Zhu Heling, Gan Panpan, Jiang Hao, Bao Liangliang, Liu Chengjiang, Yu Jiawen
Department of Oncology, Affiliated Anqing First People's Hospital of Anhui Medical University, Anqing, China.
Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Anqing, China.
Front Med (Lausanne). 2025 Aug 6;12:1642980. doi: 10.3389/fmed.2025.1642980. eCollection 2025.
This study aims to examine the factors contributing to the increase in extracellular water to total body water ratio (ECW/TBW) among tumor patients without visible edema, and to offer insights into the diagnosis and prompt management of early water retention in such patients.
A cohort of 274 tumor patients admitted to Anqing First People's Hospital, affiliated with Anhui Medical University between December 2020 and December 2022, were selected, excluding those with clinically observable edema. General clinical data, main laboratory test outcomes, and body composition indices were gathered. Valuable variables were identified for linear regression analysis using ECW/TBW, based on professional knowledge and univariate analysis results.
Age, gender, hemoglobin, serum sodium, serum potassium, and phase angle (PA) were determined as independent influencing factors for elevated ECW/TBW. ECW/TBW increased with age (partial regression coefficient = 0.009, = 0.001), was higher in males than in females ( = -0.349, < 0.001), and was negatively affected by hemoglobin (Hgb) ( = -0.003, = 0.039). Serum sodium had a positive influence on ECW/TBW ( = 0.019, = 0.011), while serum potassium exhibited a negative effect ( = -0.180, = 0.001). PA was the most influential factor among all independent variables affecting ECW/TBW ( = -1.006, < 0.001). Nonetheless, Performance Status (PS) score, Patient-Generated Subjective Global Assessment (PG-SGA) score, tumor stage, prealbumin, albumin, and body fat percentage were not identified as independent factors influencing elevated ECW/TBW.
The early factors influencing water retention in tumor patients primarily stem from abnormal cell membrane function, but are also impacted by age, gender, anemia, and electrolyte levels. Timely body composition testing can assist in subsequent intervention decision-making.
本研究旨在探讨无明显水肿的肿瘤患者细胞外液与总体液比值（ECW/TBW）升高的相关因素，并为这类患者早期水潴留的诊断和及时处理提供见解。
选取2020年12月至2022年12月期间入住安徽医科大学附属安庆市第一人民医院的274例肿瘤患者，排除有临床可观察到水肿的患者。收集一般临床资料、主要实验室检查结果和身体成分指标。根据专业知识和单因素分析结果，确定使用ECW/TBW进行线性回归分析的有价值变量。
年龄、性别、血红蛋白、血清钠、血清钾和相位角（PA）被确定为ECW/TBW升高的独立影响因素。ECW/TBW随年龄增加而升高（偏回归系数=0.009，P=0.001），男性高于女性（P=-0.349，P<0.001），并受到血红蛋白（Hgb）的负面影响（P=-0.003，P=0.039）。血清钠对ECW/TBW有正向影响（P=0.019，P=0.011），而血清钾则呈现负向影响（P=-0.180，P=0.001）。PA是所有影响ECW/TBW的独立变量中最具影响力的因素（P=-1.006，P<0.001）。然而，体能状态（PS）评分、患者主观整体评定法（PG-SGA）评分、肿瘤分期、前白蛋白、白蛋白和体脂百分比未被确定为影响ECW/TBW升高的独立因素。
影响肿瘤患者水潴留的早期因素主要源于细胞膜功能异常，但也受年龄、性别、贫血和电解质水平的影响。及时进行身体成分检测有助于后续的干预决策。
