Endocrine Abstracts

Background: Heart failure (HF) is a chronic inflammatory syndrome, with increased morbidity, mortality, and decreased quality of life. The publication of GLIM criteria has standardized the diagnosis of malnutrition. With these criteria, the nutritional status of patients with heart failure, who usually have normal weight, overweight or obesity, has acquired a new perspective, since malnutrition may affect the clinical evolution and prognosis of these patients.

Objective: To evaluate nutritional parameters including body composition using bioimpedance, adipose and muscle ultrasound in patients with HF and to determine the incidence of malnutrition using the GLIM criteria. Methods Thirty-eight patients with at least one hospital admission during the previous year were included. Anthropometric, biochemical, ultrasound and functional tests were collected. Statistical analysis was performed with SSPS v.24.

Results: In our cohort 72.2% were males, 75% of the patients had overweight or obesity and 58.3% presented with malnutrition according to the GLIM criteria; among them, 41.6% with BMI>25 kg/m². Patients with malnutrition tended to have a higher rate of hospitalization due to HF in the previous 12 months (2.1 vs 1.7; P = 0.420), increased length of stay in hospital (5.25 vs 4.5 days; P = 0.43) and increased vitamin D defficiency (58.8% vs 41.2%). There was no relation between the presence of malnutrition, serum NT-proBNP nor ejection fraction measured by echocardiogram. Altered serum nutritional parameters were observed in 65% of patients, 21% had decreased hand dynamometry values. The mean of the Up And Go test was 20.87 seconds. Median value of adipose tissue thickness in rectus femoris (measured by ultrasound) was 0.68 cm, with a median circumference of 8.8 cm and an area of 3.5 cm² in the referred muscle. Patients with malnutrition presented lower longitudinal axis of the rectus femoris (P < 0.05). Abdominal adipose tissue ultrasound revealed a total thickness of 2.19 cm, the median values were: superficial adipose tissue 0.63 cm, deep adipose tissue 0.92 cm and preperitoneal adipose tissue 0.54 cm.

Conclusions: GLIM criteria has a key role in early detection and diagnosis of malnutrition in patients with HF. The nutritional status assesed by serum parameters, body composition and muscle evaluation techniques might be related with the clinical evolution of these patients.