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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1440402
This article is part of the Research Topic Assessment of Nutritional Status in Chronic Diseases View all 11 articles

Rectus Femoris cross sectional Area and Timed Up and go test potential useful of as a predictor of sarcopenia and mortality in idiopathic pulmonary fibrosis

Provisionally accepted
Rocio Fernández Jiménez Rocio Fernández Jiménez 1,2,3,4*Eva Cabrera-Cesar Eva Cabrera-Cesar 5*Alicia Sanmartín-Sánchez Alicia Sanmartín-Sánchez 6Ana Sánchez-Garcia Ana Sánchez-Garcia 2*Francisco Espildora-Hernandez Francisco Espildora-Hernandez 7*Isabel Vegas-Aguilar Isabel Vegas-Aguilar 2,8*Maria d. Amaya-Campos Maria d. Amaya-Campos 1,2*Patricia Guirado-Pelaez Patricia Guirado-Pelaez 1*Víctor J. Simón Frapolli Víctor J. Simón Frapolli 1,2,3Mora Murri Mora Murri 10,2,9Lourdes Garrido-Sanchez Lourdes Garrido-Sanchez 2,9Lorena Piñel-Jimenez Lorena Piñel-Jimenez 5*Miguel Benítez Cano-Gamonoso Miguel Benítez Cano-Gamonoso 11,5*Javier López-García Javier López-García 5*Belén Gómez-Rodríguez Belén Gómez-Rodríguez 5*Jose L. Velasco-Garrido Jose L. Velasco-Garrido 5*Francisco J. Tinahones Francisco J. Tinahones 1,2,9José Manuel García Almeida José Manuel García Almeida 1,2,4,9
  • 1 Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
  • 2 Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
  • 3 Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Malaga, Spain
  • 4 Department of Endocrinology and Nutrition, Hospital Quirónsalud Málaga, Málaga, Spain
  • 5 Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
  • 6 Department of Endocrinology and Nutrition, Hospital Universitario Son Espases, Palma, Illes Balears, Spain
  • 7 Department of Neumology, Regional University Hospital of Malaga, Malaga, Spain
  • 8 Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga, Spain
  • 9 Clinical Management Unit of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga, Spain
  • 10 Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
  • 11 Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Andalusia, Spain

The final, formatted version of the article will be published soon.

    Introduction: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease often complicated by sarcopenia, significantly impacting patient outcomes. This study investigates the prevalence and clinical implications of sarcopenia in IPF patients using morphofunctional assessment methods. Materials and Methods: Eighty-four IPF patients (predominantly male) were evaluated for sarcopenia using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Assessments included bioelectrical impedance vectorial analysis (Nutrilab, Akern), handgrip strength (HGS), Timed Up and Go test (TUG), and nutritional ultrasound (NU) measurements of rectus femoris and abdominal adipose tissue. Statistical analysis was performed (version 2.3.28 for macOS) to obtain sarcopenia cut-off points for the different techniques, and then the predictive capacity of these values for survival was analyzed using a Kaplan-Meier curve. Results: Sarcopenia was prevalent in 20.2% of the cohort. Sarcopenic patients exhibited significantly lower forced vital capacity (FVC) (2142 ml vs. 2745.6 ml, p < 0.05), higher GAP stages (p < 0.05), and worse quality of life (SGRQ impact scores: 45.2 vs. 27.5, p < 0.05). The identified cutoff values were 2.94 cm² for RFCSA, 9.19 seconds for TUG, and 1.08 cm for the RF-Y-axis and body cell mass (BCM) cutoff of 25.4 kg. Kaplan-Meier analysis indicated a higher hazard ratio (HR) for mortality in sarcopenic patients. Specifically, RFCSA sarcopenia patients had a 2.37 times higher risk of events (HR = 2.37, 95% CI: 1.02 - 5.48, p = 0.045), and TUG sarcopenia presented a 4.89 times higher risk of adverse events (HR = 4.89, 95% CI: 1.43-16.70, p = 0.011). Conclusion: Sarcopenia is prevalent in IPF patients and is associated with greater disease severity and reduced quality of life. RFCSA, BCM, and TUG are good predictors of sarcopenia and 12-month mortality, improving the prognostic value of classical diagnostics based on EWGSOP2 criteria. Despite limitations such as a predominantly male sample and cross-sectional design, the findings emphasize the importance of early detection and targeted interventions. Future research should focus on longitudinal studies to better understand sarcopenia progression in IPF and evaluate the efficacy of various therapeutic approaches.

    Keywords: Idiopathic Pulmonary Fibrosis, Sarcopenia, morphofunctional assessment, Quality of Life, Espacio Antes: 6 pto, Después: 12 pto

    Received: 29 May 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Fernández Jiménez, Cabrera-Cesar, Sanmartín-Sánchez, Sánchez-Garcia, Espildora-Hernandez, Vegas-Aguilar, Amaya-Campos, Guirado-Pelaez, Simón Frapolli, Murri, Garrido-Sanchez, Piñel-Jimenez, Benítez Cano-Gamonoso, López-García, Gómez-Rodríguez, Velasco-Garrido, Tinahones and García Almeida. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Rocio Fernández Jiménez, Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
    Eva Cabrera-Cesar, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
    Ana Sánchez-Garcia, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
    Francisco Espildora-Hernandez, Department of Neumology, Regional University Hospital of Malaga, Malaga, Spain
    Isabel Vegas-Aguilar, Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga, Spain
    Maria d. Amaya-Campos, Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
    Patricia Guirado-Pelaez, Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
    Lorena Piñel-Jimenez, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
    Miguel Benítez Cano-Gamonoso, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, 29010, Andalusia, Spain
    Javier López-García, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
    Belén Gómez-Rodríguez, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
    Jose L. Velasco-Garrido, Department of Neurology. Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain

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