Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil.
Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
Nutrition. 2021 Apr;84:111122. doi: 10.1016/j.nut.2020.111122. Epub 2021 Jan 6.
Individuals with cancer are affected by a loss of cell membrane integrity due to electrolyte imbalance between the intra- and extracellular fluids. Cell membrane integrity and hydration status can be assessed according to the phase angle (PhA) and the risk for sarcopenia, by using the Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire. To our knowledge, this approach has not been validated in patients with cancer. The aims of this study were to verify the prevalence of the risk for sarcopenia, and to analyze the association between PhA and the risk for sarcopenia with and without adjustment for extracellular water content.
This was a cross-sectional study conducted with 124 male and female cancer patients (77.4% men). PhA and hydration status were assessed using bioelectrical impedance analysis (BIA), and the risk for sarcopenia (cutoff ≥4) was assessed using the SARC-F questionnaire.
Of the 124 patients, 28 (22.5%) were at risk for sarcopenia (SARC-F ≥4). There was no association between PhA and the risk for sarcopenia in the crude model, nor in the model adjusted for age, sex, smoking, alcohol consumption, and physical activity, nor after adjusting for use of supplements, body mass index, treatment type, performance status, and type and stage of cancer. However, we found an association between lower PhA values and a higher risk for sarcopenia after adjusting for hydration abnormalities (odds ratio, 1.74; 95% confidence interval, 1.03-2.93; P < 0.035).
We found that 22.5% of patients with cancer presented with a risk for sarcopenia. Additionally, an association between lower PhA values and enhanced risk for sarcopenia highlighted the importance of adequate hydration and evaluation of fluid status via BIA as a new recommendation to prevent sarcopenia.
由于细胞内外液电解质失衡，癌症患者的细胞膜完整性受到影响。细胞膜完整性和水合状态可以根据相位角（PhA）和 Strength、Assistance for walking、Rise from a chair、Climb stairs 和 Falls（SARC-F）问卷评估的肌肉减少症风险来评估。据我们所知，这种方法尚未在癌症患者中得到验证。本研究的目的是验证肌肉减少症风险的发生率，并分析 PhA 与肌肉减少症风险之间的关联，以及在不调整细胞外液含量的情况下进行调整。
这是一项横断面研究，共纳入 124 名男性和女性癌症患者（77.4%为男性）。使用生物电阻抗分析（BIA）评估 PhA 和水合状态，使用 SARC-F 问卷评估肌肉减少症风险（临界值≥4）。
在 124 名患者中，28 名（22.5%）有肌肉减少症风险（SARC-F≥4）。在未经调整的模型中，PhA 与肌肉减少症风险之间没有关联，在调整年龄、性别、吸烟、饮酒和体力活动后，以及在调整补充剂使用、体重指数、治疗类型、表现状态以及癌症类型和分期后，也没有关联。然而，我们发现，在调整水合异常后，较低的 PhA 值与较高的肌肉减少症风险之间存在关联（优势比，1.74；95%置信区间，1.03-2.93；P<0.035）。
我们发现，22.5%的癌症患者存在肌肉减少症风险。此外，较低的 PhA 值与肌肉减少症风险增加之间的关联强调了适当水合和通过 BIA 评估液体状态的重要性，这是预防肌肉减少症的新建议。
