Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome

Kitty S. Chan; Marina Mourtzakis; Lisa Aronson Friedman; Victor D. Dinglas; Catherine L. Hough; E. Wesley Ely; Peter E. Morris; Ramona O. Hopkins; Dale M. Needham

doi:10.1038/s41430-018-0106-1

Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome

Kitty S. Chan, Marina Mourtzakis, Lisa Aronson Friedman, Victor D. Dinglas, Catherine L. Hough, E. Wesley Ely, Peter E. Morris, Ramona O. Hopkins, Dale M. Needham

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

Original language	English
Pages (from-to)	613-617
Number of pages	5
Journal	European Journal of Clinical Nutrition
Volume	72
Issue number	4
DOIs	https://doi.org/10.1038/s41430-018-0106-1
State	Published - Apr 1 2018

Bibliographical note

Publisher Copyright:
© 2018 Macmillan Publishers Limited, part of Springer Nature.

Funding

Acknowledgements This research was supported by the NHLBI (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (ICTR) (UL1 TR 000424-06), and the ALTA, EDEN, OMEGA and SAILS trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536 171C, HHSN268200536173C, HHSN268200536174C, HSN2682005 36175C, and HHSN268200536179C). This research was supported by the NHLBI (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (ICTR) (UL1 TR 000424-06), and the ALTA, EDEN, OMEGA and SAILS trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536 171C, HHSN268200536173C, HHSN268200536174C, HSN2682005 36175C, and HHSN268200536179C).

Funders	Funder number
Universidade de Cruz Alta
Eden Project	HHSN268200536173C, HHSN268200536174C, HSN268200536170C, HHSN268200536 171C, HSN2682005 36175C, HHSN268200536179C
Johns Hopkins Institute for Clinical and Translational Research
National Heart, Lung, and Blood Institute (NHLBI)	R01HL091760, R01HL096504, R24 HL111895, P050HL73994, R01HL88045
Eden Hall Foundation
Institute for Clinical and Translational Research, University of Wisconsin, Madison	UL1 TR 000424-06

ASJC Scopus subject areas

Medicine (miscellaneous)
Nutrition and Dietetics

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title = "Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome",

abstract = "Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.",

author = "Chan, \{Kitty S.\} and Marina Mourtzakis and \{Aronson Friedman\}, Lisa and Dinglas, \{Victor D.\} and Hough, \{Catherine L.\} and Ely, \{E. Wesley\} and Morris, \{Peter E.\} and Hopkins, \{Ramona O.\} and Needham, \{Dale M.\}",

note = "Publisher Copyright: {\textcopyright} 2018 Macmillan Publishers Limited, part of Springer Nature.",

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doi = "10.1038/s41430-018-0106-1",

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AU - Hough, Catherine L.

AU - Ely, E. Wesley

AU - Morris, Peter E.

AU - Hopkins, Ramona O.

AU - Needham, Dale M.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

AB - Survivors of acute respiratory distress syndrome (ARDS) experience severe muscle wasting. Upper arm anthropometrics can provide a quick, non-invasive estimate of muscle status, but its accuracy is unknown. This study examines the accuracy of upper arm percent muscle area (UAMA) with reference measures of lean mass from dual energy X-ray absorptiometry (DXA). Data are from 120 ARDS survivors participating in a multicenter national study. Receiver operating characteristic (ROC) curves, by patient sex, demonstrated that UAMA did no better than chance in discriminating low appendicular skeletal muscle mass identified using DXA findings (c-statistics, 6 months: 0.50-0.59, 12 months: 0.54-0.57). Modest correlations of UAMA with DXA measures (whole-body: r = 0.46-0.49, arm-specific: r = 0.50-0.51, p < 0.001) and Bland-Altman plots indicate poor precision. UAMA is not an appropriate screening measure for estimating muscle mass when compared to a DXA reference standard. Alternate screening measures should be evaluated in ARDS survivors.

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Upper arm anthropometrics versus DXA scan in survivors of acute respiratory distress syndrome

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