The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study

There is increasing evidence supporting the use of morphofunctional assessment (MFA) as a tool for clinical characterization and decision-making in malnourished patients. MFA enables the diagnosis of malnutrition, sarcopenia, obesity, and cachexia, leading to a novel phenotype-based classification o...

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Main Authors: Alicia Sanmartín-Sánchez, Rocío Fernández-Jiménez, Eva Cabrera-César, Francisco Espíldora-Hernández, Isabel Vegas-Aguilar, María del Mar Amaya-Campos, Fiorella Ximena Palmas-Candia, Josefina Olivares-Alcolea, Víctor José Simón-Frapolli, Isabel Cornejo-Pareja, Ana Sánchez-García, Mora Murri, Patricia Guirado-Peláez, Álvaro Vidal-Suárez, Lourdes Garrido-Sánchez, Francisco J. Tinahones, Jose Luis Velasco-Garrido, Jose Manuel García-Almeida
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Language:English
Published: MDPI AG 2025-03-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/4/516
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author Alicia Sanmartín-Sánchez
Rocío Fernández-Jiménez
Eva Cabrera-César
Francisco Espíldora-Hernández
Isabel Vegas-Aguilar
María del Mar Amaya-Campos
Fiorella Ximena Palmas-Candia
Josefina Olivares-Alcolea
Víctor José Simón-Frapolli
Isabel Cornejo-Pareja
Ana Sánchez-García
Mora Murri
Patricia Guirado-Peláez
Álvaro Vidal-Suárez
Lourdes Garrido-Sánchez
Francisco J. Tinahones
Jose Luis Velasco-Garrido
Jose Manuel García-Almeida
author_facet Alicia Sanmartín-Sánchez
Rocío Fernández-Jiménez
Eva Cabrera-César
Francisco Espíldora-Hernández
Isabel Vegas-Aguilar
María del Mar Amaya-Campos
Fiorella Ximena Palmas-Candia
Josefina Olivares-Alcolea
Víctor José Simón-Frapolli
Isabel Cornejo-Pareja
Ana Sánchez-García
Mora Murri
Patricia Guirado-Peláez
Álvaro Vidal-Suárez
Lourdes Garrido-Sánchez
Francisco J. Tinahones
Jose Luis Velasco-Garrido
Jose Manuel García-Almeida
author_sort Alicia Sanmartín-Sánchez
collection DOAJ
description There is increasing evidence supporting the use of morphofunctional assessment (MFA) as a tool for clinical characterization and decision-making in malnourished patients. MFA enables the diagnosis of malnutrition, sarcopenia, obesity, and cachexia, leading to a novel phenotype-based classification of nutritional disorders. Bioelectrical impedance analysis (BIVA), nutritional ultrasound<sup>®</sup> (NU) and computed tomography (CT) are included, along with functional tests like the Timed Up and Go test (TUG). Myoesteatosis, detectable via CT, can occur independently from nutritional phenotypes and has been identified as a significant mortality predictor in idiophatic pulmonary fibrosis (IPF). Our aim is to analyze the prevalence and overlap of nutritional phenotypes in IPF and evaluate the prognostic value of myoesteatosis. Our bicenter cross-sectional study included 82 IPF patients (84.1% male and with a medium age of 71.1 ± 7.35 years). MFA was performed using BIVA, NU, CT at the T12 level (CT-T12), the handgrip strength (HGS) test, and the TUG. CT-T12 BC parameters were analyzed using FocusedON<sup>®</sup> software, while statistical analyses were conducted with JAMOVI version 2.3.22. All four major nutritional phenotypes were represented in our cohort, with significant overlap. A total of 80.5% met the GLIM criteria for malnutrition, 14.6% had cachexia, 17% were sarcopenic, and 28% were obese. Of the obese patients, 70% were also malnourished, while 100% of sarcopenic obese patients (5.9% of total) had malnutrition. A total of 55% of sarcopenic patients with available CT also had myosteatosis, suggesting muscle quality deterioration as a potential driver of functional impairment. The presence of myosteatosis > 15% in T12-CT was an independent predictor of 12-month mortality (HR = 3.13; 95% CI: 1.01–9.70; <i>p</i> = 0.049), with survival rates of 78.1% vs. 96.6% in patients with vs. without myosteatosis, respectively. To conclude, this study underscores the relevance of MFA in the nutritional characterization of patients with IPF, demonstrating its potential to identify specific phenotypes associated with malnutrition, functional impairment, and the presence of <b>myoesteatosis,</b> thereby providing a valuable tool for clinical decision-making.
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spelling doaj-art-6891ae011b2a4fd78b7aff76f484dfea2025-08-20T03:13:50ZengMDPI AGLife2075-17292025-03-0115451610.3390/life15040516The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control StudyAlicia Sanmartín-Sánchez0Rocío Fernández-Jiménez1Eva Cabrera-César2Francisco Espíldora-Hernández3Isabel Vegas-Aguilar4María del Mar Amaya-Campos5Fiorella Ximena Palmas-Candia6Josefina Olivares-Alcolea7Víctor José Simón-Frapolli8Isabel Cornejo-Pareja9Ana Sánchez-García10Mora Murri11Patricia Guirado-Peláez12Álvaro Vidal-Suárez13Lourdes Garrido-Sánchez14Francisco J. Tinahones15Jose Luis Velasco-Garrido16Jose Manuel García-Almeida17Department of Endocrinology and Nutrition, Son Espases University Hospital, 07120 Mallorca, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Neumology, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Neumology, Regional University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainEndocrinology and Nutrition Department, Vall D’Hebron University Hospital, 08035 Barcelona, SpainDepartment of Endocrinology and Nutrition, Son Espases University Hospital, 07120 Mallorca, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Neumology, Virgen de la Victoria University Hospital, 29010 Malaga, SpainDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Malaga, SpainThere is increasing evidence supporting the use of morphofunctional assessment (MFA) as a tool for clinical characterization and decision-making in malnourished patients. MFA enables the diagnosis of malnutrition, sarcopenia, obesity, and cachexia, leading to a novel phenotype-based classification of nutritional disorders. Bioelectrical impedance analysis (BIVA), nutritional ultrasound<sup>®</sup> (NU) and computed tomography (CT) are included, along with functional tests like the Timed Up and Go test (TUG). Myoesteatosis, detectable via CT, can occur independently from nutritional phenotypes and has been identified as a significant mortality predictor in idiophatic pulmonary fibrosis (IPF). Our aim is to analyze the prevalence and overlap of nutritional phenotypes in IPF and evaluate the prognostic value of myoesteatosis. Our bicenter cross-sectional study included 82 IPF patients (84.1% male and with a medium age of 71.1 ± 7.35 years). MFA was performed using BIVA, NU, CT at the T12 level (CT-T12), the handgrip strength (HGS) test, and the TUG. CT-T12 BC parameters were analyzed using FocusedON<sup>®</sup> software, while statistical analyses were conducted with JAMOVI version 2.3.22. All four major nutritional phenotypes were represented in our cohort, with significant overlap. A total of 80.5% met the GLIM criteria for malnutrition, 14.6% had cachexia, 17% were sarcopenic, and 28% were obese. Of the obese patients, 70% were also malnourished, while 100% of sarcopenic obese patients (5.9% of total) had malnutrition. A total of 55% of sarcopenic patients with available CT also had myosteatosis, suggesting muscle quality deterioration as a potential driver of functional impairment. The presence of myosteatosis > 15% in T12-CT was an independent predictor of 12-month mortality (HR = 3.13; 95% CI: 1.01–9.70; <i>p</i> = 0.049), with survival rates of 78.1% vs. 96.6% in patients with vs. without myosteatosis, respectively. To conclude, this study underscores the relevance of MFA in the nutritional characterization of patients with IPF, demonstrating its potential to identify specific phenotypes associated with malnutrition, functional impairment, and the presence of <b>myoesteatosis,</b> thereby providing a valuable tool for clinical decision-making.https://www.mdpi.com/2075-1729/15/4/516idiopathic pulmonary fibrosismorphofunctional assessmentbody compositionsarcopeniacachexiamyoesteatosis
spellingShingle Alicia Sanmartín-Sánchez
Rocío Fernández-Jiménez
Eva Cabrera-César
Francisco Espíldora-Hernández
Isabel Vegas-Aguilar
María del Mar Amaya-Campos
Fiorella Ximena Palmas-Candia
Josefina Olivares-Alcolea
Víctor José Simón-Frapolli
Isabel Cornejo-Pareja
Ana Sánchez-García
Mora Murri
Patricia Guirado-Peláez
Álvaro Vidal-Suárez
Lourdes Garrido-Sánchez
Francisco J. Tinahones
Jose Luis Velasco-Garrido
Jose Manuel García-Almeida
The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
Life
idiopathic pulmonary fibrosis
morphofunctional assessment
body composition
sarcopenia
cachexia
myoesteatosis
title The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
title_full The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
title_fullStr The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
title_full_unstemmed The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
title_short The Nutritional Phenotyping of Idiopathic Pulmonary Fibrosis Through Morphofunctional Assessment: A Bicentric Cross-Sectional Case–Control Study
title_sort nutritional phenotyping of idiopathic pulmonary fibrosis through morphofunctional assessment a bicentric cross sectional case control study
topic idiopathic pulmonary fibrosis
morphofunctional assessment
body composition
sarcopenia
cachexia
myoesteatosis
url https://www.mdpi.com/2075-1729/15/4/516
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