Qin Zheng, Lu Kai, Jiang Tiantian, Wang Mei, Weng Yue, Tang Xiaoqiong, Zhao Yu
Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
Int J Gen Med. 2022 Feb 9;15:1261-1269. doi: 10.2147/IJGM.S351241. eCollection 2022.
We aimed to explore the potential association of body composition parameters measured by bioelectrical impedance analysis (BIA) with the incidence of sarcopenia in patients with acute myeloid leukemia (AML) (non-M3) after chemotherapy.
This was a single-center observational study. Sixty-nine patients with newly diagnosed AML underwent BIA at the time of initial diagnosis and after completion of three chemotherapy sessions. Pre- and post-chemotherapy BIA parameters were compared. Sarcopenia was defined as low skeletal muscle mass plus low muscle strength according to the Asian Working Group for Sarcopenia (AWGS). Association of sarcopenia with mid-arm muscle circumference (MAMC) and intracellular water (ICW) was assessed by multivariate logistic regression.
There was a significant increase in the prevalence of sarcopenia after chemotherapy (39.1% vs 14.5%, <0.001). Skeletal muscle mass (SMM), fat-free mass (FFM), and soft lean mass (SLM) showed a significant decrease after chemotherapy (<0.05). MAMC, ICW, and total body water (TBW) significantly decreased after chemotherapy (<0.05). BIA indices including appendicular skeletal muscle mass (ASM) (=0.889, <0.001), ICW (=0.869, <0.001), MAMC (=0.849, <0.001) showed a positive correlation with SMI. Moreover, ASM (=-0.453 =0.001), ICW (=-0.322, <0.05), and MAMC (=-0.352, <0.05) showed a negative correlation with sarcopenia. On multivariate logistic regression analysis, increased ICW was associated with decreased risk of sarcopenia [odds ratio (OR): 0.50; 95% confidence interval (CI) 0.30-0.82]. Each additional unit of MAMC after chemotherapy was associated with 71% lower risk of sarcopenia (OR: 0.29; 95% CI 0.13-0.66).
The incidence of sarcopenia was associated with chemotherapy of patients with AML (non-M3) as reflected by body composition changes.
我们旨在探讨通过生物电阻抗分析（BIA）测量的身体成分参数与急性髓系白血病（AML，非M3型）患者化疗后肌肉减少症发生率之间的潜在关联。
这是一项单中心观察性研究。69例新诊断的AML患者在初诊时及完成三个化疗疗程后接受了BIA检测。比较化疗前后的BIA参数。根据亚洲肌肉减少症工作组（AWGS）的标准，肌肉减少症定义为骨骼肌质量低加上肌肉力量低。通过多因素逻辑回归评估肌肉减少症与上臂中部肌肉周长（MAMC）和细胞内水（ICW）的关联。
化疗后肌肉减少症的患病率显著增加（39.1%对14.5%，P<0.001）。化疗后骨骼肌质量（SMM）、去脂体重（FFM）和软瘦体重（SLM）显著下降（P<0.05）。化疗后MAMC、ICW和全身水（TBW）显著下降（P<0.05）。包括四肢骨骼肌质量（ASM）（r=0.889，P<0.001）、ICW（r=0.869，P<0.001）、MAMC（r=0.849，P<0.001）在内的BIA指数与骨骼肌指数（SMI）呈正相关。此外，ASM（r=-0.453，P=0.001）、ICW（r=-0.322，P<0.05）和MAMC（r=-0.352，P<0.05）与肌肉减少症呈负相关。多因素逻辑回归分析显示，ICW增加与肌肉减少症风险降低相关[比值比（OR）：0.50；95%置信区间（CI）0.30-0.82]。化疗后MAMC每增加一个单位，肌肉减少症风险降低71%（OR：0.29；95%CI 0.13-0.66）。
如身体成分变化所示，肌肉减少症的发生率与AML（非M3型）患者的化疗有关。
