4.4 Article

Evaluating Sarcopenia by Using the Bioelectrical Impedance Analysis in Patients with Acute Myeloid Leukemia After Chemotherapy

Journal

INTERNATIONAL JOURNAL OF GENERAL MEDICINE
Volume 15, Issue -, Pages 1261-1269

Publisher

DOVE MEDICAL PRESS LTD
DOI: 10.2147/IJGM.S351241

Keywords

acute myeloid leukemia; sarcopenia; bioelectrical impedance analysis; mid-arm muscle circumference

Funding

  1. Chongqing Medical Research Project: Study on early cardiotoxicity of antitumor drugs in lymphoma patients [2021MSXM276]
  2. Chongqing Natural Science Foundation [cstc2019jcyj-msxmX0043]

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This study explores the potential association between body composition parameters and the incidence of sarcopenia in patients with acute myeloid leukemia (AML) after chemotherapy. The study finds a significant increase in the prevalence of sarcopenia after chemotherapy, with a decrease in skeletal muscle mass, fat-free mass, and soft lean mass. The study also identifies a correlation between mid-arm muscle circumference and intracellular water with sarcopenia.
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.

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