Body composition changes differ by gender in stomach, colorectal, and biliary cancer patients with cachexia: Results from a pilot study

Few studies have examined the possibility that cachexia may affect men and women differently. This pilot study assessed gender differences in body composition in stomach, colorectal, and biliary cancer patients with cachexia. A sample of 38 participants (Female: Male = 17:21, mean age 57.4 years) were included if they were undergoing chemotherapy and experienced weight loss of 5% or more over a 6‐month period. Bioelectrical impedance analysis (BIA) was applied to measure body composition. Phase angle (PA) and levels of extra‐/intracellular water (ECW; ICW) were determined. Data were analyzed first by gender and then compared to age‐ and gender‐matched healthy controls from the NHANES‐III dataset. PA was lower (P < .01) in both genders compared with healthy controls, and PA was lower in female patients compared with male patients (P = .03). Male cancer patients with lower PA also had lower ICW levels compared with healthy controls (r = .98, P < .01). For female patients, PA and ICW were negatively correlated (r = .897, P < .01). A lower ECW/ICW ratio was highly correlated (r = .969 for men, r = .639 for women) with increased PA in cancer patients. ICW changes are gender‐specific in patients with GI cancer. ECW/ICW ratios and PA may be suitable surrogate markers for gender‐specific changes in cell composition and health status.

[1]  G. Vanhoutte,et al.  Cachexia in cancer: what is in the definition? , 2016, BMJ open gastroenterology.

[2]  N. Ichihashi,et al.  Increase in echo intensity and extracellular-to-intracellular water ratio is independently associated with muscle weakness in elderly women , 2017, European Journal of Applied Physiology.

[3]  D. Guttridge,et al.  Inflammation Based Regulation of Cancer Cachexia , 2014, BioMed research international.

[4]  C. Tsigos,et al.  Stress and inflammatory biomarkers and symptoms are associated with bioimpedance measures , 2015, European journal of clinical investigation.

[5]  L Nescolarde,et al.  Localized bioimpedance to assess muscle injury , 2013, Physiological measurement.

[6]  G. Doherty,et al.  Gastro-intestinal toxicity of chemotherapeutics in colorectal cancer: the role of inflammation. , 2014, World journal of gastroenterology.

[7]  S. Anker,et al.  Treatment of cachexia: An overview of recent developments. , 2015, International journal of cardiology.

[8]  Aluísio J D Barros,et al.  Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations , 2005, Current opinion in clinical nutrition and metabolic care.

[9]  G. Grabenbauer,et al.  Management of radiation and chemotherapy related acute toxicity in gastrointestinal cancer. , 2016, Best practice & research. Clinical gastroenterology.

[10]  K R Foster,et al.  Whole-body impedance--what does it measure? , 1996, The American journal of clinical nutrition.

[11]  J. Grutsch,et al.  Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colorectal cancer. , 2004, The American journal of clinical nutrition.

[12]  O. Grundmann,et al.  The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients—a comprehensive review , 2015, European Journal of Clinical Nutrition.

[13]  J. Grutsch,et al.  Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer , 2009, BMC Cancer.

[14]  M. Elia,et al.  Bioelectrical impedance analysis-part II: utilization in clinical practice. , 2004, Clinical nutrition.

[15]  T. Zimmers,et al.  Chemotherapy-related cachexia is associated with mitochondrial depletion and the activation of ERK1/2 and p38 MAPKs , 2016, Oncotarget.

[16]  F. Dumler,et al.  Body composition analysis by bioelectrical impedance in chronic maintenance dialysis patients: comparisons to the National Health and Nutrition Examination Survey III. , 2003, Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation.

[17]  P. Porporato.  Understanding cachexia as a cancer metabolism syndrome , 2016, Oncogenesis.

[18]  Diane D. Liu,et al.  Association Between Multi-frequency Phase Angle and Survival in Patients With Advanced Cancer. , 2017, Journal of pain and symptom management.

[19]  Kheir M. Al-Kodmany.  Preliminary Findings , 2020, The Urban Book Series.

[20]  G. Crepaldi,et al.  Bioimpedance vector pattern in cancer patients without disease versus locally advanced or disseminated disease. , 2003, Nutrition.

[21]  S. Heymsfield,et al.  Bioelectrical impedance analysis: population reference values for phase angle by age and sex. , 2005, The American journal of clinical nutrition.

[22]  D. Schoeller,et al.  The validity of bioelectrical impedance models in clinical populations. , 2004, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[23]  V. Baracos,et al.  Body Composition, Symptoms, and Survival in Advanced Cancer Patients Referred to a Phase I Service , 2012, PloS one.

[24]  Matthias Pirlich,et al.  Cutoff percentiles of bioelectrical phase angle predict functionality, quality of life, and mortality in patients with cancer. , 2010, The American journal of clinical nutrition.

[25]  D. Häussinger,et al.  Cellular hydration state: an important determinant of protein catabolism in health and disease , 1993, The Lancet.

[26]  B. Tan,et al.  Cachexia: prevalence and impact in medicine , 2008, Current opinion in clinical nutrition and metabolic care.

[27]  Marta Canuti,et al.  Influenza and Other Respiratory Viruses Involved in Severe Acute Respiratory Disease in Northern Italy during the Pandemic and Postpandemic Period (2009–2011) , 2014, BioMed research international.

[28]  A. Fucic,et al.  Gender Difference in Distribution of Estrogen and Androgen Receptors in Intestinal-type Gastric Cancer. , 2017, Anticancer research.

[29]  S. Anker,et al.  Treatment of cachexia: an overview of recent developments. , 2014, Journal of the American Medical Directors Association.

[30]  E. Bruera,et al.  Phase angle for prognostication of survival in patients with advanced cancer: Preliminary findings , 2014, Cancer.

[31]  E. Blaak,et al.  Gender differences in fat metabolism , 2001, Current opinion in clinical nutrition and metabolic care.

[32]  Shumei S. Guo,et al.  Body composition estimates from NHANES III bioelectrical impedance data , 2002, International Journal of Obesity.