Body composition changes differ by gender in stomach, colorectal, and biliary cancer patients with cachexia: Results from a pilot study

Saunjoo L Yoon, Oliver Grundmann, Joseph J Williams, Lucio Gordan, Thomas J George Jr, Saunjoo L Yoon, Oliver Grundmann, Joseph J Williams, Lucio Gordan, Thomas J George Jr

Abstract

Few studies have examined the possibility that cachexia may affect men and women differently. This pilot study assessed gender differences in body composition in stomach, colorectal, and biliary cancer patients with cachexia. A sample of 38 participants (Female: Male = 17:21, mean age 57.4 years) were included if they were undergoing chemotherapy and experienced weight loss of 5% or more over a 6-month period. Bioelectrical impedance analysis (BIA) was applied to measure body composition. Phase angle (PA) and levels of extra-/intracellular water (ECW; ICW) were determined. Data were analyzed first by gender and then compared to age- and gender-matched healthy controls from the NHANES-III dataset. PA was lower (P < .01) in both genders compared with healthy controls, and PA was lower in female patients compared with male patients (P = .03). Male cancer patients with lower PA also had lower ICW levels compared with healthy controls (r = .98, P < .01). For female patients, PA and ICW were negatively correlated (r = .897, P < .01). A lower ECW/ICW ratio was highly correlated (r = .969 for men, r = .639 for women) with increased PA in cancer patients. ICW changes are gender-specific in patients with GI cancer. ECW/ICW ratios and PA may be suitable surrogate markers for gender-specific changes in cell composition and health status.

Trial registration: ClinicalTrials.gov NCT02148159.

Keywords: bioelectrical impedance analysis; body composition; cachexia; colorectal cancer; gender; phase angle.

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Bioelectrical impedance analysis (BIA) measurements. How the raw measures of reactance and resistance can be used to derive phase angle (PA) and body composition measures used in this study
Figure 2
Figure 2
A, Phase angle versus intracellular water (%) by gender and condition. Healthy controls were age matched to corresponding gender. Determination of significance between cancer and control group was based on correlation analysis with P < .05. B, Extracellular water (%) vs fat mass (%) by gender and condition. Healthy controls were age matched to corresponding gender. Determination of significance between cancer and control group was based on correlation analysis with P < .05
Figure 3
Figure 3
A, Extracellular water (%) and intracellular water (%) by gender and condition. Columns represent means with bars showing standard deviations. Determination of significance via t test with P < .05. B, Phase angle versus extracellular: intracellular ratio by gender and condition. Healthy controls were age‐matched to corresponding gender. Correlation coefficient for each group: male cancer: r = .969, female cancer: r = .894, male control: r = .153, female control: r = .192
Figure 4
Figure 4
A, Extracellular: intracellular ratio by gender and condition. Columns represent means with bars showing standard deviations. Determination of significance via t test with P < .05. B, Phase angle versus extracellular: intracellular ratio by gender and condition. Healthy controls were age matched to corresponding gender. Determination of significant slope differences between cancer and control groups was based on correlation and two‐sided t test analysis with P < .05

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