Valeria Succa

NUTRITIONAL AND PSYCHO-FUNCTIONAL STATUS IN ELDERLY PATIENTS WITH ALZHEIMER'S DISEASE

ObjectivesAnalysis of variations of nutritional status in relation to psycho-functional conditions in elderly patients with mild to moderate Alzheimer’s disease (AD) by means of bioelectrical impedance vector analysis (BIVA).DesignCross-sectional study. Setting: Alzheimer Center, SS. Trinità Hospital, Cagliari (Italy).Participants83 free-living patients (29 men, 54 women) with mild-moderate Alzheimer’s disease, aged 66 to 96 years, and 91 age-matched controls (37 men and 54 women).MeasurementsNutritional status was evaluated by anthropometry (weight, height, waist and upper arm circumferences, triceps skinfold; body mass index, BMI; arm muscle area, AMA); Mini Nutritional Assessment, MNA®; bioelectrical impedance vector analysis, BIVA. Psycho-functional status was assessed by the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL).ResultsCompared to the control groups, patients with Alzheimer’s disease had a worse psycho-functional and nutritional status. BIVA detected lower body cell mass in Alzheimer’s patients with respect to controls (men: T2= 23.4; women: T2=27.3; p<0.01), as well as in the female patients with lower levels of IADL and MMSE (respectively, T2= 8.0; T2=7.4; p<0.05). In patients with AD, a worse psycho-functional status was associated with obesity.ConclusionThe psycho-functional decline of patients with AD is related to body composition variations, with a relative increase of fat mass with respect to the muscle component. The BIVA technique distinguished patients from controls and patients with different levels of cognitive decline. Therefore, it is a suitable tool for the screening and monitoring of nutritional status in Alzheimer’s disease.

GENETIC STRUCTURE OF SOUTHWESTERN CORSICA (FRANCE)

The distribution of nine red cell enzymes (ACP, ADA, AK, DIA, ESD, GLO1, PGM1, PGD, and SOD) and seven plasma proteins (C3, GC, HP, ORM, PI, PLG, and TF) was analyzed in a sample of 274 unrelated individuals from the southwestern area of Corsica (France), specifically from Ajaccio and nearby villages. The aim of the research was to study the genetic structure of Corsica and to add further to our knowledge about microgeographic variability of polymorphisms in Corsica. The analysis, carried out by genetic distances and R‐matrix through 39 alleles of 13 genetic markers, reveals a certain degree of differentiation within Corsica. The results show a genetic heterogeneity between Corsica and other European and Mediterranean populations, although the genetic differences appear to be smaller between Corsicans and Sardinians than among Corsicans and other compiled populations. Am. J. Hum. Biol. 10:567–577, 1998.

Efficacy of specific bioelectrical impedance vector analysis (BIVA) for assessing body composition in the elderly

ObjectivesThis study aimed to ascertain the efficacy of bioelectrical impedance vector analysis (BIVA) in assessing body composition in the elderly by comparing findings with the results of dual-energy X-ray absorptiometry (DXA), and to test an analytical variant of the method (specific BIVA).DesignCross-sectional study.ParticipantsThe sample comprised 207 free-living elderly individuals (75 men and 132 women) aged 65 to 93 years.MeasurementsAnthropometric and bioelectrical measurements were taken according to standard criteria. BIVA was applied using the ‘classic’ procedure and correcting bioelectrical values for body geometry to obtain an estimate of the whole-body impedivity. DXA was used as a reference body composition assessment method. BIVA (classic and specific values) and DXA findings were compared using Student’s t and Hotelling’s T2 tests, and Pearson’s correlation coefficient.ResultsIn both sexes, BIVA distinguished between individuals with different amounts of fat and fat-free mass (lean mass including bone mineral content), according to DXA, but not between those with different proportions of fat mass (FM%). Specific bioelectrical values detected changes in body composition.ConclusionBIVA should be used with caution for evaluating body composition in the elderly. Specific bioelectrical values proved effective, showing promise as a methodological variant of BIVA, suitable for identifying age-related changes in body fatness.

Red cell and serum protein polymorphisms in Sardinia

Four Sardinian population samples, from the provinces of Cagliari, Oristano, Nuoro and Sassari, were studied with regard to the erythrocyte enzyme systems ACP, ESD, PGM1, ADA, AK, 6PGD and Dia, and to the serum protein systems GC and C3. The findings showed a rather high degree of genetic heterogeneity of the Sardinians compared to the other populations from the Mediterranean area (Continental Italy, Sicily, Spain, North Africa).

A new, effective and low cost three-dimensional approach for the estimation of upper-limb volume

The aim of this research was to validate a new procedure (SkanLab) for the three-dimensional estimation of total arm volume. SkanLab is based on a single structured-light Kinect sensor (Microsoft, Redmond, WA, USA) and on Skanect (Occipital, San Francisco, CA, USA) and MeshLab (Visual Computing Lab, Pisa, Italy) software. The volume of twelve plastic cylinders was measured using geometry, as the reference, water displacement and SkanLab techniques (two raters and repetitions). The right total arm volume of thirty adults was measured by water displacement (reference) and SkanLab (two raters and repetitions). The bias and limits of agreement (LOA) between techniques were determined using the Bland–Altman method. Intra- and inter-rater reliability was assessed using the intraclass correlation coefficient (ICC) and the standard error of measurement. The bias of SkanLab in measuring the cylinders volume was −21.9 mL (−5.7%) (LOA: −62.0 to 18.2 mL; −18.1% to 6.7%) and in measuring the volume of arms’ was −9.9 mL (−0.6%) (LOA: −49.6 to 29.8 mL; −2.6% to 1.4%). SkanLab’s intra- and inter-rater reliabilities were very high (ICC >0.99). In conclusion, SkanLab is a fast, safe and low-cost method for assessing total arm volume, with high levels of accuracy and reliability. SkanLab represents a promising tool in clinical applications.

Serum Protein Markers in the Piaroa Indians of Amazonia (Venezuela)

A sample of 121 Piaroa Indians from the Federal Amazonia Territory (Venezuela) was studied for the following serum protein polymorphisms: haptoglobin (HP), group-specific component subtypes (GC), orosomucoid (ORM), third component of complement (C3), transferrin C subtypes (TF) and alpha 1-antitrypsin subtypes (PI). The gene frequencies in the whole sample were: HP1 = 0.821; GC1S = 0.698; GC1F = 0.058; GC2 = 0.244; ORMS = 0.434; C3S = 0.699; C3F = 0.289; C3var = 0.012; TFC1 = 0.955; PIM1 = 0.467; PIM2 = 0.004; PIM3 = 0.529. The studied Piaroa sample came from three different communities: Gavilan, Paria and Alto Carinagua. The distribution of GC, C3 and HP polymorphisms was heterogeneous within the three groups. All the examined serum protein markers were polymorphic, in contrast to some enzymatic markers (ADA, DIA, 6PGD, AK) previously studied, which were shown to be monomorphic in the Piaroa. The results were compared with data from other populations living in the same territory.

Elderly subjects with type 2 diabetes show altered tissue electrical properties

OBJECTIVE The aim of the present research was to show the characteristics of body composition in a sample of elderly subjects with type 2 diabetes compared with healthy controls matched by age and body mass index (BMI) by bioelectrical impedance vector analysis. METHODS The sample consisted of 144 free-living patients (84 women and 60 men) with type 2 diabetes 60 to 84 y old and 209 age-matched controls (116 women and 93 men). Anthropometric measurements (weight; height; upper arm, hip, waist, and calf circumferences; biceps; triceps; and subscapular and suprailiac skinfolds) were taken. Blood samples for the assessment of plasma glucose and glycated hemoglobin were collected. The BMI, upper arm muscular area, and waist-to-hip ratio were calculated. Bioelectrical impedance vector analysis was applied. The analysis was performed in the entire diabetic sample and the healthy BMI-matched groups. RESULTS Compared with healthy subjects, patients had greater weight (P < 0.01 in women), higher BMI (P < 0.01 in women), smaller muscular area (P < 0.01 in men), and thicker skinfolds (P < 0.01 in women and men). Female and male patients showed larger phase angles (P < 0.01). Moreover, female patients showed a shorter vector length and lower resistance (P < 0.01) and male patients showed a higher reactance (P < 0.01). The BMI-matched analysis confirmed that patients were characterized by larger phase angles. CONCLUSIONS Older patients with type 2 diabetes were characterized by peculiar anthropometric and bioelectrical patterns, which can be related to their smaller appendicular muscular area and lower extracellular/intracellular water ratio.

Gc and C3 Polymorphisms in South Sardinia

The distribution of phenotypes and gene frequencies of the group-specific component (Gc) and C3 complement were studied in South Sardinia. The gene frequencies were: Gc1 = 0.7346; C3F = 0.1963.

Gc and C3 Polymorphisms in Central Sardinia

The distribution of phenotypes and gene frequencies of the group-specific component (Gc) and C3 complement were studied in Central Sardinian sample. The gene frequencies were:Gc1 = 0.733; C3F = 0.237.

Specific BIVA recognizes variation of body mass and body composition: Two related but different facets of nutritional status

OBJECTIVE The aim of this study was to demonstrate the different information provided by body mass index (BMI) in combination with specific bioelectrical impedance vector analysis (specific BIVA) in the measure of relative body fat. METHODS Anthropometric and bioelectrical values and dual-energy x-ray absorpitometry measurements from a sample of 1590 US adults of both sexes were retrieved from the National Health and Nutrition Examination Survey 2003-2004. The sample distribution of the BMI of each sex was divided into deciles. Quartiles were calculated for percent fat mass (FM%) after stratifying by BMI deciles. Body composition and bioelectrical characteristics of groups below the first and above the third quartile were compared using analysis of variance and the Hotellings T-square test. RESULTS BMI and specific BIVA showed a different accuracy in detecting body composition variations: BMI showed similar values in groups represented by different FM percentages, whereas the bioelectrical differences were statistically significant. The mean impedance vectors corresponding to cases below the first FM% quartiles were shorter and located on the left side of the ellipses (the region of higher fat-free mass), whereas those above the third FM% quartiles were on the right and toward the upper pole (the region of higher FM%). CONCLUSIONS Specific BIVA is a technique for the evaluation of body composition which can add relevant information regarding BMI.