Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis...Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.展开更多
Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral ...Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral fat area versus changes in musculoskeletal mass in a cohort of adult men with obesity. Subjects and Methods: A retrospective cohort study in which the file of eighty-two male subjects, aged 20 - 60 years, was studied for three months. Patients had been instructed to follow a balanced-hypocaloric diet, physical activity plan and general advice for combating the unhealthy lifestyle habits through the study period. Those who succeeded to loss > 5% of their body weight were classified as weight loser (WL) group, while others as weight resistant (WR) group. The results of In Body-720 bioelectric impedance analysis were used to report the fat mass (FM), visceral fat area (VFA), skeletal muscle mass (SMM), SMM/VFA ratio, osseous mass (OM), and basal metabolic rate (BMR) before and after the study period. Anthropometric measures, glucose, and lipid profile were also analyzed. Paired t-test was used to detect the significance of change between before and after measures, independent sample t-test was used to compare WL vs. WR groups. Results: There were significant decreases in weight, FM (p 0.05) and VFA (p 0.001), in addition to a significant rise of SMM/VFA ratio (p 0.05), together with insignificant changes of osseous mass, SMM and BMR after 3 months. Additionally, total cholesterol, low-density lipoprotein, and triglycerides were significantly reduced (P 0.05). The percentages of reduction in weight, FM and VFA in WL vs. WR groups were highly significant (p 0.001), while the percentages of change in SMM, SMM/VFA ratio and BMR were significant (p 0.05). Conclusion: Lifestyle modification might be effective in production of positive changes in the body composition of patients with obesity. These changes were more significant in weight losers.展开更多
基金supported by a grant from Suzhou Science and Tech-nology Project Plan(No.SZM2021006).
文摘Background:It is well-known that body composition metrics can influence the prognosis of various diseases.This study investigated how body composition metrics predict acute respiratory distress syndrome(ARDS)prognosis,focusing on the ratio of visceral fat area(VFA)to subcutaneous fat area(SFA),SFA to standard body weight(SBW),VFA to SBW,and muscle area(MA)to SBW.These metrics were assessed at the level of the twelfth thoracic vertebra(T12 computed tomography[CT]level)to determine their correlation with the outcomes of ARDS.The goal was to utilize these findings to refine and personalize treatment strategies for ARDS.Methods:Patients with ARDS admitted to the intensive care units(ICUs)of three hospitals from January 2016 to July 2023 were enrolled in this study.Within 24 hours of ARDS onset,we obtained chest CT scans to mea-sure subcutaneous fat,visceral fat,and muscle area at the T12 level.We then compared these ratios between survivors and non-survivors.Logistic regression was employed to identify prognostic risk factors.Receiver oper-ating characteristic(ROC)curve analysis was utilized to determine the optimal cutofffor predictors of in-hospital mortality.Based on this cutoff,patients with ARDS were stratified.To reduce confounding factors,1:1 propensity score matching(PSM)was applied.We conducted analyses of clinical feature and prognostic differences pre-and post-PSM between the stratified groups.Additionally,Kaplan-Meier survival curves were generated to compare the survival outcomes of these groups.Results:Of 258 patients with ARDS,150 survived and 108 did not.Non-survivors had a higher VFA/SFA ra-tio(P<0.001)and lower SFA/SBW and MA/SBW ratios(both P<0.001).Key risk factors were high VFA/SFA ratio(OR=2.081;P=0.008),age,acute physiology and chronic health evaluation(APACHE)II score,and lac-tate levels,while MA/SBW and albumin were protective.Patients with a VFA/SFA ratio≥0.73 were associated with increased mortality,while those with an MA/SBW ratio>1.55 cm^(2)/kg had lower mortality,both pre-and post-PSM(P=0.001 and P<0.001,respectively).Among 170 patients with pulmonary-origin ARDS,87 survived and 83 did not.The non-survivor group showed a higher VFA/SFA ratio(P<0.001)and lower SFA/SBW and MA/SBW(P=0.003,P<0.001,respectively).Similar risk and protective factors were observed in this cohort.For VFA/SFA,a value above the cutoffof 1.01 predicted higher mortality,while an MA/SBW value below the cutoffof 1.48 cm2/kg was associated with increased mortality(both P<0.001 pre-/post-PSM).Conclusions:Among all patients with ARDS,the VFA to SFA ratio,MA to SBW ratio at the T12 level,age,APACHE II score,and lactate levels emerged as independent risk factors for mortality.
文摘Background: The lifestyle modification remains the fundamental approach for the obesity treatment. The aim of this study is to demonstrate the effect of the multimodal lifestyle intervention on the estimated visceral fat area versus changes in musculoskeletal mass in a cohort of adult men with obesity. Subjects and Methods: A retrospective cohort study in which the file of eighty-two male subjects, aged 20 - 60 years, was studied for three months. Patients had been instructed to follow a balanced-hypocaloric diet, physical activity plan and general advice for combating the unhealthy lifestyle habits through the study period. Those who succeeded to loss > 5% of their body weight were classified as weight loser (WL) group, while others as weight resistant (WR) group. The results of In Body-720 bioelectric impedance analysis were used to report the fat mass (FM), visceral fat area (VFA), skeletal muscle mass (SMM), SMM/VFA ratio, osseous mass (OM), and basal metabolic rate (BMR) before and after the study period. Anthropometric measures, glucose, and lipid profile were also analyzed. Paired t-test was used to detect the significance of change between before and after measures, independent sample t-test was used to compare WL vs. WR groups. Results: There were significant decreases in weight, FM (p 0.05) and VFA (p 0.001), in addition to a significant rise of SMM/VFA ratio (p 0.05), together with insignificant changes of osseous mass, SMM and BMR after 3 months. Additionally, total cholesterol, low-density lipoprotein, and triglycerides were significantly reduced (P 0.05). The percentages of reduction in weight, FM and VFA in WL vs. WR groups were highly significant (p 0.001), while the percentages of change in SMM, SMM/VFA ratio and BMR were significant (p 0.05). Conclusion: Lifestyle modification might be effective in production of positive changes in the body composition of patients with obesity. These changes were more significant in weight losers.
