Current Study Of Body Composition And Sarcopenia In Elderly Stroke Patients In The Acute Phase

Part I.Current study of body composition in elderly patients w ith stroke in the acute phaseObjective: To collect and analyze data on body composition of eld erly stroke patients in the acute phase to discover the differences in bo dy composition under different nutritional status and clinical characteristi cs,and to provide a basis for effectively improving the accuracy of indi vidualized nutritional support,clinical treatment and late rehabilitation.Methods: The study included 105 elderly stroke patients in the acu te phase who were treated in the neurology ward and neurosurgery war d of the First Hospital of Hebei Medical University from June 2022 to November 2022,and the included patients were surveyed for general inf ormation(gender,age,stroke type,lesion site,disease severity),height a nd weight measurements,body composition assessment,the nutritional st atus survey(Geriatric Nutritional Risk Index(GNRI)),and laboratory-rel ated indexes were examined.Differences in body composition outcomes were compared between sex,age,stroke type,disease severity,BMI,nut ritional status,activities of daily living,and risk of falls/falling out of b ed.All data were entered into SPSS 25.0 statistical software for statistic al analysis,and the P value for a statistically significant difference was set at ≤0.05.Results: A complete data set of 105 acute stage elderly stroke pati ents was obtained,with 61 males and 44 females among all patients inc luded in the study.The median age was 68 years and the interquartile r ange was 8 years.There were significant differences in body compositio n parameters between patient genders except for BMI,PBF,CA,ECW/TBW,and VFA;there were statistically significant differences in PA,B MI,PBF,BFM,CA,AC,ECW/TBW,and VFA in elderly stroke patien ts in the acute phase according to GNRI grouping,and each of these p arameters was statistically different except for ECW/TBW.The body co mposition parameters of elderly stroke patients with different BMI were statistically different in the acute phase except for TBW/FFM and prot ein,and all of them showed an increasing trend;only PBF,BFM and VFA were statistically different in the acute phase of elderly patients wi th different stroke types,P< The PBF,FFM,TBW,ICW,SMM,BCM,TBW/FFM,protein and muscle mass were statistically different in the a cute phase of elderly stroke patients with different disease severity,and all body composition parameters except PBF showed an increasing trend.There were statistically significant differences in a SMI,PA,PBF,FFM,TBW,ICW,ECW,BFM,SMM,BCM,protein,inorganic salts,BMC,muscle mass,and VFA among elderly stroke patients with different adm ission risk of fall/bed fall in the acute phase;there were no statistically significant differences in all body composition parameters among elderly stroke patients with different admission risk of fall/bed fall in the acute phase.Conclusions:1.The correlation between the different subgroups of gender,GNRI,BMI,disease severity,and ability to perform activities of daily living o n admission and the difference in body composition outcomes in elderly patients with acute stroke was greater,whereas the correlation between t he different subgroups of stroke type and risk of fall/bed fall on admiss ion and the difference in body composition outcomes in elderly patients with acute stroke was smaller,but it is noteworthy that PBF,BFM,and VFA were greater in patients with cerebral infarction than in patients w ith cerebral hemorrhage.2.Favorable body composition indices in elderly stroke patients in t he acute phase gradually deteriorate with decreasing nutritional status.It is suggested that the body composition of patients can be improved by improving their nutritional status as early as possible,thus providing a basis for clinical treatment and rehabilitation.Part II Study of factors influencing acute phase angle and sarc openia in elderly stroke patientsObjective:To investigate the factors associated with PA and sarcope nia in the acute phase of elderly stroke patients and to provide a basis for improving the prognosis of elderly stroke patients.Methods:BIA body composition assessment was performed in 105 i ncluded elderly stroke patients in the acute phase,and PA data could b e obtained directly at a frequency of 50 Hz.The diagnostic criteria for sarcopenia in the included patients were established according to the A WGS expert consensus,and data on general information and clinical cha racteristics were combined to analyze the relevant factors affecting PA a nd sarcopenia in elderly stroke patients in the acute phase.Data will be processed and analyzed in SPSS 25.0 statistical software,and p-values f or statistically significant differences will be set at ≤0.05.Results:The mean PA of 105 elderly stroke patients in the acute p hase of the study was 4.71° with a standard deviation of 0.77°.For dif ferent groups,analysis of variance or rank sum test yielded statistically significant differences in PA by gender,GNRI and BMI,P<0.05.The median PA in men was greater than that in women;the mean value of PA in the severe malnutrition group was statistically different from that in the no malnutrition group and the mild malnutrition group,whereas there was no statistically significant difference between the no malnutriti on group and the mild malnutrition group,and The mean value of PA i n the severe malnutrition group was lower than that in the no malnutriti on group and the mild malnutrition group;the mean value of PA in the BMI grouping was the lowest in the lean group,while there was no sta tistical difference between the normal,overweight and obese groups,but there was an increasing trend,while there was no difference between t he different disease types,disease severity,whether it was the first time,transfer status and patients’ Barthel index at admission and fall/falling bed risk PA was negatively correlated with age by Pearson or Spearma n rank correlation analysis(P<0.05);PA was positively correlated with GNRI,BMI,triglycerides,albumin,hemoglobin and red blood cell press ure(P<0.05),while PA was correlated with total cholesterol,HDL chole sterol,LDL cholesterol and total There was no correlation between PA and total cholesterol,HDL cholesterol,LDL cholesterol and total protein.Multiple linear regression analysis suggested that age,total protein and albumin independently affected PA size(P<0.05).GNRI,BMI,TG,LD L-C,HGB and HCT had no effect on PA size(P>0.05).According to t he formula Skeletal muscle mass index of extremities = skeletal muscle mass of extremities(kg)/[height(m)]2,25 patients(23.80%)with sarco penia and 80 patients(76.20%)without sarcopenia were diagnosed,14 p atients(13.33%)with sarcopenia in males and 11 patients(10.48%)in f emales.The results of univariate logistic regression analysis suggested th e association of age,GNRI,BMI,FFM,PA,TBW,ICW,ECW,SMM,CA,BCM,AC,TBW/FFM,ECW/TBW,protein,inorganic salt,bone mineral,muscle mass,white blood cell count,and ADL with the occurr ence of sarcopenia.Multifactorial logistic regression analysis revealed G NRI,BMI,FMM,SMM,CA,AC,and BCM as independent protective factors for the development of acute phase sarcopenia in elderly stroke patients after adjusting for confounding factors such as age,sex,smokin g,alcohol consumption,hypertension,and diabetes mellitus.Comparison of body composition and laboratory-related parameters between elderly stroke patients with and without sarcopenia in the acute phase revealed that there were statistically significant differences between all body com position parameters except fat-related parameters(PBF,BFM,VFA)at P<0.05,and that the mean or median values of all parameters except B MI and ECW/TBW were greater in patients without sarcopenia than in sarcopenic patients.In contrast,only hs-CRP and white blood cell count were statistically different between sarcopenia and sarcopenia,P<0.05,while all other indicators were not statistically different.Conclusions:1.PA correlated with sex,age,GNRI,BMI,TG,albumin,hemoglo bin,and erythrocyte pressure indices,but after adjustment for confounde rs,PA correlated with age,total protein,and albumin.2.Age,GNRI,BMI,FFM,PA,TBW,ICW,ECW,SMM,CA,BC M,AC,TBW/FFM,protein,inorganic salt,bone mineral,muscle mass,and white blood cell count were independent protective factors for the d evelopment of acute phase sarcopenia in elderly stroke patients,and EC W/TBW and ADL were independent protective factors for the developm ent of acute phase sarcopenia in elderly stroke patients.After adjusting for confounders,GNRI,BMI,FMM,SMM,CA,AC,and BCM were in dependent protective factors for the development of acute myasthenia gr avis in elderly stroke patients,and ADL was an independent risk factor for the development of acute myasthenia gravis in elderly stroke patien ts,and patients with myasthenia gravis had poor nutritional status,low PA levels,and poor body composition relative to patients without myast henia gravis.