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PP086-MON STUDY OF THE BODY COMPOSITION AND NUTRITIONAL STATUS OF ELDERLY PATIENTS WITH OROPHARYNGEAL DYSPHAGIA
172 PP085-MON Outstanding abstract CLINICAL FEATURES OF PARKINSON’S DISEASE WHEN ONSET OF DIABETES CAME FIRST: A CASE CONTROL STUDY E. Cereda1 , M. Barichella2 , E. Cassani2 , R. Caccialanza1 , G. Pezzoli2 . 1 Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, 2 Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy Rationale: Recent literature suggests that diabetes is a risk factor for Parkinson’s disease (PD). We investigated the clinical features of idiopathic PD (IPD) patients in whom the onset of diabetes came first. Methods: We designed a case-control study. From the cohort of all new IPD patients free of vascular disease (n = 783) admitted and evaluated at our Institute over a 3-year period (2007 2010) we included all the patients with a diagnosis of diabetes prior to PD onset (n = 89) and a control group (n = 89) matched (1:1) for gender, body mass index (±1 kg/m2 ) and duration of PD (±1 year). The Unified PD Rating Scale (UPDRS) motor score was the primary endpoint. Results: At study entry, patients with diabetes were similar to controls in terms of most demographic, lifestyle and general medical features with exception of statins (18% vs. 3.4%; P = 0.003). However, diabetes was associated with higher UPDRS motor (22.3±9.0 vs. 19.3±7.9; P = 0.019) and activities of daily living (9.7±5.1 vs. 8.3±4.3; P = 0.049) scores, more severe Hoehn-Yahr staging (P = 0.009) and higher treatment doses of levodopa (mg/day, 448±265 vs. 300±213; P < 0.0001; mg/kg/day, 5.8±4.0 vs. 3.8±2.9; P < 0.0001). Conclusion: Onset of diabetes before the onset of PD appears to be a risk factor for more severe PD symptoms. These findings support the hypothesis that diabetes has a role in the etiopathogenesis of PD. Neurologists should be aware of the potential impact of diabetes on overall PD patient management. Disclosure of Interest: E. Cereda Grant/Research Support from: From Nutricia Italia, the Fondazione Grigioni per il Morbo di Parkinson and the Fondazione IRCCS Policlinico San Matteo, Consultant of: Nutricia Italia, M. Barichella: None Declared, E. Cassani: None Declared, R. Caccialanza: None Declared, G. Pezzoli: None Declared.
PP086-MON STUDY OF THE BODY COMPOSITION AND NUTRITIONAL STATUS OF ELDERLY PATIENTS WITH OROPHARYNGEAL DYSPHAGIA S. Carri´ on1 , V. Arreola1 , M. Roca2 , E. Palomera3 , P. Clav´ e1 . 1 Functional Gastrointestinal Unit, 2 Dietetic o, Matar´ o, Service, 3 Research Unit, Hospital de Matar´ Barcelona, Spain Rationale: Prospective descriptive study to assess the nutritional status and the body composition of elderly (>70 yr) patients with oropharyngeal dysphagia (OD). Methods: Diagnosis of OD by videofluoroscopy (VFS); Screening of risk of malnutrition with the Mini Nutritional Assessment (MNA); Assessment of nutritional status by anthropometric measures and bioelectrical impedance (BIA 101) and by analytical parameters (cholesterol, albumin and lymphocytes).
Poster presentations Results: 89 elderly patients (mean age: 79.1 years, 48.2% women) were diagnosed by VFS with OD associated with aging or neurological diseases, 75.3% showing impairment in both safety and efficacy of swallow; 41%, risk of malnutrition and 20.5%, malnutrition according to MNA. Patients malnourished or at risk of malnutrition presented: a) reduced lymphocyte counts (p = 0.008) and cholesterol levels below normal (<180 mg/dl) (p = 0.02) and reduced albumin levels (4.2 vs 3.4 g/dL, p < 0.001); b) reduced weight (p = 0.009), BMI (p = 0.009) and arm circumference (p = 0.01), and c) reduced muscle mass (27.8 kg vs 20 kg, p < 0.001) and intracellular water (p = 0.02) as well as reduced basal metabolism (1362.5 vs 1111.8 kcal) according to the bioimpedance study. Conclusion: 61.5% of elderly patients with oropharyngeal dysphagia present poor nutritional status with impaired analytical and anthropometric nutritional measurements as well as severe impairment in body composition including reduced muscle mass and water content. We recommend routine evaluation of nutritional and hydration status in all elderly patients with oropharyngeal dysphagia. Disclosure of Interest: None Declared.
PP087-MON MITOCHONDRIAL CAPACITY AND MYOSIN ATPASE ACTIVITY ARE IMPAIRED IN OXIDATIVE SKELETAL MUSCLES IN A RAT MODEL OF CARDIAC CACHEXIA R. Thibault1 , S. Chans´ eaume2 , K. Azarnoush3 , 4 C. Guillet , C. Giraudet4 , V. Patrac4 , J.-R. Lusson2 , N. Cano1 , Y. Boirie1 , S. Walrand4 . 1 INRA, UMR 1019, UNH, CRNH Auvergne, Clermont Universit´ e, Service de Nutrition Clinique, 2 Service de Cardiologie, 3 Service de Chirurgie Vasculaire, CHU Clermont-Ferrand, 4 INRA, UMR 1019, UNH, CRNH Auvergne, Clermont Universit´ e, Clermont-Ferrand, France Rationale: Cardiac cachexia is a severe form of undernutrition associated with heart failure. It could result from alterations in protein metabolism and mitochondrial functions in skeletal muscles and myocardium. This study aimed to assess mitochondrial protein synthesis and enzymatic activity and myosin ATPase activity in different types of muscle fibers in a rat model of cardiac cachexia. Methods: Myocardial infarction was induced in seven rats through a surgical ligation of the left coronary artery. Left ventricular dysfonction was confirmed by echocardiography. Cachexia was defined as a 7.5% loss of initial body weight. Six cachectic rats were agepaired with six control rats. After the infusion of a stable isotope ([13 C]valine), blood, muscles (soleus, gastrocnemius, tibialis anterior), heart, liver and visceral adipose tissue (VAT) were removed and weighed. The fractional synthesis rates of mitochondrial proteins (FSR) were measured using mass spectrometry. Activities of mitochondrial cytochrome c oxydase (COX) IV and citrate synthase (CS) and of myosin ATPase were measured by spectrophotometry. Results: Liver weight was significantly higher in the cachectic rats, while weight of soleus, gastrocnemius and VAT were significantly lower (p < 0.05). Soleus FSR was higher in cachectic rats (0.516±0.03%/h vs
PP086-MON STUDY OF THE BODY COMPOSITION AND NUTRITIONAL STATUS OF ELDERLY PATIENTS WITH OROPHARYNGEAL DYSPHAGIA S. Carri´ on1 , V. Arreola1 , M. Roca2 , E. Palomera3 , P. Clav´ e1 . 1 Functional Gastrointestinal Unit, 2 Dietetic o, Matar´ o, Service, 3 Research Unit, Hospital de Matar´ Barcelona, Spain Rationale: Prospective descriptive study to assess the nutritional status and the body composition of elderly (>70 yr) patients with oropharyngeal dysphagia (OD). Methods: Diagnosis of OD by videofluoroscopy (VFS); Screening of risk of malnutrition with the Mini Nutritional Assessment (MNA); Assessment of nutritional status by anthropometric measures and bioelectrical impedance (BIA 101) and by analytical parameters (cholesterol, albumin and lymphocytes).
Poster presentations Results: 89 elderly patients (mean age: 79.1 years, 48.2% women) were diagnosed by VFS with OD associated with aging or neurological diseases, 75.3% showing impairment in both safety and efficacy of swallow; 41%, risk of malnutrition and 20.5%, malnutrition according to MNA. Patients malnourished or at risk of malnutrition presented: a) reduced lymphocyte counts (p = 0.008) and cholesterol levels below normal (<180 mg/dl) (p = 0.02) and reduced albumin levels (4.2 vs 3.4 g/dL, p < 0.001); b) reduced weight (p = 0.009), BMI (p = 0.009) and arm circumference (p = 0.01), and c) reduced muscle mass (27.8 kg vs 20 kg, p < 0.001) and intracellular water (p = 0.02) as well as reduced basal metabolism (1362.5 vs 1111.8 kcal) according to the bioimpedance study. Conclusion: 61.5% of elderly patients with oropharyngeal dysphagia present poor nutritional status with impaired analytical and anthropometric nutritional measurements as well as severe impairment in body composition including reduced muscle mass and water content. We recommend routine evaluation of nutritional and hydration status in all elderly patients with oropharyngeal dysphagia. Disclosure of Interest: None Declared.
PP087-MON MITOCHONDRIAL CAPACITY AND MYOSIN ATPASE ACTIVITY ARE IMPAIRED IN OXIDATIVE SKELETAL MUSCLES IN A RAT MODEL OF CARDIAC CACHEXIA R. Thibault1 , S. Chans´ eaume2 , K. Azarnoush3 , 4 C. Guillet , C. Giraudet4 , V. Patrac4 , J.-R. Lusson2 , N. Cano1 , Y. Boirie1 , S. Walrand4 . 1 INRA, UMR 1019, UNH, CRNH Auvergne, Clermont Universit´ e, Service de Nutrition Clinique, 2 Service de Cardiologie, 3 Service de Chirurgie Vasculaire, CHU Clermont-Ferrand, 4 INRA, UMR 1019, UNH, CRNH Auvergne, Clermont Universit´ e, Clermont-Ferrand, France Rationale: Cardiac cachexia is a severe form of undernutrition associated with heart failure. It could result from alterations in protein metabolism and mitochondrial functions in skeletal muscles and myocardium. This study aimed to assess mitochondrial protein synthesis and enzymatic activity and myosin ATPase activity in different types of muscle fibers in a rat model of cardiac cachexia. Methods: Myocardial infarction was induced in seven rats through a surgical ligation of the left coronary artery. Left ventricular dysfonction was confirmed by echocardiography. Cachexia was defined as a 7.5% loss of initial body weight. Six cachectic rats were agepaired with six control rats. After the infusion of a stable isotope ([13 C]valine), blood, muscles (soleus, gastrocnemius, tibialis anterior), heart, liver and visceral adipose tissue (VAT) were removed and weighed. The fractional synthesis rates of mitochondrial proteins (FSR) were measured using mass spectrometry. Activities of mitochondrial cytochrome c oxydase (COX) IV and citrate synthase (CS) and of myosin ATPase were measured by spectrophotometry. Results: Liver weight was significantly higher in the cachectic rats, while weight of soleus, gastrocnemius and VAT were significantly lower (p < 0.05). Soleus FSR was higher in cachectic rats (0.516±0.03%/h vs