Is the handgrip strength a good nutritional assessment method for people living with HIV?
Palavras-chave:
Nutritional assessment, HIV, Muscle strengthResumo
Objective
The study aimed to verify the relationship between handgrip strength measurement and classic anthropometric values in HIV positive outpatients.
Methods
This was a cross-sectional study that enrolled HIV-positive outpatients treated at the Gaffrée and Guinle University Hospital, aged between 20 and 60 years and considered to be well-nourished or moderately malnourished, according to the Global Subjective Analysis. The patients’ bilateral handgrip strength were assessed (Jamar dynamometer), and classic anthropometry variables (weight, height, body mass index, arm muscle area, arm fat area, arm muscle circumference, and triceps skin fold) were measured. The Kolmogorov-Smirnov test, t-test, bivariate correlation and regression analysis were used (SPSS 21® software), with a significance level of 5%.
Results
A total of 242 patients were assessed. According to the Global Subjective Analysis, 218 (90.1%) patients were classified as well nourished (Global Subjective Analysis-A) and 24 (9.9%) as moderately malnourished (Global Subjective Analysis-B). The average dominant hand handgrip strength with standard deviation was 30.5±9.5kgf and 24.1±6.1kgf for Global Subjective Analysis-A and Global Subjective Analysis-B patients, respectively. Handgrip values were not influenced by age. The handgrip strength showed in both genders a significant correlation with weight, body mass index, and with anthropometric parameters related to lean body mass (arm muscle circumference and arm muscle area), but without correlation with the non-lean mass parameter (arm fat area). The handgrip strength of the dominant hand was a predictor of the following variables associated with lean body mass, i.e., arm muscle circumference and arm muscle area (R2=0.194, t=7.7, p<0.001, and R2=0.192, t=7.6, p<0.001, respectively). However, handgrip strength was not a predictor of arm fat area.
Conclusion
Measurement of handgrip strength was a useful method for nutritional assessment in outpatients with HIV due to a significant relationship with anthropometric parameters associated with lean body mass.
Referências
Dworkin MS, Williamson JM. AIDS wasting syndrome: trends, influence on opportunistic infections, and survival. Adult/Adolescent Spectrum of HIV Disease Project. Acquir Immune Defic Syndr. 2003;33(2):267.
Wanke CA, Silva M, Knox TA, Forrester J, Speigelman D, Gorbach SL. Weight loss and wasting remain common complications in individuals infected with human immunodeficiency virus in the era of highly active antiretroviral therapy. Clin Infect Dis. 2000;31(3):803.
Jensen GL, Bistrian B, Roubenoff R, Hemiburger DC. Malnutrition Syndromes: a conundrum vs continuum. J Parenter Enter Nutr. 2009;33(6):710-6
Metter EJ, Talbot LA, Schrager M,Conwit R. Skeletal muscle strength as a predictor of all-cause mortality in healthy men. J Gerontol A Biol Sci Med. 2002;57(10):359-65.
Norman K, Stobäus N, Gonzalez M, Schulzke J, Pirlich M. Handgripstrength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;30(2):135-42.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al., Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2018;48(1):16-31.
Raso V, Shephard RJ, Rosário Casseb JS, Silva Duarte AJ, D’Andréa, Greve JM. Handgrip force offers a measure of physical function in individuals living with HIV/AIDS. J Acquir Immune Defic Syndr. 2013; 63(1):e30-2. http://dx.doi.org/10.1097/QAI.0b013e31828c42bb
Organización Mundial de la Salud. El Estado físico: uso e interpretación de la antropometria. OMS Serie de Informes Técnicos 854. Genebra: Organización; 1995.
Dias J, Ovando A, Külkamp W, Borges Junior N. Força de preensão palmar: métodos de avaliação e fatores que influenciam a medida. Rev Bras Cineantropom Desempenho Hum. 2011;12(3):209-16.
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? J Parenter Enter Nutr. 1987;11(1):8-13.
Silva E, Lewi D, Vedovato G, Garcia V, Tenore S, Bassichetto K. Estado nutricional, clínico e padrão alimentar de pessoas vivendo com HIV/Aids em assistência ambulatorial no município de São Paulo. Rev Bras Epidemiol. 2010;13(4):677-88.
Budziareck M, Purezaduarte R, Barbosasilva M. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008;27(3):357-62.
Policarpo S, Moreira A, Rodrigues T, Valadas E. PP182-MON: handgrip strength in hiv infected outpatients as an indicator of immune status: to use or not to use? Clin Nutr. 2014;33:S196-S7.
Schlüssel M, Anjos L, Vasconcellos M, Kac G. Reference values of handgrip dynamometry of healthy adults: a population-based study. Clin Nutr. 2008;27(4):601-7.
Guerra R, Fonseca I, Pichel F, Restivo M, Amaral T. Handgrip strength and associated factors in hospitalized patients. J Parenter Enter Nutr. 2013;39(3):322-30.
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Copyright (c) 2022 Rodrigo Moura ELARRAT, Julio Cesar TOLENTINO JUNIOR, Arthur Fernandes CORTEZ, Ana Lucia Taboada GJORUP, Juliano Heluany DUARTE, Gabriel Teixeira FERNANDES
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.