Abstract Rationale Pulmonary tuberculosis (TB) often leads to weight loss and muscle wasting that can impair recovery. Sarcopenia has been reported in 30-40% of patients affected by TB. However, muscle condition at the time of TB diagnosis is rarely assessed objectively. This study aimed to determine whether patients newly diagnosed with TB already meet the criteria for malnutrition and sarcopenia, and to evaluate their inflammatory status. Methods We conducted a cross-sectional study including 18 adults recently diagnosed with pulmonary TB, either untreated or within the first week of initiating therapy. Nutritional status was assessed using the GLIM criteria for malnutrition, and body composition was analyzed through bioelectrical impedance analysis (BIA). Serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured to evaluate inflammatory status. Muscle strength was assessed using a digital hand dynamometer on the dominant hand. In 13 participants, musculoskeletal ultrasound of the dominant lower limb was performed to assess the thickness of the rectus femoris, vastus intermedius, gastrocnemius, and soleus muscles. Muscle tissue quality was further quantified through grayscale analysis of ultrasound images using ImageJ software (NIH, Bethesda, Maryland, USA). Results At diagnosis, 16 of 18 patients (89%) met the GLIM criteria for malnutrition. Low muscle mass and low muscle strength were each observed in 50% of participants, with 39% meeting the European consensus criteria for sarcopenia. Mean quadriceps thickness (rectus femoris + vastus intermedius) was 2.6 cm, corresponding to the lower limit of normality reported in adults. Mean rectus femoris echo intensity was 75 grayscale units, indicating increased intramuscular fat infiltration. Mean CRP and IL-6 were 6.2 mg/dL and 23 pg/mL, respectively, reflecting moderately elevated inflammatory activity at diagnosis. Patients with higher CRP and IL-6 tended to have lower skeletal muscle index (SMI) and quadriceps thickness, suggesting inflammation-associated muscle wasting and early functional impairment. Detailed data stratified by sex are presented in Table 1. Conclusion At the time of pulmonary TB diagnosis, nearly all participants met strict criteria for malnutrition, and a considerable proportion also fulfilled established criteria for sarcopenia. Muscle ultrasound analysis revealed reduced muscle quantity and quality. These findings highlight the importance of early nutritional and rehabilitative assessment at TB diagnosis to address sarcopenia and improve treatment outcomes. The prognostic value of these parameters, along with strategies for the prevention, management, and monitoring of sarcopenia, should be further evaluated in future studies. This abstract is funded by: None
Aguirre et al. (Fri,) studied this question.