/10.18858/smn.2021.12.1.7

Purpose: Bioelectrical impedance analysis (BIA) evaluates body composition and electrical resistance according to weight and height but assumes all limbs are intact. This study evaluated the validity and accuracy of BIA in older amputees with leprosy.
Materials and Methods: We evaluated BIA’s effectiveness for determining body composition by measuring muscle mass, water percentage, and physical resistance, including phase angle, in older amputees with leprosy. BIA was performed on 42 individuals with leprosy aged ≥65 years. Comparative analyses were performed by amputation types (left lower limbs, right lower limbs, bilateral lower limbs, and non-amputees). Twenty people without leprosy or amputations of similar age, height, and weight were considered controls.
Results: Between the controls, amputee, and the controls without leprosy, BIA showed significant mean differences in skeletal muscle mass (22.5±5.6 kg, 19.6±5.6 kg, 18.2±3.9 kg, respectively; P=0.037); whole-body extracellular water (ECW) ratios (0.410±0.011, 0.401±0.007, 0.393±0.009, respectively; P<0.001) and phase angle (4.2±1.2, 4.4±0.7, 5.0±0.8, respectively; P=0.029). The bilateral lower limb amputation group (median, 0.415; range, 0.407–0.426) showed significantly higher whole-body ECW values than the non-amputee group (median, 0.401, range: 0.391–0.415) (P=0.013). Right leg lean mass was highest in the right lower limb amputation group, followed by bilateral lower limb amputation, non-amputee, and left lower limb amputation groups (median: 9.86, 6.04, 5.02, 3.95, respectively, P=0.001). As the length of the amputated lower limb was shortened, the lower limb's impedance decreased. However, BIA was evaluated without reflecting the shortened length, resulting in an error in the skeletal muscle mass readings.
Conclusion: Phase angle, ECW ratio, and bioelectrical impedance vector analysis obtained by BIA appeared accurate, but the skeletal muscle mass showed significant errors for amputated areas.

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Current Trend of Nutritional Support Treatment Guidelines for Critically Ill Patients: Yoo Jin Choi, Jae-Myeong Lee; J Clin Nutr 2017;9(2):38-47. Published online December 31, 2017; DOI: https://doi.org/10.15747/jcn.2017.9.2.38

Abstract PDF ePub: Critically ill and injured patients admitted in the intensive care unit have a range of diseases with various severities. Their conditions should be assessed and the patients should receive specialized nutrition therapy depending on their condition. Like general intensive care, nutrition therapy is upgraded every few years with revised information to provide more idealized nutrition support. The main guidelines in this review are from the Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Their previous 2009 guidelines were revised and published in 2016. This review summarizes the 2016 SCCM/ASPEN guidelines focusing on the changes from the previous 2009 guidelines.

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Vitamin D Deficiency in Critically Ill Patients: Ji Hyun Lee, Jae-Myeong Lee; Surg Metab Nutr 2017;8(2):17-22. Published online December 30, 2017; DOI: https://doi.org/10.18858/smn.2017.8.2.17

Abstract PDF ePub: Vitamin D deficiency is a commonly observed global phenomenon in both the general population as well as hospitalized patients, especially critically ill patients. Many studies have demonstrated an association between vitamin D deficiency and risk of chronic diseases, including cardiovascular disease, diabetes, cancers, autoimmune diseases, and infectious diseases. Vitamin D deficiency is also associated with multiple adverse health outcomes, including increased morbidity and mortality in critically ill patients. The purpose of this review article is to present the current knowledge of clinical outcomes as well as the positive and adverse effects of vitamin D supplements on the relationship between vitamin D status and critical illness. In addition, future strategies for dealing with vitamin D deficiency are suggested.

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