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Abstract

Objectives: The aim of the study was to assess the relationship between body composition, nutritional status and physical ability in elderly outpatients.
Method:. In this cross-sectional study, demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic from October 2010 to February 2014. Body composition was examined using a dual-energy X-ray absorptiometry. Physical performance was assessed by gait speed (GS), Timed Up & Go Test (TUG), Six Minute Walk Test (6MWT). The nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and serum albumin level.
Results: Mean age (± SD) of 76 patients (64.47% men) was 71.93 ± 8.88 yrs. The most common diseases were: hypertension (89.47%), coronary heart disease (81.58%) and chronic heart failure (68.4%). In multiple regression analyses, the factors significantly affecting GS were: age (B = –0.017, p ≤0.0001), good nutritional status (B = 0.038, p <0.01) and percent of lower extremity fat (B = –0.009, p <0.05). Longer TUG time was associated with poorer nutritional status (B = –0.031, p <0.01), older age (B = 0.01, p <0.01) and a higher number of comorbidities (B = 0.034, p <0.05). 6MWT was influenced negatively by age (B = –3.805, p <0.01) and percent of lower extremity fat (B = –2.474, p <0.05).
Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Different measures of physical performance are influenced by different elements of body composition — no single element of body composition was found determining the deterioration of all assessed parameters of physical fitness.
Identifying the relationship between body composition, nutritional status and physical performance can help elucidate the causes of disability and target preventive measures.
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Authors and Affiliations

Paulina Fatyga-Kotula
1
Barbara Wizner
2
Małgorzata Fedyk-Łukasik
2
Tomasz Grodzicki
2
Anna Skalska
2

  1. Department of Toxicology and Occupational Diseases, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Common variable immunodeficiency (CVID) is a primary immunodeficiency disorder related to recurrent infections, as well as a range of non-infectious manifestations including autoimmune and inflammatory disorders. We hypothesized that patients with CVID and different clinical phenotypes would demonstrate alterations in lymphocyte T subsets, including T lymphocytes expressing programmed cell death protein 1 (PD-1), and regulatory T lymphocytes. We performed flow cytometry in two CVID groups: group 1 with infections only, and group 2 with infections and concomitant noninfectious manifestations. Patients were 18–59 years old (mean 35.8 years of age). Increased proportions of CD8+PD-1+ T cells and reduced regulatory T cells were associated with lymphadenopathy. Amount of regulatory T cells correlated with CD8+PD-1+ T lymphocytes (r = 0.54; p = 0.013), and with CRP (r = –0.64; p = 0.004). Forty percent of patients expressed manifestations in addition to infections (group 2), and they had reduction in number of regulatory T cells [8 (3–12) vs. 24 (11–26)/μl; p = 0.034), naive CD4+ T lymphocytes [36 (27–106) vs. 149 (81–283)/μl; p = 0.034], and elevated C-reactive protein (CRP) [5.33 (3.15–8.82) vs. 1 (1–2.16) mg/l; p = 0.003] in comparison to group 1. In conclusion, the amount of CD8+ T cells expressing PD-1 is associated with lymphadenopathy and number of regulatory T cells in patients with CVID. Patients with CVID and non-infectious complications have increased level of inflammation and alterations in regulatory T cells.
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Authors and Affiliations

Ewelina Nowak
1
Joanna Sulicka-Grodzicka
2
Magdalena Strach
1
Karolina Bukowska-Strakova
3
Maciej Siedlar
3
Mariusz Korkosz
2
ORCID: ORCID
Tomasz Grodzicki
1

  1. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Rheumatology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland

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