Body composition assessment before and after weight loss following a Roux-en-Y gastric bypass. Are bioimpedanciometry estimations reliable?

Abstract

Objetivo: el objetivo de este estudio fue evaluar la prevalencia de hipovitaminosis D en los candidatos a cirugía bariátrica (CB) y su relación con factores de riesgo y los componentes del síndrome metabólico. Material y métodos: los parámetros clínicos, antropométricos y bioquímicos se midieron en 56 pacientes caucásicos incluidos en un protocolo de cirugía bariátrica entre enero y junio de 2014. Los pacientes fueron estratificados en tres grupos de acuerdo al status de vitamina D: suficiencia (≥ 40 ng/ml), insuficiencia (40-20 ng/ml) y deficiencia (< 20 ng/ml). Resultados: se observó deficiencia de vitamina D en el 75% de los pacientes. Estos pacientes tenían mayor índice de masa corporal (p = 0,006) y concentraciones plasmáticas mas bajas de PTH (p = 0,045). Además, hubo más pacientes con diabetes mellitus tipo 2 (DM2) y dislipemia (DLPM) en el grupo con niveles de 25 (OH) D < 20 ng/ml. Asimismo la 25 (OH) D se correlacionó negativamente con la masa grasa (r =-0,504; p = 0,009), el IMC (r =-0,394; p = 0,046) y la hipertensión arterial (r =-0,637; p = 0,001). Conclusión: De nuestros hallazgos concluimos que la deficiencia de vitamina D es muy común entre los candidatos a CB y que la misma está asociada con DM2 y DLPM. Aunque hay pocos datos sobre el mejor tratamiento para el bajo nivel de vitamina D en los pacientes candidatos CB, la detección de la deficiencia de vitamina D debe realizarse de forma rutinaria en estos casos. 25-hydroxy vitamin D and syndrome metabolic components in candidates to bariatric surgery Vitamina D y componentes del síndrome metabólico en candidatos a cirugía bariátrica

Extracellular water to total body water ratio, a novel predictor of recurrence in patients with colorectal cancer

“…Recent research has shown the predictive nature of cachexia, leading to sarcopenia and frailty, for postoperative recurrence in cancer patients. [2][3][4] Since sarcopenic patients, evaluated by muscle mass, have poorer tolerance to cancer therapies with a greater incidence of complications, chemotherapy toxicity, and perioperative problems, including recurrence, the evaluation of sarcopenic status can help to develop treatment strategies. In addition, accumulating evidence has shown that sarcopenia and frailty can be induced by various mechanisms, such as malnutrition, systemic inflammation, and other organ diseases.…”

“…This is the first study, to our knowledge, demonstrating the effectiveness of ECW/TBW as a predictive factor for recurrence in cancer patients. Recent research has shown the predictive nature of cachexia, leading to sarcopenia and frailty, for postoperative recurrence in cancer patients 2–4 . Since sarcopenic patients, evaluated by muscle mass, have poorer tolerance to cancer therapies with a greater incidence of complications, chemotherapy toxicity, and perioperative problems, including recurrence, the evaluation of sarcopenic status can help to develop treatment strategies.…”

“…1,2 In cancer patients, BIA assessment for sarcopenia or obesity is reportedly useful for predicting poor patient outcomes. 3,4 Of the body composition parameters, the total body water (TBW) fraction is an important indicator that accounts for 60% of the body weight. Cancer and extracellular water (ECW) are closely linked, as cancer generally elevates the metabolic rate and induces malnutrition, inflammation, and fluid retention conditions, including ascites, pleural effusion, and edema of peripheral extremities.…”

“…Body composition assessment in patients with various diseases is essential because unfavorable changes in body composition could be responsible for low exercise capacity, sarcopenia, cachexia, and frailty, which lead to poor patient outcomes 1,2 . In cancer patients, BIA assessment for sarcopenia or obesity is reportedly useful for predicting poor patient outcomes 3,4 . Of the body composition parameters, the total body water (TBW) fraction is an important indicator that accounts for 60% of the body weight.…”

Extracellular Water-to-total Body Water Ratio as an Objective Biomarker for Frailty in Lung Cancer Patients

“…However, the present study suggested that the important parameters in BIA would not be SMI or FFMI, which are secondarily calculated based on electric current, resistance, and reactance, but rather ECW/TBW, which is directly calculated. Several reports (20,21) have also indicated that FFM measured by BIA would not be appropriate parameters for detecting the frail population among cancer patients, which might be related to the effect of body fluid retention on muscle mass estimation via altered impedance. Furthermore, this study indicated that ECW/TBW would more accurately detect the frail population among LC patients with potentially poor PS and/or ageing than Ph-A, directly calculated based on electric current, resistance, and reactance.…”