Changes In Body Composition Parameters Research Articles

Differences in the Evaluation of Malnutrition and Body Composition Using Bioelectrical Impedance Analysis, Nutritional Ultrasound, and Dual-Energy X-ray Absorptiometry in Patients with Heart Failure.

Although malnutrition is frequently observed in patients with heart failure (HF), this diagnosis should be performed carefully since HF itself is associated with increased inflammatory activity, which affects body weight, functionality, and some nutritional parameters; thus, its isolated interpretation can erroneously identify surrogate markers of severity as markers of malnutrition. In this context, we aimed to evaluate the prevalence of malnutrition using different classification systems and perform a comprehensive nutritional evaluation to determine the reliability of different diagnostic techniques. Eighty-three patients with a recent hospital admission due to HF were evaluated. GLIM diagnosis criteria and subjective global assessment (SGA) were performed; a comprehensive anthropometric, functional, and biochemical nutritional evaluation was performed, in which bioelectrical impedance analysis (BIA), nutritional ultrasound, and dual-energy X-ray absorptiometry (DXA) were performed. Additionally, mortality and additional admissions due to HF were determined after a mean follow up of 18 months. Malnutrition according to the GLIM criteria (54%) accurately distinguished patients with impaired functionality, lower lean mass, skeletal mass index, and appendicular muscle mass (BIA), as well as lower trunk fat mass, trunk lean mass, fat-free mass (DXA), and decreased albumin and increased C-reactive protein serum levels. According to SGA, there were significant changes in body composition parameters determined by BIA, muscle ultrasound, and functional tests between well-nourished patients and patients with risk of malnutrition (53.7%) or who had malnutrition (7.1%), but not when the last two groups were compared. BIA and DXA showed strong correlations when evaluating muscle and fat mass in HF patients, but correlations with nutritional ultrasound were limited, as well as functional tests. A multivariate analysis showed that no significant association was observed between body composition and mortality, but preperitoneal fat was associated with an increased risk of new hospital admissions (OR: 0.73). GLIM criteria identified a lower percentage of patients with HF and malnutrition compared with SGA; thus, SGA could have a role in preventing malnutrition in HF patients. Nutritional evaluation with BIA and DXA in patients with HF showed reliable results of body composition parameters in HF, and both help with the diagnosis of malnutrition according to the GLIM or SGA criteria and could provide complementary information in some specific cases.

Abstract PO1-02-12: Nutritional guidance effect on anthropometric and inflammatory parameters in young women with breast cancer

Abstract Background Young women with breast cancer (YWBC) debut with more aggressive and advanced diseases; it may be related to chronic inflammation caused by the tumor. However, in Latin America, breast cancer is also related to malnutrition conditions such as obesity. Malnutrition is commonly associated with physiological adaptations to stress and inflammation resulting in muscle catabolism and loss of functionality, which may affect oncology outcomes. Our research group had previously reported that YWBCs in Mexico are overweight or obese at diagnosis. Although they received educational support, this malnutrition prevalence continues or increases during the follow-up. A limitation of this previous study is that we only have data such as weight and height and miss other anthropometric parameters to measure the metabolic impact of weight gain. Body composition assessment is valuable for measuring malnutrition, obesity, and sarcopenia. The body composition assessment with Bioimpedance analysis (BIA) provides valuable parameters such as phase angle (PhA), which correlates with nutritional status, disease prognosis, inflammation, cell health, and metabolic activity. BC patients with a PhA >5.6 show a better survival rate. Another accessible tool to evaluate systemic inflammation is the neutrophil-lymphocyte ratio (NLR). Higher NLR (>2.12) is associated with worse disease-free and overall survival. This pilot study aims to measure the importance of PhA and NLR in YWBC with early breast cancer at diagnosis and at 12 months to evaluate the effects of personal nutritional guidance on these parameters. Methods Patients included in the “Joven & Fuerte (J&F) navigator program” of the National Institute of Cancerology (INCan) from 2021 to 2022 were invited to participate in this observational study. To evaluate the efficacy of personal nutritional guidance in anthropometric and NLR parameters, basal and 12-month BIA and anthropometric measures such as the Waist-Hip index were assessed, and NLR was obtained from the patient's records. Results Eleven early breast patients agreed to participate in the pilot intervention. The median age of the participants was 37 years. The majority had local advanced disease (54.5%), regarding molecular subtype luminal was the more frequent subtype (45.5%), followed by HER2 (36.4%), triple-negative (18.2%). According to BMI at diagnosis, 18.2% had normal-weight, 63.6% were overweight, and 18.2% had obesity. At follow-up, 9.1% had normal-weight, 63.6% were overweight, and 27.3% had obesity. A significant change in body composition parameters was observed, the percentage of patients with excess adipose tissue increased from 54.5% at baseline to 81.1%. All patients exhibited cardiovascular risk, as indicated by a Waist-Hip ratio greater than 0.80, and maintained a PhA (5.2 at baseline, 5.5 final) associated with overall survival risk. No significant changes were observed in the NLR ratio (2.14 baseline, 2.34 final), maintaining the related risk for this parameter. Conclusions This pilot analysis suggests that a nutritional intervention based only in nutritional guidance and support seems inefficient in impacting nutritional or inflammatory parameters. A multidisciplinary intervention involving multidisciplinary healthcare teams, including rehabilitation, and psychology, may be required to achieve therapeutic effectiveness in this population. Further studies with larger sample sizes are necessary to confirm these findings and determine the most effective strategies to improve the nutritional status, cardiovascular health, and clinical outcomes of YWBC. Anthropometric and inflammatory parameters a The values presented as median and interquartile range, Wilcoxon. b The values presented as mean and standard deviation, paired t-test. Citation Format: Aline Barranco-Cortés, Fernanda Sarahi Fajardo-Espinoza, Ana Lorena Espadas-Vargas, Dana Aline Pérez-Camargo, Sara Aileen Cabrera-Nieto, Marlid Cruz-Ramos, Alejandro Mohar, Lucero Itzel Labra Alvarado, Cynthia Mayté Villarreal Garza. Nutritional guidance effect on anthropometric and inflammatory parameters in young women with breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-02-12.

Body Composition of Master Swimmers before and after the COVID-19 Pandemic: A Longitudinal Study.

The long-term effect of physical activity on body composition in Master athletes is rarely presented in the literature. The aim of this study was to identify possible changes in body composition of Master swimmers over a period of 4 years, including during the COVID-19 pandemic. Additionally, we wanted to discover if sarcopenia symptoms would occur in Master athletes during the analyzed period. The body compositions of one hundred and sixty-seven Master swimmers were assessed with the InBody 270 analyzer in 2018. In 2022, the measurements were repeated in forty-six men and fourteen women. The Muscle Mass Index and the Skeletal Muscle Index were calculated to identify sarcopenia-related changes in body composition. We surveyed participants to gather data on their training patterns and SARS-CoV-2 infection history. No significant changes in body composition parameters were noted in Master swimmers during the analysis period (p > 0.05). Sarcopenia risk was not identified in examined athletes, and sarcopenia indicators did not change markedly over the 4-year period (p > 0.05). Participants with a history of SARS-CoV-2 infection did not differ from non-infected subjects in terms of body composition. Training cessation during the COVID-19 pandemic and SARS-CoV-2 infection did not induce long-term changes in body composition of Master swimmers. Life-long participation in swimming activities appears to delay negative changes in body composition, including sarcopenia symptoms.

Early post-treatment changes in body composition parameters are associated with overall survival and need of transplantation in cirrhotic patients with HCC undergoing locoregional treatments

Early post-treatment changes in body composition parameters are associated with overall survival and need of transplantation in cirrhotic patients with HCC undergoing locoregional treatments

Handgrip strength, physical activity, and body composition in young adults with juvenile idiopathic arthritis

Background. Handgrip strength (HGS) and physical activity (PA) reflect an individual’s overall health and can predict morbidity and mortality. The purpose of the study was to investigate the level of PA and HGS and associated factors in young adults with juvenile idiopathic arthritis (JIA) and determine the connection with body composition parameters. Materials and methods. We conducted a cross-sectional monocentric study of 40 young adults aged 18–30. We collected data on PA and anthropometric and clinical measurements, including disease activity and articular and extra-articular damages. All patients had the following evaluations performed: body composition (dual X-ray absorptiometry), PA level (International Physical Activity Questionnaire), and HGS measurement (using manual hand dynamometer). Results. Sixteen (40 %) patients were considered sedentary, and 32 (80 %) JIA patients had low HGS. The reduced HGS was likely in women, patients with lower body mass index, higher disease activity, and articular damage. In contrast, bone mineral density (BMD) and lean mass were protective factors for reduced HGS (p < 0.05). The level of PA was positively correlated with BMD and lean mass and negatively correlated with fat mass, swollen joint count, and articular damage (p < 0.05). Conclusions. JIA leads to changes in body composition parameters, particularly lean (muscle) mass and muscle strength, and therefore is a risk factor for the development of sarcopenia.

Abstract OT2-17-02: The ARETHA Study: A phase 2 randomized control trial of Eribulin with Evexomostat (SDX-7320) or placebo for patients with metastatic triple-negative breast cancer and metabolic dysfunction

Abstract Background: The prognosis for advanced/metastatic triple negative breast cancer (TNBC) remains poor and novel therapeutic strategies are urgently needed to improve outcomes. Insulin resistance and obesity contribute to cancer progression and are independent predictors of worse survival after TNBC diagnosis. Chemotherapy worsens insulin resistance, body mass index, and multiple other metabolic parameters which can paradoxically limit treatment efficacy and survival. Methionine aminopeptidase 2 (MetAP2/p67) is overexpressed in many tumor types and MetAP2 inhibitors exhibit broad anti-tumor activity. Additionally, MetAP2 inhibitors improve insulin resistance, reduce adiposity, and normalize levels of adipokines, attenuating the effects of metabolic dysfunction on tumor growth. Evexomostat (SDX-7320) is a second-generation MetAP2 inhibitor designed to improve drug-like properties and minimize central nervous system toxicities. Evexomostat improved insulin sensitivity, reduced fat mass and normalized adipokine levels in preclinical models of obesity, and reduced tumor growth in preclinical models of TNBC. In phase 1 trials, MetAP2 inhibition combined with chemotherapy was safe and well tolerated, while evexomostat monotherapy partially restored insulin sensitivity, reduced angiogenic factors as well as adipokines and showed anti-metastatic effects in patients with advanced solid tumors. The goal of this phase 2 study is to test whether evexomostat in combination with eribulin chemotherapy prevents worsening of insulin resistance and augments tumor response in patients with metastatic TNBC and concomitant metabolic dysfunction. Methods: This is a single-center, placebo-controlled phase 2 randomized control trial of evexomostat, a MetAP2 inhibitor, in combination with eribulin chemotherapy. Eligible patients must have histologically confirmed metastatic TNBC, measurable disease or ≥1 predominantly lytic bone lesion, baseline metabolic dysfunction defined as hemoglobin A1c >5.5% and/or BMI ≥30 kg/m2, have received ≤2 prior lines of therapy in the advanced/metastatic setting, have ECOG performance status ≤1, and adequate organ function. Patients with uncontrolled or insulin-dependent type II diabetes, or who require combination antihyperglycemic therapy are excluded. During the safety run-in period, 15 patients will be assigned to receive evexomostat 49 mg/m2 every 2 weeks in combination with eribulin 1.4 mg/m2 administered on days 1 and 8 of a 21-day cycle. Upon safety confirmation, an additional 40 patients will be randomized 2:1 to receive evexomostat or placebo in combination with eribulin. The primary endpoint is metabolic efficacy assessed by change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score. Secondary endpoints include objective response rate, progression-free survival, duration of response, safety and tolerability, patient-reported outcomes, changes in metabolic markers, and changes in body composition parameters. Historically, HOMA-IR scores double during chemotherapy, and this trial will test whether evexomostat will attenuate the expected rise in HOMA-IR. Specifically, the trial will have >90% power to detect a difference between a 1.5-fold change in HOMA-IR in the control arm versus no change in the investigational arm while controlling the Type I error at 5%. This trial opened to accrual in July 2022. A total accrual of 61 patients is planned with a goal of 55 evaluable patients. For any inquiries/questions, please contact Sherry Shen at shens1@mskcc.org. Clinical trial registry number: pending Funding, study drug evexomostat and other support provided by: SynDevRx, Inc. Citation Format: Sherry Shen, Anna Whalen, Mark E. Robson, Larry Norton, Tiffany A. Traina, Neil M. Iyengar. The ARETHA Study: A phase 2 randomized control trial of Eribulin with Evexomostat (SDX-7320) or placebo for patients with metastatic triple-negative breast cancer and metabolic dysfunction [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-17-02.

Association between CT-based body composition assessment and patient outcomes during neoadjuvant chemotherapy for epithelial ovarian cancer

ObjectiveThe aim of this study was to characterize the body composition of patients undergoing neoadjuvant chemotherapy (NACT) for epithelial ovarian cancer (EOC), identify factors associated with sarcopenia at diagnosis, and evaluate the impact of pretreatment sarcopenia and changes in body composition parameters during therapy on perioperative and disease-related outcomes. MethodsPatients undergoing NACT for EOC between 2008 and 2020 were identified. Pre-treatment and post-treatment contrast-enhanced CT scans were reviewed to determine skeletal muscle index (SMI) and visceral adipose tissue (VAT) area at the mid-fourth lumbar vertebral level. SMI and VAT were analyzed for association with clinical and treatment variables. Results174 patients were identified. Mean pretreatment SMI and VAT were 38.3 cm2/m2 ± 7.9 and 51.2 cm2/m2 ± 34.3, respectively. Comparatively, mean post-treatment SMI and VAT were 37.8 cm2/m2 ± 7.9 and 43.7 cm2/m2 ± 29.7, respectively. Most patients exhibited an overall decrease in SMI from pretreatment to posttreatment scans. Caucasian race, older age, and lower body mass index at diagnosis were associated with lower pretreatment SMI. Lower pre-treatment SMI was associated with lower surgical complexity scores (p < 0.001) and estimated blood loss (p = 0.029). Decrease in SMI after NACT was associated with increased rates of ICU admissions and length of stay. While there was no association between SMI and overall survival (OS) or progression-free survival (PFS), >2% decrease per 100 days in VAT was significantly associated with worse OS. ConclusionsPatients with lower pretreatment SMI tend to undergo less complex surgery than those with higher SMI despite NACT. Decrease in VAT may be a potential indicator of worse OS. Information on body composition can aid in clinical decision making in patients with EOC.

Effects of green tea catechins and exercise training on body composition parameters

The impact of phytochemicals, as green tea catechins, on body composition measures has become a relevant topic as ongoing epidemiological evidence suggests their potential role in weight loss. Although catechins have been shown to modulate fat and energy metabolism, clinical effects of green tea consumption still remain controversial. Given the role played by physical exercise in weight management, it is important to determine whether the association of catechins and exercise is able to improve outcomes over and above the beneficial effects of exercise alone. Considering that scientific findings on this topic are not entirely consistent, aim of the present review was to assess the current scientific literature regarding the interplay between green tea catechins and exercise in overweight and obese populations. In particular, it was evaluated whether the addition of green tea supplementation to exercise training was able to further improve the exercise‐induced changes in body composition parameters.

The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial.

End-stage kidney disease (ESKD) is strongly associated with factors that aggravate the physical activity level and body composition status of hemodialysis patients (HD). Even though exercise in HD patients have shown remarkable benefits on hemodialysis adequacy, it is yet inconclusive if exercise can positively affect body composition parameters or if dialysis adequacy may affect body composition status. This study aimed to investigate the effect of a 6-month intradialytic exercise training program on dialysis adequacy indices and body composition parameters in HD patients. A total of 24 HD patients were randomly assigned into two equally sized groups. The exercise group (EX group) participated in a 6-month intradialytic moderate-intensity aerobic exercise training program at the beginning of the HD sessions, three times a week for 60min, and maintained a Borg's Rating of Perceived Exertion score between 13 and 14. The Control group (C group) remained untrained. At baseline, during, and at the end of the 6-month study, we assessed single-pool Kt/V, urea reduction ratio (URR), and body composition parameters, such as extracellular water (ECW)/ intracellular water (ICW) ratio, body mass index (BMI) and lean tissue mass (LTM). In all patients, the 6-min-walking test (6MWT) was performed as a marker of physical performance. A significant increase of both Kt/V (increase by 19%, p = 0.01), and URR (increase by 7%, p = 0.03) values has been observed in the EX group after the 6-month training program. Similarly, a statistically significant increase in 6MWT distance (from 442 ± 67m to 481 ± 68m, p = 0.02) in the EX group has also been found, compared to the C group (from 393 ± 59m to 427 ± 81m, p = 0.06). Neither EX nor C group has shown significant changes in body composition parameters. After training, linear regression analysis revealed a strong positive correlation between Kt/V and 6MWT changes (r = 0.74, p = 0.04) in the EX group. Six months of intradialytic aerobic exercise might increase dialysis adequacy, by increasing Kt/V and URR, and physical performance, regardless of changes in body composition indices.

Changes in Body Composition Predict the Time to Treatment Failure of Lenvatinib in Patients with Advanced Hepatocellular Carcinoma: A Pilot Retrospective Study

ABSTRACT: Aim Changes in body composition parameters are important prognostic factors in hepatocellular carcinoma (HCC) treatment. This study aimed to assess the clinical impact of early changes in body composition during lenvatinib (LEN) treatment on its time to treatment failure (TTF) for patients with advanced HCC. Methods In this retrospective study, we enrolled 65 patients who were administered LEN as the first-line treatment for unresectable HCC and evaluated the body composition change using computed tomography. We focused on the body composition change after 2 weeks of LEN treatment and assessed its impact on TTF and prognosis. Results Significant changes in body composition were observed during 14 weeks of LEN treatment. Among these changes, mean-skeletal muscle attenuation (SMA) decreased significantly within 2 weeks (P = 0.004) without symptoms or changes in the other parameters. In multivariate analysis, this early change in mean-SMA after LEN treatment was a significant predictor of time to treatment failure (HR: 2.67, 95%CI: 1.338–5.081, P = 0.005) in patients with HCC. Conclusions This study revealed that LEN treatment induces a change in the skeletal muscle asymptomatically for a short period, and evaluation of this change may help to predict the TTF of LEN treatment in patients with HCC. Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2049322 .

Efficacy and safety of long-acting growth hormone in adult growth hormone deficiency: A systematic review and meta-analysis

Background & aimsNo meta-analysis has analysed efficacy and safety of long-acting growth hormone (GH) therapy in adult GH deficiency. We undertook this meta-analysis to address this gap in knowledge MethodsElectronic databases were searched for RCTs involving adult GH deficiency patients receiving weekly long-acting GH as compared to daily GH/placebo controls. Primary outcome was to evaluate changes in body-composition parameters. Secondary outcomes were to evaluate alterations in glycaemia and adverse-events. ResultsData from 5 studies involving 648 patients were analysed (4 studies having daily GH as active controls; 1 study having placebo as passive controls). Over 24–34 weeks clinical use, patients receiving long-acting GH had comparable change in lean mass [MD-0.28 kg (95%CI: 0.94 – 0.38); P = 0.41; I2 = 29% (low heterogeneity)] and fat mass [MD-0.10 kg (95%CI: 1.97–1.78); P = 0.92; I2 = 77%(considerable heterogeneity)] as compared to daily GH injections. Long-acting GH use was associated with significantly lower visceral adipose tissue [MD-1.75 cm2(95%CI: 2.14 to −1.35); P < 0.01; I2 = 0% (low heterogeneity)] and higher gynoid fat-mass [MD 0.14 kg(95%CI:0.02–0.26); P = 0.03] compared to daily GH injections. Total adverse events [Risk ratio (RR) 1.65 (95% CI: 0.83–3.29); P = 0.15; I2 = 68%] and severe adverse events [RR 0.60 (95% CI: 0.30–1.19); P = 0.14; I2 = 0%] were not significantly different in long-acting GH group compared to controls. Occurrence of headache, arthralgia, nasopharyngitis, new onset diabetes, anti-GH antibodies were comparable among groups. Long-acting GH users had significantly higher treatment adherence compared to controls [OR 4.80 (95%CI:3.58–6.02); P < 0.01; I2 = 0%]. ConclusionLong-acting GH has comparable beneficial impact on body composition parameters in adult GH deficiency, is well tolerated without any increased adverse events.

The Effect of Different Periodization and Modes of Concurrent Strength and Endurance Training on Double Poling Performance and Body Composition in Adolescent Cross-Country Skiers.

The aim of the study was to compare the effects of different types and periodization of strength training on body composition and maximal aerobic performance in 10-week training period in adolescent XC skiers. Twenty-eight adolescent competitive cross-country skiers, including 10 females (age 17.9 ± 1.8 years; body mass 69.6 ± 9.7 kg; height 1.77 ± 0.1 m; training experience 8.6 ± 3.2 years) took part in this study. Pre-and post-intervention performance was measured with the incremental exercise test (Pmax) on a double poling ski ergometer. Changes in body composition were measured with DXA. In addition to regular endurance training, experimental group one (EXP1) performed maximal and explosive strength training two times per week, experimental group two (EXP2) performed maximal and explosive strength training 1–3 times per week, and the traditional (TRAD) group performed low intensity–high volume strength training 2 times per week. Increases in arm, trunk, and overall lean mass were found in TRAD (p < 0.05). Increases in arm lean-mass was found in EXP1 (p < 0.05), while no changes in body composition occurred in EXP2 (p ≥ 0.05). Pmax improved significantly in all groups (p < 0.05). Changes in body mass, overall and arm lean mass was related to changes in absolute performance (W; p < 0.05), while no relationships were found between changes in body composition parameters and relative performance (W/kg; p ≥ 0.05). In conclusion, different periodization of strength training led to similar improvements in double poling ergometer performance, but resulted in different changes in body composition (lean mass) in adolescent cross-country skiers.

Age-related changes in body composition parameters in healthy Japanese

Age-related changes in body composition parameters in healthy Japanese

Impact of Skeletal Muscle Loss and Visceral Obesity Measured Using Serial CT on the Prognosis of Operable Breast Cancers in Asian Patients.

ObjectiveThis study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients.Materials and MethodsThis study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I–III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival.ResultsAmong 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm2/m2 and 72.0 ± 46.0 cm2, respectively. The mean value of the delta SMI was -0.9 cm2/m2 and the delta VAT was 0.5 cm2. The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937–1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995–1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766–1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989–1.014; p = 0.848, respectively).ConclusionOur study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

Selected Body Composition Parameters Analysis Based on Bioelectrical Impedance in Patients Operated for Gastrointestinal Cancer.

Bioelectrical Impedance Analysis is a method that evaluates body composition, useful in assessing the nutritional status of cancer patients. The analysis of its indicators may be helpful in predicting clinical course. The aim of the study was to evaluate the following body composition parameters: fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM), muscle mass index (MMI), visceral fat (VF) and body mass index (BMI) measured before and after surgery in patients with gastrointestinal cancer and to determine the relationship between body composition and the course of treatment. The study included 125 patients, aged 65-68, operated on due to gastric, pancreatic or colorectal cancer. Body composition was assessed with electrical bioimpedance before and on the fifth postoperative day. The severity of complications was assessed with the Clavien-Dindo classification. In the whole group of patients, the percentage of FM, VF, and BMI levels measured before surgery were significantly higher in curative surgery patients in comparison to palliative surgery patients, p<0.001. The MMI value was also significantly higher, p=0.045. In patients after curative surgery, the values of BMI and FM significantly decreased (BMI - p<0.001; FM - p=0.003) after the surgery. There was no relation between body composition parameters and severity of postoperative complications. In the investigated group, body composition differed between radical and palliative surgery groups. Surgery with curative intent produced more changes in body composition parameters in the early postoperative period than palliative surgery. These observations may be helpful in prehabilitation planning for such patients.

Degradation of skeletal mass in locally advanced oesophageal cancer between initial diagnosis and recurrence

BackgroundThe prognostic value of a low skeletal mass index (SMI) has been investigated in locally advanced oesophageal (LAE) cancer at diagnosis. However, nothing is known about its evolution and clinical impact between initial diagnosis and recurrence.MethodsA total of 89 patients treated for LAE cancer between January 2009 and December 2019 were included in this study. Computed tomography (CT) scans before treatment and at recurrence were evaluated. SMI and other body composition parameters were analysed by the L3 scan method.ResultsParticipants were aged 66.0 (36.0–86) years. The incidence of low SMI increased by 12.3% between diagnosis and recurrence (70.7% vs. 83.0%, respectively) over a median follow-up of 16.9 (1.7–101.6) months. Patients with high SMI at diagnosis showed loss of muscle mass (58.0 vs. 55.2 cm2/m2, respectively; P < 0.001) and decreased body mass index (BMI) (27.9 vs. 26.3 kg/m2, respectively; P = 0.05), but fat mass was increased (68.9 vs. 72.0 cm2/m2, respectively; P = 0.01). Patients with low SMI at diagnosis showed no significant changes in body composition parameters and no improvement of SMI, even with nutritional support. Low SMI (hazard ratio [HR]: 1.8; 95% confidence interval [CI]: 1.02–3.16) was an independent predictor (P = 0.041) of high nutritional risk index (HR: 1.79; 95% CI: 1.03–3.11; P = 0.039) at diagnosis.ConclusionsThe percentage of patients with a low SMI increased during follow-up. Our data suggest that an assessment of skeletal muscle parameters and nutrition support may be more useful in patients with a high SMI.

Changes in body composition during and after inpatient rehabilitation in people with recent spinal cord injury.

Prospective cohort study. To investigate changes in body composition parameters in people with recent spinal cord injury (SCI) during their first inpatient rehabilitation and up to 1 year after discharge and whether those potential changes over time varied between different personal and lesion characteristics groups. Rehabilitation center, the Netherlands. People with recent SCI (≥18 years; n = 53) were tested around admission (T0) and discharge (T1) of inpatient rehabilitation. A sub-group (n = 19) was measured 1 year after discharge (T2). Personal and lesion characteristics were registered at T0. Anthropometry (height, body mass, body mass index, and waist circumference) was performed at T0, T1, and T2. Bioelectrical impedance analysis (BIA) was measured at T0 and T1. During inpatient rehabilitation, no significant changes in all body composition parameters were found. During the first year after discharge, body mass index (26.8 kg/m2) significantly increased compared with the level at both admission (25.4 kg/m2; p = 0.01, 95% CI: 0.32-2.52) and discharge (25.1 kg/m2; p = 0.02, 95% CI: 0.26-3.00). People with paraplegia showed an increase in absolute waist circumference (6.5%) compared with people with tetraplegia who showed a net decrease (-5.5%) in the year after discharge (p = 0.047, 95% CI: 0.27-33.62). A stable body composition during inpatient rehabilitation is followed by an increased BMI in the year after discharge in people with recent SCI. People with paraplegia showed an increase in absolute waist circumference compared with people with tetraplegia who showed a net decrease in the year after discharge.

Concurrent Chemoradiotherapy Induces Body Composition Changes in Locally Advanced Head and Neck Squamous Cell Carcinoma: Comparison between Oral Cavity and Non-Oral Cavity Cancer

Few prospective cohort trials have evaluated the difference in treatment-interval total body composition (TBC) changes assessed by dual-energy X-ray absorptiometry (DXA) between two patient subgroups with locally advanced head and neck squamous cell carcinoma (LAHNSCC) receiving concurrent chemoradiotherapy (CCRT): oral cavity cancer with adjuvant CCRT (OCC) and non-oral cavity with primary CCRT (NOCC). This study prospectively recruited patients with LAHNSCC. Clinicopathological variables, blood nutritional/inflammatory markers, CCRT-related factors, and TBC data assessed by DXA before and after treatment were collected. Multivariate linear regression analysis identified the factors associated with treatment-interval changes in body composition parameters, including lean body mass (LBM), total fat mass (TFM), and bone mineral content (BMC). A total of 127 patients (OCC (n = 69) and NOCC (n = 58)) were eligible. Body composition parameters were progressively lost during CCRT in both subgroups. Extremities lost more muscle mass than the trunk for LBM, whereas the trunk lost more fat mass than the extremities for TFM. BMC loss preferentially occurred in the trunk region. Different factors were independently correlated with the interval changes of each body composition parameter for both OCC and NOCC subgroups, particularly mean daily calorie intake for LBM and TFM loss, and total lymphocyte count for BMC loss. In conclusion, treatment-interval TBC changes and related contributing factors differ between the OCC and NOCC subgroups.

Weight Status and Body Composition Dynamics in Children and Adolescents During the COVID-19 Pandemic.

Introduction: The preventive measures taken in attempt to prevent COVID-19 spread lead to closure of schools and leisure time activities. The impact of the pandemic on pediatric weight status is unclear, reports from around the world predict grave consequences with increasing obesity. We aimed to examine the change in body composition parameters of children and adolescents during the pandemic.Materials and Methods: An observational study of 220 pediatric subjects (109 boys; mean current age 11.8 ± 3.3 years; 37 with underweight, 123 with normal weight, and 60 with overweight/obesity) who underwent height and body composition measurements by bioelectrical impedance analysis, Tanita MC-780MA, GMON Professional Software before and during the pandemic. Height, body mass index (BMI) and muscle-to-fat ratio (MFR) z-scores were calculated. Data collected from the participants' medical files included home address for socioeconomic position calculation, pubertal stage, and self-reported sleep duration and physical activity performance.Results: The vast majority of the cohort (81.8%) had stable or improved MFR z-scores during the pandemic. MFR z-scores significantly increased in subjects with underweight (p = 0.05) and normal weight (p = 0.008), but not in subjects with overweight/obesity (p = 0.169). There were significant associations in BMI z-scores (r = 0.961, p < 0.001) and MFR z-scores (r = 0.854, p < 0.001) before and during the pandemic. A multivariate linear regression model identified socioeconomic position, pre-pandemic BMI z-scores, pre-pandemic MFR z-scores, and physical activity levels during the pandemic as predictors for delta MFR z-scores (F = 12.267, p < 0.001). Age, sex, pre-pandemic physical activity, and the time that had elapsed between initiation of the first nationwide lockdown and the BIA assessment during the pandemic did not emerge as predictors for delta MFR z-score.Conclusions: Our encouraging findings demonstrate improvement in body composition parameters of subjects with underweight and normal weight and stability in subjects with overweight/obesity. Engagement in physical activity during the pandemic predicted improvement, while lower socioeconomic position predicted deterioration.

Anti-Interleukin-17 Therapy of Severe Psoriatic Patients Results in an Improvement of Serum Lipid and Inflammatory Parameters’ Levels, but Has No Effect on Body Composition Parameters

BACKGROUND: Psoriasis is frequently accompanied by metabolic syndrome. Effect of anti-tumor necrosis factor therapies on increases in body weight is well-known. Data on the effects of interleukin-17 inhibitors are limited. Authors determined the effect of anti-interleukin-17 therapies on the body composition and serum lipid and inflammatory parameters among severe psoriatic patients. METHODS: Thirty-five severe psoriatic patients were enrolled. Twenty-two received secukinumab and 13 received ixekizumab as their 2nd-or 3rd-line biological treatment. Before treatment initiation and 6 months later, laboratory examinations measuring metabolic and inflammatory panels and body composition analyses were performed. RESULTS: After 6 months, a significant reduction was observed in psoriasis area severity index (p < 0.001) from 18 to 0, in c-reactive protein (p < 0.001) from 6.6 to 4.00 mg/L, in low-density lipoprotein-cholesterol (p = 0.004) from 3.69 to 3.19 mmol/L, and an improvement in high-density lipoprotein-cholesterol (p = 0.022) from 1.31 to 1.40 mmol/L. Median baseline body mass index was 32.80 kg/m2. The body composition parameters did not show any significant changes. CONCLUSIONS: Anti-interleukin-17 therapy of severe psoriatic patients does not cause significant changes in body composition parameters. Improvements in the lipid and inflammatory parameters might have a beneficial effect on patients’ cardiometabolic status. This effect might be detectable in high-risk obese psoriatic patients.