Predictive value of bioelectrical impedance analysis and CT in cancer cachexia

Abstract

Objective To evaluate the association between indicators of bioelectrical impedance analysis (BIA) and CT-realated indices and cancer cachexia in patients, and explore the predictive value.Methods Patients with cancer in the oncology department of Shanxi Bethune Hospital in Taiyuan were selected from August 2022 to September 2023. Their body composition-related indices, including whole-body phase angle (PhA), fat free mass (FFM), basal metabolic rate (BMR), skeletal muscle index (SMI), and visceral fat area (VFA), were obtained by BIA within 48 h of admission to the hospital. The MIM planning system was used to delineate the boundaries of fat and skeletal muscle in the mid-point cross-section of the third lumbar vertebra in the abdominal CT images of the patients, providing semi-automated relevant parameters, including CT-skeletal muscle index (CT-SMI) and CT-fat mass index (CT-FMI). Differences in basic information and nutritional indicators between the cachexia and non-cachexia groups were compared using the t test or χ2 test, the relationship between each indicator and the occurrence of malignant disease was analyzed using univariate Logistic regression, the predictive value of the two for tumor malignancy was determined by the ROC curve, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were calculated using the predictABEL package in R 4.2.0 Results A total of 100 cases were included, in which 53 cases of cachexia group, 47 cases of non-cachexia group. Compared with the two groups, cachexia group had a higher percentage of male patients. PhA, BMI, FFM, BMR, SMI, VFA, CT-SMI and CT-FMI in cachexia group were lower than those in non-cachexia group, and the differences were statistically significant (P﹤0.05). Univariate Logistic regression analysis showed that male and the decline of PhA, BMI, FFM, BMR, SMI, VFA, CT-SMI and CT-FMI were the risk factors for cachexia in tumor patients. The ROC curve showed that both BIA and CT had good predictive value for cancer cachexia. Compared with CT-SMI, the IDI of SMI measured by BIA for predicting cachexia was 0.031 [95%CI(-0.011, 0.073)], and the NRI was -0.080 [95%CI(-0.241, 0.081)], reflecting that the diagnostic efficacy of BIA for cachexia was not superior to that of CT, but was not inferior to that of CT.Conclusion The decrease of PhA, FFM, BMR, SMI, VFA, CT-SMI and CT-FMI were related risk factors for cancer cachexia. Male tumor patients seemed to be more likely to be complicated with cachexia. CT and BIA had similar efficacy in evaluating the body's muscle and fat levels, and both of them can be used to predict cancer cachexia.

Keywords

• tumor
• cachexia
• ct
• bioelectrical impedance analysis