P606 - MUSCLE MASS EVALUATION IN PATIENTS WITH INTESTINAL FAILURE AND INSUFFICIENCY: COMPARISON OF METHODS

P606

MUSCLE MASS EVALUATION IN PATIENTS WITH INTESTINAL FAILURE AND INSUFFICIENCY: COMPARISON OF METHODS

M. Køhler^1,*, S. Mikkelsen¹, S. M. Nielsen², K. B. Weesgaard², P. T. Christensen², S. Byskov², M. Holst^1,2, J. L. Poulsen¹, H. H. Rasmussen^1,2,3

¹Center for Nutrition and Intestinal Failure, Danish Nutrition Science Center, Department of Gastroenterology, Aalborg University Hospital, ²Department of Clinical Medicine, Aalborg University, Aalborg, ³Dietetic and Nutritional Research Unit, EATEN, Copenhagen University Hospital, Herlev-Gentofte, Denmark

Rationale: Reduced muscle mass is common in patients with malnutrition, intestinal failure (IF) and -insufficiency (INS). Bioelectrical impedance measure (BIA) is safe but requires fasting and is not available in all clinics. The aim of this study was to investigate if use of simple and more available methods is sufficient to evaluate reduced muscle mass and further to investigate the prevalence of reduced muscle mass in patients with IF and INS.

Methods: Calf circumference (CC), BMI corrected CC (CC-corr), arm muscle circumference (AMC), BIA measured fat free mass (FFM), and skeletal muscle (SM) were measured in 300 patients, 2021-2024. Measures were compared using descriptive statistics including Pearson correlation coefficients. Further, agreement analysis using Cohens Kappa as well as sensitivity and specificity were calculated to compare diagnostic accuracy.

Results: Reduced muscle mass was common in both IF and INS. Low muscle mass was seen based on AMC (7.0%), FFMI (42.7%), CC-corr (57.3%), CC (52.7%) and SM (58.0%), respectively. The best agreement was between SM index (SMI) and FFM Index (FFFI) (κ=0.700). The agreement between SM and AMC/CC-corr/CC were below the minimal satisfactory agreement of 0.6 (κ=0.093/κ=0.276/κ=0.570). Pearson correlation coefficient was nearest 1 between SMI and FFMI (r>0.800, p<0.001). Significant linear associations were found between SMI and FFMI as well as between SM and CC-corr, CC and AMC both unadjusted and adjusted for gender, age, BMI and in the two patient groups (p<0.05). Only CC-corr differed between the groups.

Conclusion: We found limited agreement between SM, CC-corr and AMC. Agreement was better using CC without adjusting for low or high BMI. Thus, it is dubious if CC-corr can serve as a proxy measure for muscle mass in IF and INS patients. Independent of methods, both groups showed a high prevalence of reduced muscle mass.

Disclosure of Interest: None declared