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使用生物电阻抗分析评估化疗后急性髓性白血病患者的肌肉减少症
Authors Qin Z, Lu K, Jiang T, Wang M, Weng Y, Tang X, Zhao Y
Received 25 November 2021
Accepted for publication 24 January 2022
Published 9 February 2022 Volume 2022:15 Pages 1261—1269
DOI https://doi.org/10.2147/IJGM.S351241
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Background: We aimed to explore the potential association of body composition parameters measured by bioelectrical impedance analysis (BIA) with the incidence of sarcopenia in patients with acute myeloid leukemia (AML) (non-M3) after chemotherapy.
Patients and Methods: This was a single-center observational study. Sixty-nine patients with newly diagnosed AML underwent BIA at the time of initial diagnosis and after completion of three chemotherapy sessions. Pre- and post-chemotherapy BIA parameters were compared. Sarcopenia was defined as low skeletal muscle mass plus low muscle strength according to the Asian Working Group for Sarcopenia (AWGS). Association of sarcopenia with mid-arm muscle circumference (MAMC) and intracellular water (ICW) was assessed by multivariate logistic regression.
Results: There was a significant increase in the prevalence of sarcopenia after chemotherapy (39.1% vs 14.5%, P < 0.001). Skeletal muscle mass (SMM), fat-free mass (FFM), and soft lean mass (SLM) showed a significant decrease after chemotherapy (P < 0.05). MAMC, ICW, and total body water (TBW) significantly decreased after chemotherapy (P < 0.05). BIA indices including appendicular skeletal muscle mass (ASM) (r =0.889, P < 0.001), ICW (r =0.869, P < 0.001), MAMC (r =0.849, P < 0.001) showed a positive correlation with SMI. Moreover, ASM (r =− 0.453 P =0.001), ICW (r =− 0.322, P < 0.05), and MAMC (r =− 0.352, P < 0.05) showed a negative correlation with sarcopenia. On multivariate logistic regression analysis, increased ICW was associated with decreased risk of sarcopenia [odds ratio (OR): 0.50; 95% confidence interval (CI) 0.30– 0.82]. Each additional unit of MAMC after chemotherapy was associated with 71% lower risk of sarcopenia (OR: 0.29; 95% CI 0.13– 0.66).
Conclusion: The incidence of sarcopenia was associated with chemotherapy of patients with AML (non-M3) as reflected by body composition changes.
Keywords: acute myeloid leukemia, sarcopenia, bioelectrical impedance analysis, mid-arm muscle circumference