Table 3.
Physical Functioning, Body Composition, Nutrition Intake, Malnutrition, and Sarcopenia in MD Patients and Controls
| Physical functioning, body composition, nutritional intake, malnutrition and sarcopenia | MD patients (n = 37) | Controls (n = 37) | P‐value* |
|---|---|---|---|
| Physical functioning test | |||
| Handgrip strength, kg, (mean ± SD) | 28 ± 10 | 43 ± 9 | <.001 |
| Too low handgrip strength a (n/%) | 6 (16) | 0 (0) | |
| Too low handgrip strength b (n/%) | 15 (41) | 0 (0) | |
| 6MMT (n chewing cycles) (mean ± SD) | 396 ± 130 (n = 29) | 577 ± 141 (n = 36) | <001 |
| 30SCT (n sit‐to‐stands) (mean ± SD) | 12 ± 4 (n = 22) | 17 ± 4 (n = 36) | <.001 |
| 6MWT (distance in m) (median; IQR) | 441: 426–427 (n = 20) | 681: 635–639 | <.001 |
| 6MWT < 400 m (n/%) | 3 (15) | 0 (0) | |
| Total body composition | |||
| FMI, kg/m2, (median; IQR) | 7.7: 6.7–8.7 | 7.0: 6.3–7.7 | .25 |
| Fat percentage (%) (mean ± SD) | 22 ± 7 | 16 ± 7 | .21 |
| High fat percentage c (n/%) | 9 (24) | 7 (19) | .21 |
| ASM, kg, (mean ± SD) | 17.6 ± 4.0 | 19.8 ± 3.8 | .02 |
| FFMI, kg/m2, (mean ± SD) | 15.2 ± 1.9 | 15.5 ± 1.6 | .38 |
| SMI, kg/m2, (mean ± SD) | 6.0 ± 1.0 | 6.3 ± 0.9 | .11 |
| Too low SMI d (n/%) | 25 (68) | 21 (57) | .34 |
| Bone density, g/cm2, (mean ± SD) | 0.31 ± 0.83 | 0.27 ± 0.80 | .99 |
| Osteopenia e (n/%) | 3 (8) | 0 (0) | .08 |
| Regional LTMI, kg/m2, (mean ± SD) | |||
| Average arm | 1.3 ± 0.30 | 1.3 ± 0.3 | .42 |
| Trunk | 12.7 ± 2.0 | 13.1 ± 1.5 | .34 |
| Average leg | 3.8 ± 0.7 | 4.3 ± 0.6 | .004 |
| Nutrition intake | |||
| Protein intake, g/kg/d, (median; IQR) | 1.1: 0.9–1.4 | 1.2: 1.1–1.7 | .07 |
| Too low protein intake f (n/%) | 25 (68%) | 4 (12%) | <.01 |
| Energy, kcal/d | 1663 ± 500 | 2322 ± 644 | <.001 |
| Energy intake (% of calculated needs, mean ± SD) | 81% ± 23.8% | 98% ± 25.1% | .03 |
| Too low energy intake g (n/%) | 25 (68%) | 17 (46%) | |
| PG‐SGA h | <.001 | ||
| PG‐SGA h 0–4 (n/%) | 5 (14%) | 35 (95%) | |
| PG‐SGA h 4–9 (n/%) | 16 (43%) | 1 (3%) | |
| PG‐SGA h ≥9 (n/%) | 16 (43%) | 1 (3%) | |
| Malnutrition i (n/%) | 17 (46%) | 10 (27%) | .09 |
| Severe malnutrition i (n/%) | 1 (3%) | 0 (0%) | |
| Sarcopenia j (n/%) | 5 (14%) | 0 (0%) | .02 |
| Sarcopenic obesity k (n/%) | 4 (11%) | 3 (8%) | .7 |
30SCT, 30‐second sit‐to‐stand test; 6MMT, 6‐minute mastication test; 6MWT, 6‐minute walk test; ASM, appendicular muscle mass; FFMI, fat‐free mass index; FMI, fat mass index; GLIM, Global Leadership Initiative on Malnutrition; IQR, interquartile range; LTMI, lean tissue mass index; PG‐SGA, Patient‐Generated Subjective Global Assessment; SMI, skeletal muscle index.
P‐values ≤. 02 (in bold) were considered significant.
Too low handgrip strength = <16 kg for women and <27 kg for men based on Dodds reference at age 70 28 according to the sarcopenia consensus 2018. 22
High fat percentage according to the sarcopenic obesity criteria of Baumgartner = >28% for men and >40% for women. 40
Too low SMI <7 kg/m2 for men and <6 kg/m2 for women according to the recommendations from European Working Group on Sarcopenia in Older People 2 (EWGSOP2). 22 , 30
Ostopenia = t‐score between −1 and −2.5.
Too low protein intake = <1.2 g/kg/d for MD patients at risk for malnutrition = PG‐SGA ≥4 and/or malnutrition according to GLIM criteria (n = 34; 92% off MD patients) and 0.8 g/kg/d for controls and MD patients not at risk for malnutrition.
Too low energy intake <90% of calculated energy needs = resting energy expenditure according to the Harris and Benedict formula (1984) and an activity factor of 1.4 for mobile MD patients, 1.2 for immobile MD patients, and 1.5 for controls. 10
PG‐SGA: 0–1 does not require nutrition input, 2–3 requires nutrition education, 4–8 requires specialized nutrition intervention, ≥9 indicates in critical need of symptom management together with specialized nutrition intervention/malnutrition. 39
Malnutrition and severe malnutrition according to GLIM criteria. 30
Sarcopenia according to 2018 consensus. 22
Sarcopenic obesity according to Baumgartner 40 low SMI and high fat percentage.