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Frailty syndrome: Visceral adipose tissue and frailty in patients with symptomatic severe aortic stenosis

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The journal of nutrition, health & aging

Abstract

Background/Objectives

In patients with severe aortic stenosis (AS), frailty is a clinically relevant measure of increased vulnerability that should be included in the preoperative risk assessment. Bioelectrical impedance analysis (BIA) derived phase angle (PA) reflects cell membrane integrity and function. Few studies are available on the relative contribution of adiposity distribution on frailty, and about the influences of frailty and visceral obesity in PA value. Therefore, we aimed to evaluate associations among frailty, visceral fat depots and PA in patients with symptomatic severe AS.

Methods

In a cohort of patients with symptomatic severe AS and preserved ejection fraction, we examined the associations between frailty, visceral fat depots and bioelectrical impedance analysis (BIA) derived phase angle (PA); and between visceral fat and PA. Frailty was defined according the Fried et al. scale criteria and the body fat distribution was determined by multidetector computed tomography and by BIA.

Results

Of the fifty-five included patients, 26 were frail (47%). Adjusting for age and gender, frailty was associated with indexed epicardial adipose tissue volume (EATVi) (the odds of frailty increased 4.1-fold per additional 100 cm3/m2 of EAT [95% confidence interval (CI) of 1.03 to 16.40, p=0.04] and with PA (OR of 0.50, 95% CI, 0.26 to 0.97, p=0.04), but not with body mass index (BMI), waist circumference (WC), indexed total, visceral and subcutaneous abdominal fat areas (TAFAi, VAFAi and SAFAi) nor with indexed mediastinal adipose tissue volume (MATVi). In an age and gender adjusted linear model, PA was inversely correlated with EATVi (β=-0.008, 95% CI, -0.016 to -0.001, p=0.03), but not with BMI, WC, nor with MATVi, VAFAi, SAFAi and TAFAi.

Conclusions

In patients with symptomatic severe AS, EATVi is associated with frailty, independently of age and gender, but not with MAFVi or VAFAi. Moreover, frailty and EATVi are associated with impaired cell membrane integrity and function assessed by PA.

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Authors and Affiliations

  1. Faculty of Nutrition and Food Sciences, Porto, Portugal

    Marília Pinheiro & A. Santos

  2. Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho and Cardiovascular R&D Unit, Department of Physiology and Cardiothoracic Surgery of Medical School of Porto, Porto, Portugal

    J. Mancio, W. Ferreira, M. Carvalho, L. Vouga, V. Gama Ribeiro, A. Leite-Moreira, I. Falcão-Pires & N. Bettencourt

  3. Cardiovascular R&D Unit, Department of physiology and cardiothoracic surgery of Medical School of Porto, Porto, Portugal

    J. Mancio & G. Conceição

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  1. Marília Pinheiro
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  2. J. Mancio
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  3. G. Conceição
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  4. W. Ferreira
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  5. M. Carvalho
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  6. A. Santos
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  7. L. Vouga
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  8. V. Gama Ribeiro
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  9. A. Leite-Moreira
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  10. I. Falcão-Pires
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Correspondence to Marília Pinheiro.

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Both authors contributed equally for this work.

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Pinheiro, M., Mancio, J., Conceição, G. et al. Frailty syndrome: Visceral adipose tissue and frailty in patients with symptomatic severe aortic stenosis. J Nutr Health Aging 21, 120–128 (2017). https://doi.org/10.1007/s12603-016-0795-x

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  • DOI: https://doi.org/10.1007/s12603-016-0795-x

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