1
|
Chung YJ, Lee GR, Kim HS, Kim EY. Effect of rigorous fluid management using monitoring of ECW ratio by bioelectrical impedance analysis in critically ill postoperative patients: A prospective, single-blind, randomized controlled study. Clin Nutr 2024; 43:2164-2176. [PMID: 39142110 DOI: 10.1016/j.clnu.2024.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 07/11/2024] [Accepted: 07/29/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND & AIMS Precise assessment of postoperative volume status is important to administrate optimal fluid management. Bioelectrical impedance analysis (BIA) which measures the body composition using electric character. Extracellular water (ECW) ratio by BIA represented as the ratio of ECW to total body water (TBW) and is known to reflect the hydration status. Based on this, we aimed to determine whether aggressive fluid control using ECW ratio could improve clinical outcomes through a single blind, randomized controlled trial. METHODS From November 2021 to December 2022, intensive care unit (ICU) patients admitted after surgery were randomly assigned to an intervention group or a control group whether postoperative fluid management was controlled via BIA. Among patients in the intervention group, dehydrated patients received a bolus infusion with crystalloid fluid whereas diuretics were administrated to overhydrated patients until the value of ECW ratio fell within its normal setting range (0.390-0.406). Contrarily, BIA was performed once a day for the control group. Patients in the control group received traditional fluid treatment regardless of BIA results. Primary outcome was in-hospital mortality in two groups. The secondary outcomes were postoperative morbidities, 28-day mortality. RESULTS 77 patients of the intervention group and 90 patients of the control group were finally analyzed. The in-hospital mortality (0 in intervention, 4.4% in control, p = 0.125) and 28-day mortality (1.3% in intervention, 14.4% in control, p = 0.002) showed lower incidence in the intervention group than in the control group. In multivariate analysis, the overhydrated status whose ECW ratio exceeding 0.406 [odds ratio (OR): 2.731, 95% confidence interval (CI): 1.001-7.663, p = 0.049] and high capillary leak index (CLI) value at ICU admission (OR: 1.024, 95% CI: 1.008-1.039, p = 0.002) were risk factors of postoperative morbidities. Regarding the 28-day mortality, high CLI value (OR: 1.025, 95% CI: 1.002-1.050, p = 0.037) and traditional strategy without BIA monitoring (OR: 9.903, 95% CI: 1.095-89.566, p = 0.041) were the significant predisposing factors. CONCLUSION Our results revealed the rigorous fluid treatment with volume control based on ECW ratio by BIA failed to achieve significant improvement in in-hospital mortality, but it could reduce 28-day mortality of ICU patients. Monitoring of ECW ratio may help establish optimal fluid treatment strategies for postoperative ICU patients who are susceptible to fluid imbalances with fluid overload. TRIAL REGISTRATION ClinicalTrials.gov, NCT06097923, retrospectively registered on October 16, 2023, https://clinicaltrials.gov/study/NCT06097923?term=NCT06097923&rank=1.
Collapse
Affiliation(s)
- Yoon Ji Chung
- Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Gyeo Ra Lee
- Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hye Sung Kim
- Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun Young Kim
- Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| |
Collapse
|
2
|
Akimoto T, Tasaki K, Ishihara M, Hara M, Nakajima H. Association of Body Water Balance, Nutritional Risk, and Sarcopenia with Outcome in Patients with Acute Ischemic Stroke: A Single-Center Prospective Study. Nutrients 2024; 16:2165. [PMID: 38999913 PMCID: PMC11243294 DOI: 10.3390/nu16132165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/05/2024] [Accepted: 07/06/2024] [Indexed: 07/14/2024] Open
Abstract
In the present study, we examined the inter-relationships between body water balance, nutritional risk, sarcopenia, and outcome after acute ischemic stroke (AIS) in patients who were living independently. We defined abnormal body water balance as overhydration, with an extracellular fluid/total body water ratio > 0.390. A geriatric nutritional risk index (GNRI) < 98 was considered low GNRI. Sarcopenia was defined according to the 2019 Asian Working Group for sarcopenia criteria. Poor outcome was defined as a modified Rankin scale (mRS) score ≥ 3 at discharge. Among 111 eligible patients (40 females, median age: 77 years), 43 had a poor prognosis, 31 exhibited overhydration, 25 had low GNRI, and 44 experienced sarcopenia. Patients with poor outcomes had significantly higher National Institutes of Health Stroke Scale (NIHSS) scores, which were significantly more common with overhydration, low GNRI, and sarcopenia (p < 0.001 for all). Concomitant overhydration, low GNRI, and sarcopenia were associated with poorer outcomes. In multivariate analysis, overhydration [odds ratio (OR) 5.504, 95% confidence interval (CI) 1.717-17.648; p = 0.004], age (OR 1.062, 95%CI 1.010-1.117; p = 0.020), and NIHSS score (OR 1.790, 95%CI 1.307-2.451; p < 0.001) were independent prognostic factors for poor outcome. The results indicated that the combination of overhydration, low GNRI, and sarcopenia predict poor outcomes following AIS. Overhydration was particularly associated with poor outcomes.
Collapse
Affiliation(s)
- Takayoshi Akimoto
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Kenta Tasaki
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Masaki Ishihara
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Makoto Hara
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Hideto Nakajima
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| |
Collapse
|
3
|
Umetani Y, Aoyagi K, Kaku H, Tanaka Y, Minami T, Isobe T, Kizaki J, Murakami N, Fujita F, Akagi Y. Factors Associated with Perioperative Edema in Patients with Stage I Gastric Cancer Using a Body Composition Analyzer. Kurume Med J 2024; 69:201-208. [PMID: 38233179 DOI: 10.2739/kurumemedj.ms6934010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE Assessment of nutritional status and nutritional interventions is important in gastric cancer patients. We investigated the factors associated with perioperative edema in patients with stage I gastric cancer using a body composition analyzer. METHODS The study included 106 patients with stage I gastric cancer who underwent distal gastrectomy. The body composition of each patient was evaluated by bioelectrical impedance analysis (BIA) using an InBody 720 body composition analyzer. Patients with an extracellular water to total body water ratio of ≥ 0.4 before and 1 week after gastrectomy were considered to have edema, the cause of which was determined retrospectively. RESULTS Patients with preoperative edema were significantly older, had a significantly higher lymph node metastasis rate and disease stage, and had a significantly poorer Controlling Nutritional Status (CONUT) score, and Prognostic Nutritional Index (PNI) compared with patients without preoperative edema. The group with postoperative edema had significantly higher proportions of elderly and female patients as well as a higher rate of Billroth-II reconstruction compared with the group without postoperative edema. The group with postoperative edema also had significantly lower intracellular water content, total body water content, protein content, skeletal muscle mass, and PNI. CONCLUSIONS Preoperative edema occurs in elderly patients with poor nutritional status, and postoperative edema occurs in elderly patients with a shorter operative time. Perioperative edema status assessed by BIA is thought to be related to perioperative nutritional status.
Collapse
Affiliation(s)
- Yuki Umetani
- Department of Surgery, Kurume University of Medicine
| | | | - Hideaki Kaku
- Department of Surgery, Kurume University of Medicine
| | - Yuya Tanaka
- Department of Surgery, Kurume University of Medicine
| | - Taizan Minami
- Department of Surgery, Kurume University of Medicine
| | - Taro Isobe
- Department of Surgery, Kurume University of Medicine
| | - Junya Kizaki
- Department of Surgery, Kurume University of Medicine
| | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University of Medicine
| |
Collapse
|
4
|
Pedro da Costa Pereira J, Santana Costa JH, Gomes de Miranda BL, de Sousa Rebouças A, Denise de Lima Bezerra A, Gomes Dantas Lopes MM, Trussardi Fayh AP. Prognostic value of overhydration and bioelectrical impedance vector on short- and long-term outcomes in hospitalized patients with cancer. Clin Nutr 2024; 43:756-764. [PMID: 38335800 DOI: 10.1016/j.clnu.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND & AIMS Water, an essential component of body composition, appears to be a significant predictor of adverse outcomes in clinical populations, despite being frequently underexplored. Bioelectrical impedance analysis (BIA) and vector analysis (BIVA) are easy and cost-effective bedside tools for estimating body composition, particularly water content. Therefore, our study aimed to assess the impact of hydration and fluid status using both BIA and BIVA on outcomes in hospitalized patients with cancer. METHODS A prospective cohort study involving hospitalized individuals with cancer was conducted. Total body water (TBW) was estimated using BIA. Extracellular-water/TBW (ECW/TBW) and ECW/intracellular-water (ECW/ICW) ratios were calculated. BIVA ellipses vectors were constructed to enhance our analysis of hydration status. Participants were followed during their hospital stay and up to six months after discharge to assess outcomes, including in-hospital mortality, 6-month non-elective rehospitalization, and 6-month mortality. RESULTS TBW, ECW/TBW, ECW/ICW ratios, and BIVA plots were not associated with non-elective rehospitalization during the follow-up period. However, TBW and an elevated ECW/ICW ratio were independent predictors of in-hospital mortality [hazard ratio (HR): 1.07 (1.01; 1.13) p = 0.020; HR: 4.23 (1.69; 10.58) p = 0.002]. Elevated ratios ECW/TBW and ECW/ICW were independent predictors of 6-month mortality [HR: 1.87 (1.10; 3.21) p = 0.022; HR: 2.49 (1.37; 4.51) p = 0.003]. BIVA vectors for in-hospital and 6-month mortality shifted significantly to the right, leading to cachexia and overhydration quadrants (p < 0.05). CONCLUSION Abnormalities related to overhydration were important predictors of short- and long-term mortality in hospitalized patients with cancer.
Collapse
Affiliation(s)
- Jarson Pedro da Costa Pereira
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, PE, Brazil
| | | | - Bruna Luisa Gomes de Miranda
- Postgraduate Program in Nutrition, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Amanda de Sousa Rebouças
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Agnes Denise de Lima Bezerra
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Márcia Marília Gomes Dantas Lopes
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Postgraduate Program in Applied Sciences to Women's Health, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana Paula Trussardi Fayh
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Postgraduate Program in Nutrition, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, Brazil.
| |
Collapse
|
5
|
Zhang W, Cui X, Li R, Ji W, Shi H, Cui J. Association between ICW/TBW ratio and cancer prognosis: Subanalysis of a population-based retrospective multicenter study. Clin Nutr 2024; 43:322-331. [PMID: 38142477 DOI: 10.1016/j.clnu.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND & AIMS Disease burden is known to alter cellular integrity and water balance. Therefore, the intracellular water/total body water (ICW/TBW) ratio is used as an adjunctive indicator to predict disease severity and prognosis. The ICW/TBW ratio of patients with cancer, who typically present with low muscle mass, poor nutritional status, and high inflammatory response, reportedly differs from that of the healthy population. Herein, we aimed to evaluate the effect of the ICW/TBW ratio on the prognosis of different subgroups of patients with cancer. METHODS This multicenter cohort study included 2787 patients with malignancies between June 2014 and December 2018. The association between covariates and overall survival (OS) was assessed using restricted cubic spline models. The multivariate Cox regression model included variables demonstrating a statistical significance in the univariate Cox regression analysis (P < 0.05) without multicollinearity. The generated nomogram used the C-index and calibration curves to validate the predictive accuracy of the scoring system. RESULTS The optimal cut-off value for the ICW/TBW ratio was 0.61. The ICW/TBW ratio was an independent prognostic factor (hazard ratio [HR]: 0.621; 95 % confidence interval [CI]: 0.537-0.719, P < 0.001). Moreover, the ICW/TBW ratio had a greater impact on the prognosis of patients receiving chemoradiotherapy than on those receiving chemotherapy alone (chemoradiotherapy: HR = 0.495, P = 0.005 vs. chemotherapy: HR = 0.646, P < 0.001). Multivariate Cox regression analysis showed that sex, age, tumor stage, body mass index, neutrophil-to-lymphocyte ratio (NLR), and ICW/TBW ratio were associated with OS. Subsequently, a nomogram was developed incorporating these variables and yielded a C-index of 0.743. CONCLUSIONS The ICW/TBW ratio was associated with muscle mass, nutritional status, and inflammation. A low ICW/TBW ratio is an independent risk factor for poor prognosis in patients with cancer, especially when they are female, have advanced cancer stage, have sarcopenia, and are receiving radiotherapy.
Collapse
Affiliation(s)
- Wenxin Zhang
- Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Xiao Cui
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Rumeng Li
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Ji
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Hanping Shi
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China.
| |
Collapse
|
6
|
Horino T, Tokunaga R, Miyamoto Y, Akiyama T, Daitoku N, Sakamoto Y, Ohuchi M, Ogawa K, Yoshida N, Baba H. Extracellular water to total body water ratio, a novel predictor of recurrence in patients with colorectal cancer. Ann Gastroenterol Surg 2024; 8:98-106. [PMID: 38250685 PMCID: PMC10797841 DOI: 10.1002/ags3.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/07/2023] [Accepted: 07/30/2023] [Indexed: 01/23/2024] Open
Abstract
Background Total body water (TBW) fraction, which accounts for 60% of body weight, is an important indicator of body composition, and the extracellular water to TBW ratio (ECW/TBW) is reportedly useful in predicting clinical outcomes of patients with organ disorders. We aimed to clarify the clinical impact of preoperative ECW/TBW status on survival outcomes in cancer patients. Methods We used a database of 320 colorectal cancer (CRC) patients who underwent potentially curative resections. Preoperative ECW/TBW was measured using a bioelectrical impedance analysis (BIA), and its correlation with patient survival outcomes, clinicopathological factors, laboratory data, and comorbidities were analyzed. Results A high preoperative ECW/TBW was significantly associated with poorer relapse-free survival (RFS; p = 0.001) and overall survival (OS; p = 0.003). A high ECW/TBW ratio was significantly associated with older age (p < 0.001), low BMI (p = 0.009), and right-sided tumors (p = 0.03). In a multivariate analysis, a high ECW/TBW significantly predicted a higher RFS mortality (HR: 2.07, 95% CI: 1.10-3.88, p = 0.024) and OS mortality (HR: 3.23, 95% CI: 1.25-8.36, p = 0.016). Furthermore, a high ECW/TBW was significantly associated with lower hemoglobin (p < 0.001) and albumin levels (p < 0.001), but not comorbidities. Conclusions A high preoperative ECW/TBW was a predictive factor for recurrence and poorer overall survival independent of the tumor, node, and metastasis (TNM) stage. Our data suggest that preoperative evaluation of ECW/TBW using BIA might serve as a novel tool for developing CRC treatment strategies.
Collapse
Affiliation(s)
- Taichi Horino
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Ryuma Tokunaga
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Takahiko Akiyama
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Nobuya Daitoku
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Yuki Sakamoto
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Mayuko Ohuchi
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Katsuhiro Ogawa
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| |
Collapse
|
7
|
Guiráo TN, de Oliveira STP, Bezerra AE, Françoso BS, Dos Santos BD, Sicchieri JMF, Chiarello PG. Development of a nutritional risk screening tool for cancer patients undergoing outpatient treatment. Clin Nutr ESPEN 2022; 52:240-244. [PMID: 36513459 DOI: 10.1016/j.clnesp.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/07/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Malnutrition is a common reality in many hospitals, especially in cancer patients. In order to avoid its late diagnosis, there are screening instruments that help professionals detect nutritional risk early, thus avoiding further damage to the nutritional status. OBJECTIVE To develop a nutritional screening tool for cancer patients undergoing outpatient treatment. MATERIAL AND METHODS This cross-sectional, observational study was carried out in cancer patients assisted at an outpatient clinic for nutritional care. Data were collected from nutritional care records, including bioelectrical and body composition data (by electrical bioimpedance spectroscopy), anthropometry (adductor pollicis muscle thickness, circumferences, and body mass index), routine clinical biochemical tests, and dynamometry. Malnourished patients were identified through screening using the NRS-2002 method, and all participants were classified according to the GLIM criterion as the control group (no risk and no malnutrition) and the malnourished group. The logistic regression method was used to select the variables that were more sensitive to nutritional risk, thus composing the final screening instrument. RESULTS The study sample consisted of 72 patients, 58% male, with a mean age of 63 years (±13.3). The malnourished group had a higher frequency of sarcopenia, worse Karnofsky Performance Status (KPS), and lower values for weight, adductor pollicis muscle thickness (APMT), body mass index (BMI), calf circumference (CC), dynamometry (HAND), and fat mass index (FMI) than the control group. After multivariate analyses and analysis of covariance, the final model was devised in the form of an equation containing two variables, which were more associated with malnutrition, the BMI and the KPS. CONCLUSION The screening instrument developed in this study resulted in an equation for screening nutritional risk, which included the variables KPS and BMI with 84% assertiveness.
Collapse
|
8
|
Lin SQ, Xie HL, Ge YZ, Ruan GT, Zhang Q, Song MM, Zhang HY, Zhang X, Li XR, Tang M, Shen X, Song CH, Li W, Shi HP. Association between systemic inflammation and water composition and survival in colorectal cancer. Front Oncol 2022; 12:896160. [PMID: 36353554 PMCID: PMC9638509 DOI: 10.3389/fonc.2022.896160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/04/2022] [Indexed: 12/05/2022] Open
Abstract
Background Systemic inflammation and water composition are important factors affecting cancer prognosis. This study aimed to explore the association between the neutrophil-to-lymphocyte ratio (NLR) and intracellular water/total body water (ICW/TBW) ratio and overall survival (OS) in colorectal cancer (CRC). Methods This multicenter, prospective cohort included 628 patients with CRC between June 2012 and December 2019. The association between the covariates and OS was assessed using a Cox proportional hazards model and restricted cubic spline models. Concordance index (C-index), which integrated discriminant improvement (IDI) index and continuous net reclassification index, (cNRI) was used to compare the predictive ability of the markers. Results The optimal cutoff values for the NLR and ICW/TBW ratio were 2.42 and 0.61, respectively. The NLR was negatively associated with OS, while the ICW/TBW ratio was positively correlated with OS. NLR ≥2.42 and ICW/TBW ratio <0.61 were both independent poor prognostic factors (hazard ratio [HR]: 2.04, 95% confidence interval [CI]: 1.44–2.88 and HR: 1.45, 95% CI: 1.04–2.02, respectively). Subsequently, we combined the two factors to construct an inflammation-water score (IWS). Patients with IWS (2, ≥1) had worse OS (HR: 2.86 and 95% CI: 1.77–4.63; HR: 1.74 and 95% CI 1.17–2.57, respectively) than those without one. Compared to its component factors, IWS score showed better predictive ability for C-index, IDI index, and cNRI. Conclusion A high NLR and a low ICW/TBW ratio were independent risk factors for poor prognosis in patients with CRC. The combination of the two factors can provide a better prognostic prediction effect.
Collapse
Affiliation(s)
- Shi-Qi Lin
- 1Department of Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Yi-Zhong Ge
- 1Department of Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - He-Yang Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Xiang-Rui Li
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Meng Tang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
| | - Xian Shen
- 1Department of Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chun-Hua Song
- Department of Cancer Center, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, China
| | - Han-Ping Shi
- 1Department of Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer Food for Special Medical Purposes (FSMP) for State Market Regulation, Beijing, China
- *Correspondence: Han-Ping Shi,
| |
Collapse
|
9
|
Park SH, Kim MJ, Kim B, Lee GY, Seo YM, Park JY, Seo AR, Seo SH, Park KS. Association between Disability and Edema Index Values in Rural Older Adult Osteosarcopenia Patients. Yonsei Med J 2022; 63:873-880. [PMID: 36031788 PMCID: PMC9424777 DOI: 10.3349/ymj.2022.63.9.873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study analyzed the relationship between degree of disability and edema index [extracellular water/total body water (ECW/TBW) ratio] values in a rural population of older adult patients with osteopenia, sarcopenia, or osteosarcopenia (OS). MATERIALS AND METHODS This study used data from the Namgaram-2 cohort. The degree of disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 12, and ECW/TBW ratio was calculated using bioelectrical impedance analysis. Based on ECW/TBW ratio, the participants were stratified into normal (<0.391) and abnormal (≥0.391) groups, and the mean WHODAS 12 scores were compared between the two groups. Multiple regression analysis corrected for demographic factors, smoking history, hypertension, diabetes, and serological test results was also conducted. RESULTS Significant differences in mean WHODAS 12 scores were observed in the healthy group (5.8±7.4 vs. 9.2±9.7, p=0.008), the osteopenia only group (7.4±8.7 vs. 12.9±12.0, p<0.001), and the OS group (16.0±13.2 vs. 23.1±17.1, p=0.004). However, no significant difference in mean WHODAS 12 score was observed in the sarcopenia only group (14.9±13.4 vs. 20.7±14.8, p= 0.051). There were significant differences in ECW/TBW ratio values between the abnormal and normal groups in the osteopenia only group (B=4.646 and p=0.001), the sarcopenia only group (B=5.097 and p=0.016), and the OS group (B=5.653 and p=0.043). CONCLUSION This study found that the degree of disability is related to the edema index in older patients with osteopenia, sarcopenia, or OS. Since the edema index indicates the nutritional status of an individual, proper nutrition and fluid intake are important to reduce disability.
Collapse
Affiliation(s)
- Soo-Hyun Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Mi-Ji Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Bokyoung Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Gyeong-Ye Lee
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Young-Mi Seo
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Jin-Young Park
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Ae-Rim Seo
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Sung-Hyo Seo
- Department of Information & Statistics, College of Natural Science, Gyeongsang National University, Jinju, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea.
| |
Collapse
|
10
|
Xiong ZH, Zheng XM, Zhang GY, Wu MJ, Qu Y. The Use of Bioelectrical Impedance Analysis Measures for Predicting Clinical Outcomes in Critically Ill Children. Front Nutr 2022; 9:847480. [PMID: 35734373 PMCID: PMC9207466 DOI: 10.3389/fnut.2022.847480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background The study aimed to investigate the association of bioelectrical impedance analysis (BIA) for predicting clinical outcomes in critically ill children. Methods This single-center prospective observational study included patients admitted to a mixed Pediatric Intensive Care Unit (PICU). All patients underwent anthropometric measurement and BIA measurements in the first 24 h of admission. The patients were classified into different groups based on body mass index (BMI) for age. Electronic hospital medical records were reviewed to collect clinical data for each patient. All the obtained data were analyzed by the statistical methods. Results There were 231 patients enrolled in our study, of which 31.6% were diagnosed with malnutrition. The phase angle (PhA) of 90-day survivors was significantly higher than that of the non-survivors (4.3° ± 1.1°vs. 3.1° ± 0.9°, P = 0.02). The age-adjusted Spearman partial correlation analysis showed a weak negative correlation between PhA and duration of medical ventilation (rs = -0.42, P < 0.05). Furthermore, length of stay in PICU has a very weak correlation with ECW/TBW (rs = 0.29, P < 0.05), and a negative correlation with protein (rs = -0.27, P < 0.05). Multivariate analysis found that PhA was a significant predictor associated with the 90-day mortality when it was adjusted for PRISM III score (adjusted OR = 1.51, CI: 1.10–2.07, p = 0.01). The area under the ROC (AUROC) of PhA for predicting 90-day mortality was 0.69 (95% CI: 0.53–0.85, p < 0.05), and the cutoff value of PhA was 3.0°, with a sensitivity and specificity of 83 and 53%, respectively. Conclusion BIA-derived PhA was found to be an independent predictor of 90-day mortality among critically ill children. A low PhA was associated with a prolonged duration of medical ventilation.
Collapse
Affiliation(s)
- Zi-Hong Xiong
- Department of Pediatric Intensive Care Unit, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xue-Mei Zheng
- University of Electronic Science and Technology of China, Chengdu, China
| | - Guo-Ying Zhang
- Department of Pediatric Intensive Care Unit, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Guo-Ying Zhang,
| | - Meng-Jun Wu
- Department of Anesthesiology, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yi Qu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
11
|
Ge YZ, Ruan GT, Zhang Q, Dong WJ, Zhang X, Song MM, Zhang XW, Li XR, Zhang KP, Tang M, Li W, Shen X, Shi HP. Extracellular water to total body water ratio predicts survival in cancer patients with sarcopenia: a multi-center cohort study. Nutr Metab (Lond) 2022; 19:34. [PMID: 35525966 PMCID: PMC9077863 DOI: 10.1186/s12986-022-00667-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Body water measured by bioelectrical impedance analysis (BIA) predicts the outcomes of many diseases. This study aimed to evaluate the relationship between body water and the prognosis of cancer patients with sarcopenia. METHODS This study employed 287 cancer patients with sarcopenia underwent BIA from a prospective multicenter study of patients with cancer in China from 2013 to 2020. The primary outcome of interest was all-cause mortality presented as the longest time to follow-up available. Eight indicators of body water [total body water, extracellular water, intracellular water, free fat mass, active cell mass, extracellular water/intracellular water, extracellular water/total body water (ECW/TBW), and intracellular water/total body water] were included in the research. Neutrophil-lymphocyte ratio (NLR) = neutrophil (× 109)/lymphocyte (× 109). The discriminatory ability and prediction accuracy of each factor were assessed using the C-index. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. RESULTS The median age was 65 years old, and 138 (48%) patients were men. During a mean follow-up of 46 months, 140 deaths were recorded, resulting in a rate of 204.6 events per 1000 patient-years. ECW/TBW showed the best predictive accuracy (C-index = 0.619) compared to the other indicators [p = 0.004, adjusted HR (95% CI) 1.70 (1.18,2.44)]. In the middle tertile (0.385-0.405), ECW/TBW had a strong independent negative association with patient survival [adjusted HR (95% CI) 2.88 (1.39-5.97), p = 0.004]. Patients who had a high ECW/TBW (ECW/TBW ≥ 0.395) combined with a high NLR had 3.84-fold risk of mortality (p < 0.001, 95% CI 1.99,7.38). CONCLUSIONS ECW/TBW was better than other indicators in predicting survival of cancer patients with sarcopenia. High ECW/TBW combined with high NLR would further increase the risk of mortality. TRIAL REGISTRATION The Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) (Chinese Clinical Trial Registry: ChiCTR1800020329, URL of registration: http://www.chictr.org.cn/showprojen.aspx?proj=31813 ).
Collapse
Affiliation(s)
- Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Wen-Jun Dong
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xiao-Wei Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xiang-Rui Li
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Kang-Ping Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng Tang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Xian Shen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.
| |
Collapse
|
12
|
Zheng K, Lu J, Liu X, Ji W, Liu P, Cui J, Li W. Applied nutritional investigation The clinical application value of the extracellular-water-to-total-body-water ratio obtained by bioelectrical impedance analysis in people with advanced cancer. Nutrition 2021; 96:111567. [PMID: 35074647 DOI: 10.1016/j.nut.2021.111567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/18/2021] [Accepted: 11/28/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Body-composition analysis using bioelectrical impedance analysis is gradually becoming more widely used in clinical practice. The ratio of extracellular water (ECW) to total body water (TBW) is thought to be related to the prognosis of a variety of diseases. However, its performance in people with advanced cancer deserves further discussion. METHODS A retrospective analysis was performed on 784 people with advanced cancer. Anthropometric indicators, serologic indicators, nutritional status, health-related quality of life, and body composition were analyzed. Participants were grouped into two groups according to ECW/TBW ratio. We used t tests and χ2 tests to analyze differences between the groups. Univariate and multivariate Cox regressions were conducted to analyze the factors influencing overall survival. Logistic regression was used to analyze the related factors of malnutrition, and linear regression for factors of health-related quality of life. RESULTS Age, body mass index, Patient-Generated Subjective Global Assessment score, Karnofsky Performance Status questionnaire score, skeletal muscle mass index, and fat-free mass index were statistically different between the non-overhydrated and overhydrated groups. Univariate and multivariate Cox regression models showed that an ECW/TBW ≥ 0.40 is a risk factor for poor prognosis in people with advanced cancer (hazard ratio = 1.511; 95% confidence interval, 1.103-2.070; P = 0.010). Subgroup analyses were next conducted according to tumor type, with ECW/TBW ≥ 0.40 emerging as a risk factor for poor prognosis for people with advanced breast cancer and advanced gastric cancer. Logistic regression showed that ECW/TBW ≥ 0.40 is a risk factor for malnutrition in people with advanced cancer (odds ratio = 1.988; 95% confidence interval, 1.049-3.767; P = 0.035). The univariate and multivariate linear regression models showed that the ECW/TBW ratio is an influencing factor for health-related quality of life in the domains of physical functioning, role functioning, and constipation. CONCLUSION We found that in people with cancer, an ECW/TBW ≥ 0.40 was a risk factor for malnutrition and lower health-related quality of life, and in people with advanced cancer, it was a risk factor for poor prognosis.
Collapse
Affiliation(s)
- Kaiwen Zheng
- The First Hospital of Jilin University, Changchun, China.
| | - Jin Lu
- The First Hospital of Jilin University, Changchun, China.
| | - Xiangliang Liu
- The First Hospital of Jilin University, Changchun, China.
| | - Wei Ji
- The First Hospital of Jilin University, Changchun, China.
| | - Pengfei Liu
- The First Hospital of Jilin University, Changchun, China.
| | - Jiuwei Cui
- The First Hospital of Jilin University, Changchun, China.
| | - Wei Li
- The First Hospital of Jilin University, Changchun, China.
| |
Collapse
|
13
|
Influence of Magnetic Fields with Induction of 7 T on Physical and Chemical Properties of Aqueous NaCl Solutions. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112311466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The physicochemical properties of NaCl aqueous solutions in a wide range of concentrations were studied. We determined that constant magnetic fields with an induction of up to 7 T had a significant effect on the physicochemical properties of these solutions. First, we detected a decrease in pH that was dependent on the magnetic field strength both in water and in NaCl solutions. This effect was not associated with the presence of sodium cations or chlorine anions in water. Secondly, with an increase in magnetic field induction the redox potential of aqueous solutions also increased. Magnetic fields did not cause any changes in the concentration of dissolved molecular oxygen in deionized water. In this case, in aqueous solutions of NaCl under the action of a magnetic field, a concentration-dependent tendency to a decrease in the concentration of dissolved molecular oxygen is observed. Third, it was shown that under the action of a magnetic field on a NaCl solution, the rate of hydrogen peroxide generation increased with increasing NaCl concentration. Fourth, the essential role of the primary state of aqueous solutions in relation to the gas composition and gas equilibrium under magnetic influence was established. The work also evaluated the contribution of flow-mixing during sample preparation on the physicochemical properties of the solutions.
Collapse
|
14
|
Ma Y, de Groot S, Weijs PJM, Achterberg W, Adriaansen J, Janssen TWJ. Accuracy of bioelectrical impedance analysis and skinfold thickness in the assessment of body composition in people with chronic spinal cord injury. Spinal Cord 2021; 60:228-236. [PMID: 34385607 DOI: 10.1038/s41393-021-00682-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES This study: (1) investigated the accuracy of bioelectrical impedance analysis (BIA) and skinfold thickness relative to dual-energy X-ray absorptiometry (DXA) in the assessment of body composition in people with spinal cord injury (SCI), and whether sex and lesion characteristics affect the accuracy, (2) developed new prediction equations to estimate fat free mass (FFM) and percentage fat mass (FM%) in a general SCI population using BIA and skinfolds outcomes. SETTING University, the Netherlands. METHODS Fifty participants with SCI (19 females; median time since injury: 15 years) were tested by DXA, single-frequency BIA (SF-BIA), segmental multi-frequency BIA (segmental MF-BIA), and anthropometry (height, body mass, calf circumference, and skinfold thickness) during a visit. Personal and lesion characteristics were registered. RESULTS Compared to DXA, SF-BIA showed the smallest mean difference in estimating FM%, but with large limits of agreement (mean difference = -2.2%; limits of agreement: -12.8 to 8.3%). BIA and skinfold thickness tended to show a better estimation of FM% in females, participants with tetraplegia, or with motor incomplete injury. New equations for predicting FFM and FM% were developed with good explained variances (FFM: R2 = 0.94; FM%: R2 = 0.66). CONCLUSIONS None of the measurement techniques accurately estimated FM% because of the wide individual variation and, therefore, should be used with caution. The accuracy of the techniques differed in different subgroups. The newly developed equations for predicting FFM and FM% should be cross-validated in future studies.
Collapse
Affiliation(s)
- Yiming Ma
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands. .,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands.
| | - Sonja de Groot
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Wendy Achterberg
- Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | | | - Thomas W J Janssen
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| |
Collapse
|
15
|
Ramos da Silva B, Rufato S, Mialich MS, Cruz LP, Gozzo T, Jordao AA. Metabolic syndrome and unfavorable outcomes on body composition and in visceral adiposities indexes among early breast cancer women post-chemotherapy. Clin Nutr ESPEN 2021; 44:306-315. [PMID: 34330483 DOI: 10.1016/j.clnesp.2021.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE The study objected to investigate potential changes in metabolic, dietary, and nutritional status in women with stages I-III breast cancer exposed to chemotherapy. METHODS Women who were starting chemotherapy with no previous treatment were recruited. Anthropometrics, bioelectrical impedance analysis, handgrip strength, blood pressure and blood sample were collected. Visceral adiposity index and lipid accumulation product were calculated. Dietary intake was evaluated, and the multiple source methods program was applied. Metabolic syndrome (MetS) was assessed following the NCEP-ATP III criteria (defined as 3 of 5 components of MetS). All data were collected at 2-time points: diagnosis (T0) and after 1 month of completion of therapy (T1). Mean, standard deviation, percentage, and ANOVA in SAS Studio® were used to explore the results. RESULTS 61 women were included. We did not find any changes in anthropometrics and body composition. However, phase angle, extracellular water (EX) and ratio EX to total body water had expressive changes (p < 0.001). The results showed changes in lipid profile (p < 0.001), and greater unfavorable outcomes on adiposities index (p < 0.001). At the end of the study, 68,8% (N = 42) of the women developed MetS post-chemotherapy. CONCLUSION We have found supporting evidence for chemotherapy treatment resulting in worsening of nutritional markers, lipid profile and adiposity markers. After chemotherapy part of the sample developed MetS, even without changes in body weight, fat mass, and food intake. Breast cancer patients may benefit from targeted interventions before starting chemotherapy to prevent MetS post-treatment, and therefore reduce the risk of cardiovascular disease. Further investigation into this theme is needed.
Collapse
Affiliation(s)
- Bruna Ramos da Silva
- Department of Health Sciences, Ribeirão Preto Medical School. University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil.
| | - Sarah Rufato
- Department of Health Sciences, Ribeirão Preto Medical School. University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| | - Mirele S Mialich
- Department of Health Sciences, Ribeirão Preto Medical School. University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| | - Loris P Cruz
- Nursing School of Ribeirão Preto, University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| | - Thais Gozzo
- Nursing School of Ribeirão Preto, University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A Jordao
- Department of Health Sciences, Ribeirão Preto Medical School. University of Sao Paulo, 3900, Bandeirantes Avenue, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
16
|
Chung YJ, Kim EY. Usefulness of bioelectrical impedance analysis and ECW ratio as a guidance for fluid management in critically ill patients after operation. Sci Rep 2021; 11:12168. [PMID: 34108597 PMCID: PMC8190036 DOI: 10.1038/s41598-021-91819-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/01/2021] [Indexed: 01/20/2023] Open
Abstract
We determined the relationship between changes in bioelectrical impedance analysis (BIA) parameters and response of critically ill patients to fluid therapy during early postoperative period. Associations between BIA values indicating volume status of postoperative patient and clinical outcomes were also evaluated. From May 2019 to April 2020, patients who were admitted to the surgical intensive care unit (SICU) of our institution at more than 48 h after surgery were enrolled. Volume status was measured with a portable BIA device every morning for five days from SICU admission. Overhydration was defined as the case where extracellular water (ECW) ratio > 0.390 measured by BIA. Participants were daily classified into an overhydration or a normohydration group. The relationship between daily hydration status and postoperative outcome was evaluated. Most of the 190 participants showed the overhydration status in the first 48 h after surgery. The overhydration status on day 3 was significant predictor of postoperative morbidities (OR 1.182) and in-hospital mortality (OR 2.040). SOFA score was significant factor of postoperative morbidities (OR 1.163) and in-hospital mortality (OR 3.151) except for the overhydration status on day 3. Cut-off values of overhydration status by ECW ratio at day 3 for predicting postoperative morbidities and in-hospital mortality were > 0.3985 and > 0.4145, respectively. BIA would be a useful and convenient tool to assess the volume status of patients requiring intensive fluid resuscitation in early postoperative period. Overhydration status by ECW ratio on postoperative day 3 needs careful monitoring and appropriate interventions to improve clinical outcomes.
Collapse
Affiliation(s)
- Yoon Ji Chung
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun Young Kim
- Division of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, South Korea.
| |
Collapse
|
17
|
Zhang J, Zhang N, Du S, Liu S, Ma G. Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT). Nutrients 2021; 13:553. [PMID: 33567589 PMCID: PMC7915432 DOI: 10.3390/nu13020553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 02/02/2023] Open
Abstract
Insufficient water intake may affect body composition. The purpose of this research was to explore the effects of water restriction and replenishment on body composition and to evaluate the optimum amount of water that improves body composition. A total of 76 young adults aged 18-23 years old (40 males and 36 females) in Baoding, China, were recruited in this randomized controlled trial, with a 100% completion rate. After fasting overnight for 12 h, at 8:00 a.m. of day 2, a baseline test, including anthropometric indices and collection of urine and blood samples, was explored. Participants were then subjected to water restriction for 24 h, and three meals with ≤75% water content were provided. At 8:00 AM of day 3, the same indices were determined as a dehydration test. Then, participants were randomly assigned into four groups: three water replenishment groups (WR groups 1, 2, and 3 given 1000, 500, and 200 mL of purified water, respectively) and one non-replenishment group (NR group, with no water). After 90 min, the same measurements were performed as a rehydration test. Compared with the baseline test, during the dehydration test, the intracellular water to total body water ratio (ICW/TBW) increased; and extracellular water (ECW), ECW/TBW (extracellular water to total body water ratio), and TBW decreased (all p < 0.05). For males, significant differences were found in ECW, ECW/ICW (extracellular water to intracellular water ratio), ICW/TBW, and ECW/TBW (all p < 0.05); for females, significant reductions were found in ICW, ECW, TBW, ECW/ICW, ICW/TBW, and ECW/TBW (all p < 0.05). Furthermore, significant differences were found in ICW, ECW, ICW/TBW, ECW/TBW, ECW/ICW, TBW, and TBW/BW between males and females during the baseline and dehydration test (all p < 0.05). Comparing the dehydration test with the rehydration test, there were significant interactions between time × volume in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040); in males, these were only found in ICW (F = 3.061, p = 0.040); in females, they were found in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040). The ICW levels in WR groups 1 and 2 were all higher than in the NR group (all p < 0.05); the TBW was higher in WR group 1 than in the NR group (p < 0.05). No significant differences were found between WR groups 1 and 2, either in males or in females (all p > 0.05). In the rehydration test, significant differences in body composition were found between males and females among the four groups (all p < 0.05). Water restriction had adverse effects on body composition, and females were more susceptible to water restriction than males. Water replenishment improved the water content of body composition, alleviating the adverse effects of water restriction on ICW and TBW. After water restriction for 36 h, the optimum volume of water to improve body composition among young male adults was 1000 mL, but this was not the case for females.
Collapse
Affiliation(s)
- Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (N.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (N.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Songming Du
- Chinese Nutrition Society, Room 1405, Beijing Broadcasting Building, No. 14 Jianguomenrai Street, Chaoyang District, Beijing 100191, China;
| | - Shufang Liu
- School of Public Health, Hebei University Health Science Center, 342 Yuhua Road, Lianchi District, Baoding 071000, China;
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China; (J.Z.); (N.Z.)
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| |
Collapse
|