Bioelectrical Impedance Vector Pattern and Biomarkers of Physical Functioning of Prostate Cancer Survivors in Rehabilitation

Abstract

Background: Knowledge of clinically established factors of physical function such as body composition, bioelectrical phase angle (PhA) and handgrip strength (HGS) with mortality predictive and health-related relevance is limited in prostate cancer survivors (PCS). Therefore, the aim of this study was to characterise and compare body composition data of PCS with extensive reference data as well as to analyse PhA and HGS and the prevalence of critical prognostic values at an early stage of cancer survivorship. Methods: One hundred and forty-eight PCS were examined at the start (T1) and end (T2) of a 3-week hospitalised urooncological rehabilitation, which began median 28 days after acute cancer therapy. Examinations included a bioimpedance analysis and HGS test. Comparison of body composition between PCS and reference data was performed using bioimpedance vector analysis (BIVA). Results: BIVA of the whole PCS group showed abnormal physiology with a cachectic state and a state of overhydration/oedema, without significant changes between T1 and T2. The age- and BMI-stratified subgroup analysis showed that PCS aged 60 years and older had this abnormal pattern compared to the reference population. HGS (T1: 38.7 ± 8.9 vs T2: 40.8 ± 9.4, kg), but not PhA (T1/T2: 5.2 ± 0.7, °), changed significantly between T1 and T2. Values below a critical threshold reflecting a potentially higher risk of mortality and impaired function were found for PhA in 20% (T1) and 22% (T2) of PCS and in 41% (T1) and 29% (T2) for HGS. Conclusions: BIVA pattern and the prevalence of critically low HGS and PhA values illustrate the necessity for intensive continuation of rehabilitation and survivorship care especially in these ‘at risk’ cases. The routine assessment of body composition, PhA and HGS offer the opportunity to conduct a risk stratification for PCS and could help personalising and optimising treatment in rehabilitation and ongoing survivorship care.

Impedance Analysis to Evaluate Nutritional Status in Physiological and Pathological Conditions

“…The validity of the method extends from prognosis to therapeutic procedures [ 71 , 72 , 73 , 74 ]; BIVA is useful in diseases requiring diuretic therapy, for the detection of fluid overload and the identification, monitoring, and therapy planning of renal patients with impaired fluid balance. However, the greater potential of the method has been found in those patients in whom basal impedance vectors had already been measured under healthy conditions [ 26 , 75 ]; In patients with average and mild obesity, BIVA was proved to be a valid method of analysis, both prognostic and therapeutic. Nonetheless, significant limitations of BIVA method in morbid obesity type III have been detected as the underestimation of body fat percentage and overestimation of FFMv [ 58 , 59 , 60 , 79 ]; in extreme interventions for the treatment of obesity, such as bariatric surgery, BIVA was shown to be useful in highlighting a loss of FM, as well as of FFM [ 78 ]; on the other hand, following therapeutic fasting, the aforementioned limitations were confirmed in the evaluation of subjects with severe obesity [ 79 ]; In the assessment of the body composition of subjects with anorexia nervosa, BIVA assumes considerable importance at the psychological level, while the results show significant limitations for BIA [ 62 , 63 ].…”

“…A study conducted on 58 patients undergoing three-week inpatient rehabilitation after acute prostate cancer therapy included BIVA and hand grip strength test (HGS) at the beginning and end of treatment. The BIVA model and the prevalence of critically low Phase angle values highlight the need for intensive rehabilitation and stand as a valuable aid in personalizing and optimizing the treatment [ 75 ].…”

“…The validity of the method extends from prognosis to therapeutic procedures [71][72][73][74]; • BIVA is useful in diseases requiring diuretic therapy, for the detection of fluid overload and the identification, monitoring, and therapy planning of renal patients with impaired fluid balance. However, the greater potential of the method has been found in those patients in whom basal impedance vectors had already been measured under healthy conditions [26,75];…”

Impedance of whole body plays a crucial role in the pathway from rheumatoid arthritis to prostate cancer: a Mendelian randomization study

“…RA patients have been reported to undergo changes in body weight, arm circumference, waist circumference, hip, resistance/height, reactance/height, and erythrocyte sedimentation rate, which can result in increases in whole-body impedance [28] . An observational study indicated that the regular evaluation of body composition provides a chance to stratify the risk of PCa and may aid in customizing and improving treatment in the rehabilitation and continued survivorship care [29] . Therefore, the main focus of this research is to investigate whether RA increases the risk of PCa through the pathway of impedance of whole body.…”