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Original Articles
- Body composition assessment using bioelectrical impedance analysis and computed tomography in patients who underwent pancreatoduodenectomy in Korea: a before and after study
- Juwan Kim, Seung-seob Kim, Ho Kyoung Hwang, Chang Moo Kang, Kyung Sik Kim, Sung Hyun Kim
- Ann Clin Nutr Metab 2023;15(3):72-80. Published online December 1, 2023
- DOI: https://doi.org/10.15747/ACNM.2023.15.3.72
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Abstract
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Supplementary Material - Purpose: This study focuses on the need for standardized body composition measurements in the hepatobiliary-pancreatic field. It evaluates and compares the effectiveness of bioelectrical impedance analysis (BIA) and computed tomography (CT) scans in assessing body composition of patients undergoing pancreatoduodenectomy (PD), aiming to establish correlations among different body composition indexes.
Methods: Ninety-seven patients who underwent PD between August 2022 and March 2023, were enrolled in this study. Muscular and fatty parameters related to BIA and CT were assessed both preoperatively and on postoperative day 6. The correlation between each parameter related to muscle fat was analyzed according to the measurement modalities.
Results: There was an increase of skeletal muscle area (SMA), total muscle area, and low attenuated muscle area after surgery. Skeletal muscle mass (SMM) measured using BIA exhibited a strong correlation with the SMA and normal attenuated muscle area (NAMA) measured using CT (r=0.86, P<0.001; r=0.76, P<0.001). The trunk muscle measured using BIA demonstrated moderate to strong correlations with SMA and NAMA measured using CT (r=0.84 P<0.001; r=0.73, P<0.001). Body fat measured using BIA and total fat area (TFA) measured using CT showed strong correlations (r=0.74, P<0.001). In the postoperative analysis, a similar trend was observed (SMM vs. SMA: r=0.80, P<0.001; SMM vs. NAMA: r=0.70, P<0.001), (trunk muscle vs. SMA: r=0.79, P<0.001; trunk muscle vs. NAMA: r=0.69, P<0.001), and (body fat vs. TFA: r=0.83, P<0.001).
Conclusion: BIA, akin to CT, serves as a valuable tool for assessing body composition ratios in patients undergoing PD.
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- Analysis of Muscle Using CT Anthropometry in Major Trauma Patients
- Hang Joo Cho, Yunsup Hwang, Yoon Hyun Lee, Dae Hyun Cho, Dae-Sang Lee, Maru Kim
- Surg Metab Nutr 2020;11(1):12-15. Published online June 30, 2020
- DOI: https://doi.org/10.18858/smn.2020.11.1.12
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Abstract
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- Purpose: The feasibility of nutritional assessment using computed tomography anthropometry has been previously proven. The abdominal muscle at the L3 vertebra is a well-known nutritional biomarker for predicting the prognosis of various diseases, and especially sarcopenia. However, any studies on nutritional assessment of the brain, face, or neck via computed tomography are still scarce. We retrospectively investigated the applicability of the masseter muscle as a nutritional biomarker.
Materials and Methods: Patients who underwent simultaneous brain and abdominopelvic computed tomography at a regional trauma center were retrospectively analyzed. Their masseter muscles at 2 cm below the zygomatic arch and abdominal muscle at L3 were assessed via computed tomography anthropometry. Basic clinical data including trauma information was also reviewed. The data was analyzed in conjunction with the patients’ mortality.
Results: A total of 411 patients were analyzed in the study (316 men and 95 women, mean age: 50.41 years, mean areas of the masseter and abdominal muscles: 10.6 and 137.3 cm2, respectively) and there 146 major trauma patients with an injury severity score higher than 15. The masseter muscle area was decreased in the mortality group of major trauma patients (10.4 vs 7.9 cm2, P=0.001). However, abdominal muscles did not show statistical significance (137.9 vs. 117.7 cm2, P=0.054).
Conclusion: The masseter muscle, when analyzed via computed tomography anthropometry, showed a statistical association with patients’ mortality and it could prove its feasibility as a nutritional biomarker.
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Review Article
- Imaging Techniques for Nutritional Assessment
- Joohyun Shim, Hoon Hur
- J Clin Nutr 2015;7(2):49-53. Published online August 31, 2015
- DOI: https://doi.org/10.15747/jcn.2015.7.2.49
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Abstract
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Accurate measurement of body composition between lean and adipose tissue mass and distribution of lipid burden may be important in the care of nutritional problems in patients observed in clinical practice and the measurement of outcomes in clinical research. In this review, we discuss the most accurate imaging methods for use as clinical tools in measurement of body composition and distribution. Dual-energy x-ray absorptiometry (DXA) is a non-invasive technique for assessment of body composition, and the radiation exposure is relatively minimal. However, measurements are influenced by thickness of tissue and lean tissue hydration. Computed tomography (CT) is a gold-standard imaging method for body composition analysis at the tissue-organ level, however the radiation generated by the CT scan is relatively high, thus it should not be considered for a measurement, which can be repeated frequently. Magnetic resonance imaging (MRI) has been a useful modality in the assessment of body composition changes in various clinical studies. However, limitations of MRI for assessment of body composition are related to its high cost and technical expertise necessary for analysis. Proper methods for measurement of body composition in specific medical situations like sarcopenia should be evaluated for determination of comparative validity and accuracy, within the context of cost-effectiveness in patient care. In conclusion, an ideal body imaging method would have a significant utility for earlier detection of nutritional risks, while overcoming the limitations of current imaging studies such as DXA, CT, and MRI.
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