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Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome

European Journal of Clinical Nutrition volume 72, pages 613–617 (2018)Cite this article

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Abstract

Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50–0.59, 12 months: 0.54–0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46–0.49, arm-specific: r = 0.50–0.51, p < 0.001) and Bland–Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

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References

  1. Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310:1591–600.

    Article  CAS  Google Scholar 

  2. Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348:683–93.

    Article  Google Scholar 

  3. Herridge MS, Tansey CM, Matté A, Tomlinson G, Diaz-Granados N, Cooper A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364:1293–304.

    Article  CAS  Google Scholar 

  4. Pfoh ER, Wozniak AW, Colantuoni E, Dinglas VD, Tellez PAM, Shanholtz C, et al. Physical declines occurring after hospital discharge in ARDS survivors: a 5-year longitudinal study. Intensive Care Med. 2016;42:1557–66.

    Article  Google Scholar 

  5. Fan E, Dowdy DW, Colantuoni E, Mendez-Tellez PA, Sevransky JE, Shanholtz C, et al. Physical complications in acute lung injury survivors: a two-year longitudinal prospective study. Crit Care Med. 2014;42:849–59.

    Article  Google Scholar 

  6. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147:755–63.

    Article  CAS  Google Scholar 

  7. Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. Ann Arbor, MI: University of Michigan Press; 1990.

    Book  Google Scholar 

  8. Guglielmi G, Ponti F, Agostini M, Amadori M, Battista G, Bazzocchi A. The role of DXA in sarcopenia. Aging Clin Exp Res. 2016;28:1047–60.

    Article  Google Scholar 

  9. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by the NHLBI (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (ICTR) (UL1 TR 000424-06), and the ALTA, EDEN, OMEGA and SAILS trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536171C, HHSN268200536173C, HHSN268200536174C, HSN268200536175C, and HHSN268200536179C).

Author contributions

KSC, MM and DMN conceived and designed the study. All authors contributed to the analysis plan. MM, CLH, EWE, PEM, ROH, DMN, and VDD acquired the data and LAF performed all analyses. All authors were involved in the interpretation of study results. KSC and MM drafted the manuscript and all authors critically revised it for important intellectual content and approved the final version to be submitted.

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Authors and Affiliations

  1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Kitty S. Chan

  2. Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada

    Marina Mourtzakis

  3. Outcomes After Critical Illness and Surgery (OACIS) Group, Baltimore, MD, USA

    Lisa Aronson Friedman

  4. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Lisa Aronson Friedman

  5. Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA

    Catherine L. Hough

  6. Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

    E. Wesley Ely

  7. Geriatric Research, Education and Clinical Center Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA

    E. Wesley Ely

  8. Division of Pulmonary, Critical Care & Sleep Medicine, University of Kentucky, Lexington, KY, USA

    Peter E. Morris

  9. Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT, USA

    Ramona O. Hopkins

  10. Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT, USA

    Ramona O. Hopkins

  11. Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT, USA

    Ramona O. Hopkins

  12. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Dale M. Needham

Authors
  1. Kitty S. Chan
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  2. Marina Mourtzakis
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  3. Lisa Aronson Friedman
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  4. Victor D. Dinglas
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  5. Catherine L. Hough
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  6. E. Wesley Ely
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  7. Peter E. Morris
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  8. Ramona O. Hopkins
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  9. Dale M. Needham
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with the National Institutes of Health NHLBI ARDS Network

Corresponding author

Correspondence to Kitty S. Chan.

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The authors declare that they have no conflict of interest.

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Chan, K.S., Mourtzakis, M., Aronson Friedman, L. et al. Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome. Eur J Clin Nutr 72, 613–617 (2018). https://doi.org/10.1038/s41430-018-0106-1

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  • DOI: https://doi.org/10.1038/s41430-018-0106-1

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