Evaluation of nutritional Status in lung cancer using bio electrical impedance analysis and Mini Nutritional Assessment

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Daghfous Hafaoua
El Ayeb Wejdène
Alouane Leila
Tritar Fatma

Abstract

Background: Malnutrition and cachexia were a frequent problem in lung cancer and increases the risks of morbidity and mortality in these patients. Bioelectrical impedance analysis (BIA) is easy, non-invasive and reproducible method that can be performed.

Aim: Evaluate nutritional status in patients with primary lung cancer by Mini Nutritional Assessment (MNA), BIA and anthropometric values (weight, arm and calf circumferences) and correlate the nutritional parameters to severity of cancer and histopathology.

Methods: The nutritional status of 73 cases of primary lung cancer was evaluated by anthropometric parameters, MNA test and impedencemetrie

Results: According to body mass index (BMI), malnutrition, overweight and obesity were noted in 34,2%, 13,7% and 5,5%. According to BMI, free-fat mass index (FFMI) and fat mass index (FMI), the investigations occurred malnutrition and depletion of muscle in respectively 19,2% and 23,3% of cases. Fat depletion was noted in 21,9%. Overweight and obesity were detected in 6,8% and 5,5% of cases. Assessment by MNA, revealed that 28,7% of patients were already malnourished and 49,3% of patients were at risk of malnutrition. A significant correlation existed between the score of MNA and arm and calf circumferences, FFMI and FMI. FMI was significantly lower in group of patients with small lung carcinoma.

Conclusion: Only FFMI allows early detection of malnutrition in cancer patients overestimated by measuring BMI and arm circumference was the better indicator of depletion of muscle.

Keywords:

Cancer, boielectical- impedance analysis, free-fat mass index, fat mass index, body mass index, malnutrition

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References

  1. Scott HR, McMillan DC, Forrest LM. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. British Journal of Cancer 2002;87: 264-7
  2. Palomares MR, Sayre JW, Shekar KC et al. Gender influence on weightloss pattern and survival of non small cell lung carcinoma patients. Cancer 1996;78:2119-26
  3. Vigano A, Bruera E, Jhangri GS et al. Clinical survival predictors in patients with advanced cancer. Arch Intern Med 2000; 160: 861-8
  4. Catalano G, Della Vittoria, Scarpati M et al. The role of "bioelectrical impedance analysis" in the evaluation of the nutritional status of cancer patients. Adv Exp Med Biol 1997;348:145-8.
  5. Déchelotte P. Prise en charge de la dénutrition chez le patient cancéreux. Nutr Clin Metab 2000;14:241-9
  6. Melchoir JC. Le diagnostic de la dénutrition. Cah Nut Diét 2000;35: 166-70
  7. Nyboer J. Electrical Impedance Plethysmography. Springfield: CharlesThomas Publisher, 1959.
  8. Hoffer EG, Meador CK, Simpson DC. Correlation of whole-body impedance with total body water volume. J Appi Physiol 1969;27:531-34.
  9. Kushner RF. Bioelectrical impedance analysis: a review of principles and applications. J Am Coll Nutr 1992;11: 199-209
  10. . Baumgartner R, ChumleaW, Roche A. Estimation of body composition from bioelectrical impedance of body segments. Am J Clin Nutr 1989;50: 221-6
  11. Hewitt MJ, Going SB, Williams DP, Lohman TG. Hydration of the fat-free body mass in children and adults: implications for body composition assessment. Am J Physiol 1993; 265: 88-95.
  12. Dittmar M. Reliability and variability of bioimpedance measures in normal adults: effects of age, gender, and body mass. Am J Phys Anthropol 2003;122:361-70
  13. Valenzuela K, Rojas P, Basfifer K. Nutritional assessment for cancer patient. Nutr Hosp 2012; 27: 516-2.
  14. Fredrix EW, Saris WH, Soeters PB et al. Estimation of body composition by bioelectrical impedance in cancer patients. Eur J Clin Nutr 1990;44: 749-52
  15. Trutschnigg B, Kilgour RD, Reinglas J et al. Precision and reliability of strength (Jamar vs. Biodex handgrip) and body composition (dual-energy X-ray absorptiometry vs. bioimpedance analysis) measurements in advanced cancer patients. Appl Physiol Nutr Metab 2008; 33: 1232-9.
  16. Hsu CL, Chen KY, Shih JY et al. Advanced non-small cell lung cancer in patients aged 45 years or younger: outcomes and prognostic factors. BMC Cancer 2012; 13: 241-8.
  17. Pedro M. Screening the nutritional status in oncology: a preliminary report on 1,000 outpatients. Support Care Cancer 2009; 17: 179-84
  18. Baracos V, Reiman T, Mourtzakis M, Gioulbasanis I. Body composition in patients with non small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. Am J Clin Nutr 2010; 91: 1335-75
  19. Baumgartner RN, Koehler KM, Gallagher D et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147: 755-63.
  20. Prado CM, Lieffers JR, McCargar LJ et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 2008; 9: 629-35
  21. Parsons HA, Baracos VE, Dhillon N, Hong DS. Body composition, symptoms, and survival in advanced cancer patients referred to a phase I service. PLo S One 2012; 13: 29-33.
  22. Trabelsi Alouane L, Bedioui AM, Rahal K. Apport de l'impédancemétrie dans le dépistage de la dénutrition chez un groupe de patients tunisiens atteints de cancer. Bull Cancer 2006;93:1055-61.
  23. Abid Kamoun H, Alouane Trabelsi L, Slimane H. L'évolution des apports alimentaires explique-t-elle la progression de l'obésité en Tunisie. Med et Nutr 2002;38:49-55.
  24. Kabat GC, Kim M, Hunt JR et al. Body Mass Index and Waist Circumference in Relation to Lung Cancer Risk in the Women's Health Initiative. Am J Epidemiol 2008; 168:158-69
  25. Prado CM, Baracos VE, McCargar LJ et al. Sarcopenia as a determinant of and time to tumor progression in metastatic breast cancer patients. Clin Cancer Res 2009; 15: 2920-6
  26. Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci 2000; 904:437-48
  27. Ramos Chaves M, BoléoTomé C, MonteiroGrillo I et al. The diversity of nutritional status in cancer: new insights.Oncologist 2010; 15: 523-30
  28. Staal-van den Brekel AJ, Schols A, Dentener MA et al. Metabolism in patients with small cell lung carcinoma compared with patients with non small cell lung carcinoma and healthy controls. Thorax 1997; 52: 338-41.