Adductor pollicis muscle and handgrip strength: potential methods of nutritional assessment in surgical patients
10.15343/0104-7809.202145595605
Keywords:
Anthropometry. Nutritional status. Hospitalization. Patient care.Abstract
Measurements of the adductor pollicis muscle thickness (APMT) and handgrip strength (HGS) are easy and quick to apply, low cost, and may detect changes in nutritional status in the short term. The use of these measurements would speed up the nutritional diagnosis and optimize the care of hospitalized patients. The aim of this study was to evaluate the association between APMT and HGS with anthropometric parameters, subjective global assessment (SGA), and biochemical markers in patients admitted for digestive tract and adnexal organ surgery. This is a cross-sectional study in which body mass index (BMI), arm circumference (AC), triceps skinfold thickness, arm muscle circumference, APMT, HGS, SGA and biochemical variables were evaluated. A total of 56 patients participated, showing that the increase of one unit in the AC promoted an increase of 0.73 kgf in the HGS (95%CI: 0.30;1.17, p=0.002). A one-unit increase in normal weight, AC, and serum albumin adjusted for height, age, and gender was associated with higher APMT values (normal weight: 0.92 mm, 95%CI: 0.18;1.66, p=0.017; AC: 0.69 mm, 95%CI: 0.27;1.11, p=0.006; serum albumin 1.83 mm, 95%CI: 0.10;3.57, p=0.039). On the other hand, the increase of one unit in weight loss (%) and BMI resulted in a reduction of 0.85 mm (95%CI: -1.46;-0.25, p=0.008) and 2.80 mm in the APMT (95%CI: -4.73;-0.88, p=0.006), respectively. There is a positive association between HGS and AC and between APMT, normal weight, AC, and serum albumin, and an inverse association between APMT, BMI, and percentage of weight loss.
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References
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7. Bragagnolo R, Caporossi FS, Dock-Nascimento DB, de Aguilar-Nascimento JE. Espessura do músculo adutor do polegar: um método rápido e confiável na avaliação nutricional de pacientes cirúrgicos. Rev Col Bras Cir. 2009;36(5):371-376. doi: 10.1590/s0100-69912009000500003.
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12. Melo CYSV, Silva SA. Músculo adutor do polegar como preditor de desnutrição em pacientes curúrgicos. ABCD Arq Bras Cir Dig. 2014;27(1):13-17. doi: 10.1590/S0102-67202014000100004.
13. World Health Organization (WHO). Obesity : preventing and managing the global epidemic : report of a WHO consultation. [Internet]. 2000 [Acessado 2021 Mar 3]. Disponível em: https://apps.who.int/iris/handle/10665/42330.
14. Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1): 55-67. doi: 10.1016/S0095-4543(21)00452-8.
15. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Hum Kinet Books; 1988.
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17. Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981;34(11):2540-2545. doi: 10.1093/ajcn/34.11.2540.
18. Lameu EB, Gerude MF, Corrêa RC, Lima KA. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin Med. 2004;59(2):57– 62. doi: 10.1590/S0041-87812004000200002.
19. Jamal SA, Leiter RE, Jassal V, Hamilton CJ, Bauer DC. Impaired muscle strength is associated with fractures in hemodialysis patients. Osteoporos Int. 2006;17(9):1390-1397. doi: 10.1007/s00198-006-0133-y.
20. Schlüssel MM, dos Anjos LA, de Vasconcellos MTL, Kac G. Reference values of handgrip dynamometry of healthy adults: a population-based study. Clin Nutr. 2008;27(4):601-607. doi: 10.1016/j.clnu.2008.04.004.
21. Detsky A, McLaughlin J, Baker J, Johnston N, Whittaker S, Mendelson R, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11(1):8-13. doi: 10.1177/014860718701100108.
22. Pereira TG, da Silva Fink J, Silva FM. Thickness of the adductor pollicis muscle: accuracy in predicting malnutrition and length of intensive care unit stay in critically ill surgical patients: thickness of the adductor pollicis muscle in surgical critically patients. Clin Nutr ESPEN. 2018;24: 165-169. doi: 10.1016/j.clnesp.2017.10.013.
23. Caporossi FS, Caporossi C, Borges Dock-Nascimento D, Aguilar-Nascimento JE. Measurement of the thickness of the adductor pollicis muscle as a predictor of outcome in critically ill patients. Nutr Hosp. [Internet]. 2012 Abr [citado 2021 Oct 25];27(2):490-495. Disponível em: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000200021&lng=es.
24. Pereira PML, Neves FS, Bastos MG, Candido APC. Aducctor Pollicis Muscle Thickness for nutritional assessment: a systematic review. Rev Bras Enferm. 2018;71(6):3093-3102. doi: 10.1590/0034-7167-2017-0913.
25. de Oliveira CMC, Kubrusly M, Mota RS, Choukroun G, Neto JB, da Silva CAB. Adductor pollicis muscle thickness: a promising anthropometric parameter for patients with chronic renal failure. J Ren Nutr. 2012;22(3):307-316. doi: 10.1053/j.jrn.2011.07.006.
26. Araújo MAR, Lima LS, Ornelas GC, Logrado MHG. Análise comparativa de diferentes métodos de triagem nutricional do paciente internado. Comun Ciências Saúde. [Internet]. 2010 [citado 2021 Oct 25];21(4):331-342. Disponível em: https://bvsms.saude.gov.br/bvs/ artigos/analise_comparativa.pdf.
27. Saka B, Ozturk GB, Uzun S, Erten N, Genc S, Karan MA, et al. Nutritional risk in hospitalized patients: impact of nutritional status on serum prealbumin. Rev Nutr. 2011;24(1):89-98. doi: 10.1590/S1415-52732011000100009.
28. Biagulo BF, Fortes RC. Métodos subjetivos e objetivos de avaliação do estado nutricional de pacientes oncológicos. Comun Ciências Saúde. [Internet]. 2013 [citado 2021 Oct 26]; 24(2):131-144. Disponível em: https://bvsms.saude.gov.br/bvs/artigos/ccs/metodos_subjetivos_ objetivos_avaliacao_oncologicos.pdf.
29. Bell JA, Carslake D, O'Keeffe LM, Frysz M, Howe LD, Hamer M, et al. Associations of body mass and fat indexes with cardiometabolic traits. J Am Coll Cardiol. 2018;72(24):3142-3154. doi: 10.1016/j.jacc.2018.09.066.
30. Costa TY, Suganuma JY, de Faria S, Spexoto MCB. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals. Nutr Hosp. 2021;38(3):519-524. doi: 10.20960/nh.03319.
31. Keller U. Nutritional laboratory markers in malnutrition. J Clin Med. 2019;8(6):775. doi:10.3390/jcm8060775
32. Soares BGFS, Vicentini AP. Use of adductor pollicis muscle thickness in hospitalized or ambulatory patients: a systematic review. Rev Latino-Am Enfermagem. 2018;26:e2960. doi: 10.1590/1518-8345.2045.2960.
33. Ghorabi S, Ardehali H, Amiri Z, Shariatpanahi ZV. Association of the adductor pollicis muscle thickness with clinical outcomes in intensive care unit patients. Nutr Clin Pract. 2016;31(4):523-526. doi: 10.1177/0884533615621547.
34. Gonzalez MC, Duarte RRP, Orlandi SP, Bielemann RM, Barbosa-Silva TG. Adductor pollicis muscle: A study about its use as a nutritional parameter in surgical patients. Clin Nutr. 2015;34(5):1025- 1029. doi: 10.1016/j.clnu.2014.11.006.
35. Gonçalves LB, de Jesus NMT, Gonçalves MB, Dias LCG, Deiró TCBJ. Preoperative nutritional status and clinical complications in the postoperative period of cardiac surgeries. Braz J Cardiovasc Surg. 2016;31(5):371-380. doi:10.5935/1678- 9741.20160077.
36. Budziareck MB, Duarte RRP, Barbosa-Silva MCG. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008; 27(3):357-362. doi: 10.1016/j.clnu.2008.03.008.
37. Valente KP, Almeida BL, Lazzarini TR, de Souza VF, Ribeiro TSC, Moraes RAG, et al. Association of Adductor Pollics Muschle Thickness and Handgrip Strength with nutritional status in cancer patients. PloS ONE. 2019;14(8):e0220304. doi: 10.1371/journal.pone.0220334.
38. Olguín T, Bunout D, de la Maza MP, Barrera G, Hirsch S. Admission handgrip strength predicts functional decline in hospitalized patients. Clin Nutr ESPEN. 2017;17:28-32. doi: 10.1016/j.clnesp.2016.12.001
2. de Paula JPBR, Lopes MG, dos Reis JM. Nutrição em cirurgia: revisão de literatura/ Nutrition in surgery: literature review. Rev Cienc Saude [Internet]. 1 [citado 24º de outubro de 2021];3(2):93-105. Disponível em: http://186.225.220.186:7474/ojs/index.php/rcsfmit_zero/article/ view/247.
3. Lim SL, Ong KC, Chan YH, Loke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31(3):345-350. doi: 10.1016/j.clnu.2011.11.001.
4. de Aguilar-Nascimento JE, Salomão AB, Waitzberg DL, Dock-Nascimento DB, Correa MITD, Campos ACL, et al. ACERTO guidelines of perioperative nutritional interventions in elective general surgery. Rev Col Bras Cir. 2017;44(6):633-648. doi: 10.1590/0100-69912017006003.
5. Paz LSC, Couto AV. Avaliação nutricional em pacientes críticos: revisão de literatura. Braspen J. 2016;31:269-277. Disponível em: http:// www.braspen.com.br/home/wp-content/uploads/2016/11/16-Avalia%C3%A7%C3%A3o-nutri-em-pacentes-criticos.pdf.
6. Valente KP, Almeida BL, Lazzarini TR, de Souza VF, Ribeiro TSC, de Moraes RAG, et al. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in cancer patients. PLoS One 2019;14(8):e0220334. doi: 10.1371/journal.pone.0220334.
7. Bragagnolo R, Caporossi FS, Dock-Nascimento DB, de Aguilar-Nascimento JE. Espessura do músculo adutor do polegar: um método rápido e confiável na avaliação nutricional de pacientes cirúrgicos. Rev Col Bras Cir. 2009;36(5):371-376. doi: 10.1590/s0100-69912009000500003.
8. Lucio AGP, Lugo MJR, Campos CIV, Acevedo OG, Martínez MLA, Hernández DG, et al. Fuerza de agarre como predictor de composición corporal en estudiantes universitarias. Rev Chil Nutr. 2020; 47:604-611. doi: 10.4067/S0717-75182020000400604.
9. Rechinelli AB, Marques IL, Viana ECRM, Oliveira IS, de Souza VF, Petarli GB, et al. Presence of dynapenia and association with anthropometric variables in cancer patients. BMC Cancer. 2020;20(1):1010. doi: 10.1186/s12885-020-07519-4.
10. Hu CL, Yu M, Yuan KT, Yu HL, Shi YY, Yang JJ, et al. Determinants and nutritional assessment value of hand grip strength in patients hospitalized with cancer. Asia Pac J Clin Nutr. 2018;27:777-784. doi: 10.6133/apjcn.072017.04.
11. Pereira GA. Acurácia de diferentes indicadores para avaliar o estado nutricional de adultos. Santa Maria: Universidade Federal de Santa Maria – UFSM, 2016. Dissertação em Educação Física.
12. Melo CYSV, Silva SA. Músculo adutor do polegar como preditor de desnutrição em pacientes curúrgicos. ABCD Arq Bras Cir Dig. 2014;27(1):13-17. doi: 10.1590/S0102-67202014000100004.
13. World Health Organization (WHO). Obesity : preventing and managing the global epidemic : report of a WHO consultation. [Internet]. 2000 [Acessado 2021 Mar 3]. Disponível em: https://apps.who.int/iris/handle/10665/42330.
14. Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1): 55-67. doi: 10.1016/S0095-4543(21)00452-8.
15. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Hum Kinet Books; 1988.
16 Frisancho AR. Anthropometric Standards for the Assessment of Growth and Nutritional Status. Ann Arbor, Michigan: University of Michigan Press; 1990.
17. Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981;34(11):2540-2545. doi: 10.1093/ajcn/34.11.2540.
18. Lameu EB, Gerude MF, Corrêa RC, Lima KA. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin Med. 2004;59(2):57– 62. doi: 10.1590/S0041-87812004000200002.
19. Jamal SA, Leiter RE, Jassal V, Hamilton CJ, Bauer DC. Impaired muscle strength is associated with fractures in hemodialysis patients. Osteoporos Int. 2006;17(9):1390-1397. doi: 10.1007/s00198-006-0133-y.
20. Schlüssel MM, dos Anjos LA, de Vasconcellos MTL, Kac G. Reference values of handgrip dynamometry of healthy adults: a population-based study. Clin Nutr. 2008;27(4):601-607. doi: 10.1016/j.clnu.2008.04.004.
21. Detsky A, McLaughlin J, Baker J, Johnston N, Whittaker S, Mendelson R, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11(1):8-13. doi: 10.1177/014860718701100108.
22. Pereira TG, da Silva Fink J, Silva FM. Thickness of the adductor pollicis muscle: accuracy in predicting malnutrition and length of intensive care unit stay in critically ill surgical patients: thickness of the adductor pollicis muscle in surgical critically patients. Clin Nutr ESPEN. 2018;24: 165-169. doi: 10.1016/j.clnesp.2017.10.013.
23. Caporossi FS, Caporossi C, Borges Dock-Nascimento D, Aguilar-Nascimento JE. Measurement of the thickness of the adductor pollicis muscle as a predictor of outcome in critically ill patients. Nutr Hosp. [Internet]. 2012 Abr [citado 2021 Oct 25];27(2):490-495. Disponível em: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112012000200021&lng=es.
24. Pereira PML, Neves FS, Bastos MG, Candido APC. Aducctor Pollicis Muscle Thickness for nutritional assessment: a systematic review. Rev Bras Enferm. 2018;71(6):3093-3102. doi: 10.1590/0034-7167-2017-0913.
25. de Oliveira CMC, Kubrusly M, Mota RS, Choukroun G, Neto JB, da Silva CAB. Adductor pollicis muscle thickness: a promising anthropometric parameter for patients with chronic renal failure. J Ren Nutr. 2012;22(3):307-316. doi: 10.1053/j.jrn.2011.07.006.
26. Araújo MAR, Lima LS, Ornelas GC, Logrado MHG. Análise comparativa de diferentes métodos de triagem nutricional do paciente internado. Comun Ciências Saúde. [Internet]. 2010 [citado 2021 Oct 25];21(4):331-342. Disponível em: https://bvsms.saude.gov.br/bvs/ artigos/analise_comparativa.pdf.
27. Saka B, Ozturk GB, Uzun S, Erten N, Genc S, Karan MA, et al. Nutritional risk in hospitalized patients: impact of nutritional status on serum prealbumin. Rev Nutr. 2011;24(1):89-98. doi: 10.1590/S1415-52732011000100009.
28. Biagulo BF, Fortes RC. Métodos subjetivos e objetivos de avaliação do estado nutricional de pacientes oncológicos. Comun Ciências Saúde. [Internet]. 2013 [citado 2021 Oct 26]; 24(2):131-144. Disponível em: https://bvsms.saude.gov.br/bvs/artigos/ccs/metodos_subjetivos_ objetivos_avaliacao_oncologicos.pdf.
29. Bell JA, Carslake D, O'Keeffe LM, Frysz M, Howe LD, Hamer M, et al. Associations of body mass and fat indexes with cardiometabolic traits. J Am Coll Cardiol. 2018;72(24):3142-3154. doi: 10.1016/j.jacc.2018.09.066.
30. Costa TY, Suganuma JY, de Faria S, Spexoto MCB. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals. Nutr Hosp. 2021;38(3):519-524. doi: 10.20960/nh.03319.
31. Keller U. Nutritional laboratory markers in malnutrition. J Clin Med. 2019;8(6):775. doi:10.3390/jcm8060775
32. Soares BGFS, Vicentini AP. Use of adductor pollicis muscle thickness in hospitalized or ambulatory patients: a systematic review. Rev Latino-Am Enfermagem. 2018;26:e2960. doi: 10.1590/1518-8345.2045.2960.
33. Ghorabi S, Ardehali H, Amiri Z, Shariatpanahi ZV. Association of the adductor pollicis muscle thickness with clinical outcomes in intensive care unit patients. Nutr Clin Pract. 2016;31(4):523-526. doi: 10.1177/0884533615621547.
34. Gonzalez MC, Duarte RRP, Orlandi SP, Bielemann RM, Barbosa-Silva TG. Adductor pollicis muscle: A study about its use as a nutritional parameter in surgical patients. Clin Nutr. 2015;34(5):1025- 1029. doi: 10.1016/j.clnu.2014.11.006.
35. Gonçalves LB, de Jesus NMT, Gonçalves MB, Dias LCG, Deiró TCBJ. Preoperative nutritional status and clinical complications in the postoperative period of cardiac surgeries. Braz J Cardiovasc Surg. 2016;31(5):371-380. doi:10.5935/1678- 9741.20160077.
36. Budziareck MB, Duarte RRP, Barbosa-Silva MCG. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008; 27(3):357-362. doi: 10.1016/j.clnu.2008.03.008.
37. Valente KP, Almeida BL, Lazzarini TR, de Souza VF, Ribeiro TSC, Moraes RAG, et al. Association of Adductor Pollics Muschle Thickness and Handgrip Strength with nutritional status in cancer patients. PloS ONE. 2019;14(8):e0220304. doi: 10.1371/journal.pone.0220334.
38. Olguín T, Bunout D, de la Maza MP, Barrera G, Hirsch S. Admission handgrip strength predicts functional decline in hospitalized patients. Clin Nutr ESPEN. 2017;17:28-32. doi: 10.1016/j.clnesp.2016.12.001
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Published
2022-02-03
How to Cite
Melo Giglio, B., Machado Schincaglia, R., Vaz de Souza Freitas, A. T., & Ferreira Stringhini, M. L. (2022). Adductor pollicis muscle and handgrip strength: potential methods of nutritional assessment in surgical patients: 10.15343/0104-7809.202145595605. O Mundo Da Saúde, 45, 595–605. Retrieved from https://revistamundodasaude.emnuvens.com.br/mundodasaude/article/view/1253
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