1
|
Akpinar Senture S, Koksal E. Evaluating Anthropometric Indices for Malnutrition Assessment in Older Adults: Scoping Review. Curr Nutr Rep 2025; 14:65. [PMID: 40332639 PMCID: PMC12058963 DOI: 10.1007/s13668-025-00654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2025] [Indexed: 05/08/2025]
Abstract
Purpose of Review The demographic transition in both global and national populations indicates a growing trend in the older population. This burgeoning older population brings about constraints marked by the effective presence of malnutrition alongside functional and physiological changes. Conducting screenings and assessments to prevent malnutrition and enable early intervention is crucial. In epidemiological and clinical studies, these screenings and assessments are often conducted through anthropometric measurements and a range of indices derived from them, encompassing both traditional ones like BMI (Body Mass Index) and newer ones like BRI (Body Roundness Index), BAI (Body Adiposity Index), ABSI (A Body Shape Index), CI (Conicity Index), WWI (Waist adjusted Weight Index), AVI (Abdominal Volume Index), Demiquet, and Mindeks. There is a lack of scrutiny regarding studies comparing these indices based on the type of malnutrition in the older population, hence this review aims to address the gap in the literature. Recent Findings Analysis of existing research reveals that BRI and waist-to-height ratio serve as predictors of obesity-related body fat quantity/distribution and metabolic risks, while WWI stands out in sarcopenic obesity, and Demiquet and Mindeks are prominent indices for screening inadequate nutrition. Summary Choosing anthropometric indices that do not include height in the older populations can have certain advantages. However, the selection of these indices should depend on the specific variable being assessed or screened such as obesity, malnutrition, or sarcopenic obesity.
Collapse
Affiliation(s)
- Serife Akpinar Senture
- Faculty of Health Science, Department of Nutrition and Dietetic, Gazi University, Emek, Bişkek Main St. 6. St No: 2, Çankaya, Ankara, 06490, Turkey.
| | - Eda Koksal
- Faculty of Health Science, Department of Nutrition and Dietetic, Gazi University, Emek, Bişkek Main St. 6. St No: 2, Çankaya, Ankara, 06490, Turkey
| |
Collapse
|
2
|
Zhang W, Zhang H, Xi X, Wu H, Jiao Y, Zhang N, Han H, Xie J. Association of Craniofacial Skeletal and Soft Tissue Characteristics With Severe Obstructive Sleep Apnea in Age-specific and BMI-specific Patient Groups. J Craniofac Surg 2025:00001665-990000000-02354. [PMID: 39791892 DOI: 10.1097/scs.0000000000011082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Accepted: 12/19/2024] [Indexed: 01/12/2025] Open
Abstract
PURPOSE To identify the key craniofacial anatomic characteristics associated with the prevalence of severe obstructive sleep apnea (OSA) in patient cohorts stratified by age and body mass index (BMI). METHODS This prospective study was conducted at the Beijing Anzhen Hospital Center for Sleep Medicine and Science between December 2023 and March 2024. Patients suspected of having OSA underwent overnight polysomnography, along with computed tomography scans of the head and neck, to evaluate the skeletal and soft tissue characteristics. Multivariable analysis was conducted to explore the independent risk factors associated with the prevalence of severe OSA (apnea hypopnea index ≥30 events/h) after adjusting for age, sex, BMI, and neck circumference. RESULTS Among the 118 participants, 75 (63.6%) were diagnosed with severe OSA. Skeletal variables, such as vertical airway length, and soft tissue-related variables, like soft palate length, were independently correlated with the prevalence of severe OSA. Furthermore, subgroup analysis revealed that all skeletal variables and a few soft tissue parameters were associated with severe OSA in patients aged older than 40 years, whereas only a specific soft tissue variable was independently associated with the occurrence of severe OSA in those aged younger than or equal to 40 years. In addition, certain soft tissue-related variables were notably associated with severe OSA in obese patients (BMI >28 kg/m2), whereas only specific skeletal variables were acted independent risk factors for severe OSA in non-obese patients (BMI ≤28 kg/m2). CONCLUSION Craniofacial skeletal and soft tissue features play essential roles in the prevalence of severe OSA, with variations observed based on age and BMI.
Collapse
Affiliation(s)
- Weikang Zhang
- Department of Otolaryngology, Head and Neck Surgery, Chengde Medical University, Handan
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
| | - Hehe Zhang
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
- Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University
| | - Xin Xi
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
- Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University
| | - Hao Wu
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
- Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University
| | - Yuanni Jiao
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
- Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing
| | - Haiping Han
- Department of Otolaryngology Head and Neck Surgery II, Handan Central Hospital, Handan, China
| | - Jiang Xie
- Beijing Anzhen Hospital Centre for Sleep Medicine and Science, Capital Medical University
- Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University
| |
Collapse
|
3
|
Ren Y, Cui X, Zhu X, Guo H, Zhou Q, Yuan P, Cheng H, Wu W. Effect of Weight Loss on the Apnea Hypopnea Index is Related to Waist Circumference in Chinese Adults with Overweight and Obesity. Diabetes Metab Syndr Obes 2024; 17:453-463. [PMID: 38299196 PMCID: PMC10829506 DOI: 10.2147/dmso.s442738] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Purpose The present study aimed to evaluate the efficiency of traditional anthropometric and body composition parameters in predicting apnea hypopnea index (AHI) change after weight loss. Patients and Methods Chinese adults with overweight and obesity were included into this study containing two parts. A cross-sectional study was conducted in 137 individuals using the baseline data from two weight loss intervention trials. The second part was the weight-loss intervention study conducted in 60 overweight and obese patients with obstructive sleep apnea (OSA). All participants underwent physical examination, bioelectrical impedance analysis and overnight polysomnography. Multivariate linear regression models were used to identify the most accurate parameters to predict AHI and the mediation analysis to evaluate the mediators between weight loss and AHI reduction. Results Waist circumference (WC), body mass index and fat mass were positively associated with AHI after adjusting multiple collinearities in the cross-sectional study. After weight-loss intervention, body weight decreased from 94.6 ± 15.3 to 88.0 ± 13.9 kg, and AHI decreased from 41.9 (13.0,66.9) to 20.7 (8.7,51.2) events/h. Among these parameters, only percentage changes in WC and AHI across the intervention were positively intercorrelated after controlling for covariates (adjusted r = 0.271, P = 0.041). The mediation analysis supported WC as a mediator between weight loss and AHI reduction (standardized indirect effect [95% CI] = 4.272[0.936,7.999]). Conclusion Both general and abdominal obesity are of high prognostic value for OSA. WC as an easily accessible parameter mediates the effects of weight loss in decreasing OSA severity.
Collapse
Affiliation(s)
- Ye Ren
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaochuan Cui
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaowen Zhu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Hua Guo
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Qunyan Zhou
- Department of Nutrition Department, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Peng Yuan
- Department of Rehabilitation, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Haiyan Cheng
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Wenjun Wu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| |
Collapse
|
4
|
Ernst G, Dalzotto P, Saban M, Ferraro FM, Salvado A, Borsini EE. The Cervical Fat Tissue Volume is a Predictor for Moderate to Severe OSA. Sleep Sci 2023; 16:e323-e328. [PMID: 38196763 PMCID: PMC10773506 DOI: 10.1055/s-0043-1772827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/27/2022] [Indexed: 01/11/2024] Open
Abstract
Objective Obstructive sleep apnea (OSA) is a disorder characterized by recurrent pharyngeal obstruction during sleep, in which upper airway anatomy plays a key role in its pathogenesis. The aim of this study was to describe whether the quantification of cervical fat tissue volume (CFTV) obtained by Computed Tomography (CT)cephalometry is related to the severity of OSA. Methods Retrospective study between 2018 and 2020 in those patients > 18 years old, with diagnosis of OSA who performed a volumetric cephalometric imaging. Three-dimensional reconstruction of the images was performed and CFTV was measured. Results 91 patients were included in this study of which: without OSA (n: 7), mild (n: 19), moderate (n: 39) and severe OSA (n: 26). We observed a progressive increase of CFTV related to OSA severity has been observed (without OSA: 58.9 ml (47.9-87.5), mild: 59.1ml (48.4-78.3), moderate: 71 ml (42.6-127.1) and severe OSA 103.6 ml (81-153); p < 0.01); nevertheless, no differences were found in the airway volume and neck area. It was showed a significant correlation between CFTV and OSA indicators: AHI, ODI and T90 (Sp r: 0.48; 0.38 and 0.36; p < 0.01 respectively). CFTV cut-off value to discriminate AHI >15 ev/h with best sensitivity-specificity relationship was 64.1 ml with an area under the curve of 0.6 ± 0.06. Multivariate analysis showed that CFTV is a predictor for moderate to severe OSA (OR:3.05, IC95%: 1.14-8.17). Conclusion Cervical fat quantification by CT cephalometry correlates with OSA severity in adults. Fat volume > 64.1 ml increased more than three times the risk of OSA moderate to severe.
Collapse
Affiliation(s)
- Glenda Ernst
- Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
| | - Pablo Dalzotto
- Hospital Británico, Diagnóstico por Imágenes, CABA, Buenos Aires, Argentina
| | - Melina Saban
- Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
| | | | | | | |
Collapse
|
5
|
Gu M, Huang W, Li X, Liu Y, Wang F, Fang C, Chen T. Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study. Nat Sci Sleep 2021; 13:2165-2173. [PMID: 34955662 PMCID: PMC8694710 DOI: 10.2147/nss.s335288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hypertriglyceridemic waist (HTGW) phenotype is an independent risk factor for metabolic disorders. Although obstructive sleep apnea (OSA) is associated with metabolic disorders, it is unclear whether there is an association between HTGW phenotype and OSA. METHODS We enrolled consecutive participants presenting to a sleep center in Shanghai, China. Full-night polysomnography was performed, and serum triglyceride (TG) levels and waist circumference (WC) were calculated. HTGW phenotype was defined as increased WC (men > 90 cm, women > 80 cm) and elevated TG levels (> 1.7 mmol/L). Participants were classified into four groups: normal TG with normal WC (NTNW); normal TG with increased WC (NTGW); elevated TG with normal WC (HTNW); and elevated TG with enlarged WC, namely HTGW. The relationships between HTGW phenotypes and OSA were assessed using binary (apnea hypopnea index, [AHI]≥5/hr) and multinomial logistic regression analyses (clinical AHI severity categories). RESULTS We included 3190 participants in this cross-sectional study. Compared to the NTNW phenotype, participants with NTGW and HTGW phenotypes had the significantly higher risk of OSA (AHI ≥5/hr, odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.91-3.31; OR = 3.76, 95% CI = 2.67-5.31, respectively), after adjustment for confounders. In subgroup analyses categorised by age, sex, and BMI, the aforementioned associations remained significant. The association between the NTGW, HTGW phenotype and OSA risk remained significant across the OSA severity groups. Multinomial logistic regression also revealed that the mild (OR = 1.63, 95% CI = 1.07-2.50), moderate (OR = 1.875, 95% CI = 1.22-2.88), and severe OSA (OR = 3.18, 95% CI = 2.14-4.73) were associated with HTGW phenotype. CONCLUSION Both NTGW and HTGW phenotype were positively associated with OSA risk in all subgroups. Further longitudinal follow-up studies are needed to determine the causal link and prognostic role of these metabolic factors.
Collapse
Affiliation(s)
- Meizhen Gu
- Department of Otolaryngology-Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Weijun Huang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Xinyi Li
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yupu Liu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Fan Wang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Chao Fang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology-Head & Neck Surgery, The First Hospital of Putian, Putian, Fujian Province, People's Republic of China
| | - Ting Chen
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| |
Collapse
|