Current Situation Of Body Composition And Sarcopenia In Patients With Malignant Tumors

Part one Current situation of body composition in patients with malignant tumorObjective:The investigation and analysis of body composition of patients with malignant tumor,and to explore the difference of body components in the different clinical features and nutritional status,so as to provide evidence for improving the accuracy of individual clinical treatment effectively.Methods:Our study recruited 321 subjects with malignant tumor from the first hospital of Hebei Medical University from October 2017 to December 2018.General data surveys were conducted within 24 hours of admission(gender,age,type of tumor,staging of tumor,major treatments received),anthropometry(height,weight,grip strength),analysis of human components,assessment of nutritional status(PG-SGA)and systemic inflammatory response(mGPS).Differences in body composition between sex,age,tumor staging,major treatments,nutritional status,and systemic inflammatory response were compared.The statistical analysis was performed using SPSS 21.0 statistical software.A p value less than 0.05 was considered statistically significant.Results:In this study,a total of 321 patients with malignant tumors were investigated,including 186 males and 135 females.The median of age was 63with an interquartile of 15.There were significant differences only in ECW/TBW between non-elderly patients(<65 years old)and elderly patients(?65 years old).According to the grouping of PG-SGA and BMI,it was found that there were significant differences in ICW,protein,BFM,SLM,FFM,SMM,ASM,ECW/TBW,VFA,BCM,AC,AMC and abdominal circumference.Except for ECW/TBW and VFA,the parameters of body composition among PG-SGA A,B and C grades decreased gradually,while ECW/TBW increased gradually.There were statistical differences in body composition among low body weight,normal body weight,overweight and obesity groups in BMI group,and the body composition indexes of obesity group were lower than those of other groups except adipose tissue related indexes.According to the different stages of cancer and the main treatment methods,it was found that only protein,BFM,PBF,VFA,AC and abdominal circumference had statistical differences in patients with malignant tumors of different stages,while only ECW/TBW had statistical differences in patients of different treatment methods.According to the scores of mGPS,the results showed that there were statistical differences among BFM,PBF,ECW/TBW,AC,AMC,VFA and abdominal circumference,and the body components except ECW/TBW,decreased gradually with the increase of inflammatory degree.Conclusion:1.Gender,PG-SGA,BMI and mGPS grouping of patients with malignant tumors had a greater impact on body composition,while tumor staging,treatment methods and age grouping had a smaller impact on body composition.2.As the nutritional status of malignant tumor patients gradually deteriorated,the degree of inflammation gradually increased,body components favorable parameters gradually decreased.It is suggested that the early correction of malnutrition and inflammatory status can improve the body composition of the patients in order to provide evidence for effective clinical treatment.Part two:Study on the influence factors of phase angle and sarcopenia in patients with malignant tumorsObjective:To explore the related factors affecting PA and sarcopenia in patients with malignant tumors,and to provide evidence for improving the prognosis of patients with malignant tumors.Methods:Using BIA to analyze 321 patients with malignant tumors,a direct parameter PA was obtained.Patients with sarcopenia were diagnosed according to the diagnostic criteria of AWGS expert consensus.According to the general data and cinical characteristics in part one,Statistical analysis of relevant factors affecting PA and the incidence of sarcopenia.The statistical analysis was performed using SPSS 21.0 statistical software.A p value less than 0.05 was considered statistically significant.Results:In this study,the median of PA was 4.70°with an interquartile of 1.10°.According to different grouping,the results of rank sum test showed that the PA of PG-SGA,BMI,mGPS,KPS was statistically different(P<0.05),and the median PA of male was greater than that of female,and the median of PA of non-elderly was greater than that of elderly.Comparing the median PA of different PG-SGA grades,it was found that the PG-SGA was A>B>C,and the PA of overweight and obesity group was higher than that of low weight and normal group and that of overweight and obesity group was higher than that of low weight group and normal group.In mGPS group,the median of PA decreases with the increase of score,while in KPS group,the median of PA increases with the increase of score.There was no significant difference in PA between different stages and treatments.Spearman rank correlation analysis showed that PA was negatively correlated with age,PG-SGA score and mGPS score,while PA was positively correlated with BMI,Hb,TG,Tp,Alb,KPS and grip strength(P<0.05).The results of multiple linear regression analysis showed that the level of PA was affected by age,BMI,PG-SGA,grip strength and Hb.According to the formula ASMI=ASM/H~2 and grip strength dividing point,102 patients(31.78%)with sarcopenia and 219 patients(68.22%)without it,the incidence of sarcopenia in different groups of patients was compared by chi-square test,and the significantly different in incidence of sarcopenia was found between patients with different PG-SGA,BMI,mGPS,KPS(P<0.05).Multivariate logistic regression analysis showed that BMI and KPS were independent factors that affect the occurrence of muscle reduction.The results of body compositions,PA level and laboratory-related nutritional indicators in patients with sarcopenia were significantly lower than those in patients without sarcopenia(P<0.05).Conclusion:1.PA is correlated with gender,age,PG-SGA,BMI,mGPS,KPS,grip strength,and laboratory-related nutritional indicators,which can be used as a predictor of clinical outcomes.2.The incidence of sarcopenia in patients with malignant tumors was related to PG-SGA,BMI,mGPS and KPS,and BMI,KPS is an independent factor.Patients with sarcopenia have poor nutritional status,high score of systemic inflammatory reaction,poor general condition and low level of PA,which is a risk factor to affect the clinical outcome.