ESPEN 2022 Late Breaking Abstracts

Topic:      Nutrition and cancer

Abstract Submission Identifier: ESPEN22-LB-2153

EXTRACELLULAR WATER TO TOTAL BODY WATER RATIO (ECW/TBW) MAY MEDIATE THE ASSOCIATION BETWEEN SKELETAL MUSCLE MASS (SMM) AND BODY MASS INDEX (BMI) IN PATIENTS WITH CANCER CACHEXIA

N. Katsura*, 1, J. Kotani 1

1Department of Disaster and Emergency Medicine, KOBE UNIVERSITY GRADUATE SCHOOL O F MEDICINE, Kobe, Japan

 

Rationale: The prognostic factor of cancer cachectic population has been researched  for a long time, however, we have not yet had outstanding one. Recently, researchers have focused on body composition measured by Bioelectrical Impedance Analysis (BIA) in which  data has been collected by measuring the impedance of body water and cell membranes. Generally, in cachectic stage, SMM of cancer patients mainly decreased with or without lipid weight decreasing, however, we cannot find any reports to investigate the association between the decreasing rates of SMM and BMI in such situation. The aim of this study was to evaluate the predictive utility of the decreasing rates of SMM depended on how ECW/TBW change. 

Methods: In total, 77 consecutive patients (both outpatients and inpatients) for whom the stage of cancer cachexia was determined from July 2020 to April 2022 in Mukaijima private Hospital, were included in this retrospective cohort study. Their mean age was 76.0 (standard deviation, 8.5) years; 41 were males and 36 females. The cubic sprain analysis between SMM and BMI with different ECW/TBW; ECW/TBW=less than 0.39, 0.40, 0.41, more than 042. 

Results:  In the case of ECW/TBW<0.42, till BMI=17.0, SMM/total body weight increased, and after that, decreased. To the contrary, in the case of ECW/TBW ≧0.42, till BMI=17.0, it decreased, after that, increased.

Conclusion: In the cachectic stage, in the case of maintaining the cellularwater balance, lipid mass is mainly consumpted till BMI=17.0. This might be the first finding against the conventional theory which said cachectic metabolism made skeletal muscle consume mainly. 

References: Gomes T L N, Soares J D P, Borges T C, Pichard C, Pimentel G D. Phase angle is not associated with fatigue in cancer patients: the hydration impact. Eur J Clin Nutr 2020; 74: 1369-1373. http://dx.doi:1

Ohashi Y, Joki N, Yamazaki K, Kawamura T, Tai R, Oguchi H, Yuasa R, Sakai K. Changes in the fluid volume balance between intra- and extracellular water in a sample of Japanese adults aged 15–88 yr old: a cross-sectional study. Am J Physiol Ren Physiol 2018; 314: F614-E622. http://dx.doi.org/10.1152/ajprenal.00477.

0.1038/s41430-020-0597-4

 

Disclosure of Interest: None Declared

 

Keywords: cancer cachexia, bioelectrical impedance analysis (BIA), extracellular water to total body water ratio (ECW/TBW)