Bioelectrical Impedance Analysis and Mid-Upper Arm Muscle Circumference Can Be Used to Detect Low Muscle Mass in Clinical Practice

Dorienke Gort-van Dijk*, Linda B. M. Weerink, Milos Milovanovic, Jan-Willem Haveman, Patrick H. J. Hemmer, Gerard Dijkstra, Robert Lindeboom, Marjo J. E. Campmans-Kuijpers

*Corresponding author for this work

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Abstract

Identification of low muscle mass becomes increasingly relevant due to its prognostic value in cancer patients. In clinical practice, mid-upper arm muscle circumference (MAMC) and bioelectrical impedance analysis (BIA) are often used to assess muscle mass. For muscle-mass assessment, computed tomography (CT) is considered as reference standard. We investigated concordance between CT, BIA, and MAMC, diagnostic accuracy of MAMC, and BIA to detect low muscle mass and their relation with the clinical outcome malnutrition provided with the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF). This cross-sectional study included adult patients with advanced esophageal and gastrointestinal cancer. BIA, MAMC, and PG-SGA-SF were performed. Routine CT-scans were used to quantify psoas muscle index (PMI) and skeletal muscle area. Good concordance was found between CTPMI and both BIA(FFMI (fat free mass index)) (ICC 0.73), and BIA(ASMI (appendicular skeletal muscle index)) (ICC 0.69) but not with MAMC (ICC 0.37). BIA(FFMI) (94%), BIA(ASMI) (86%), and MAMC (86%) showed high specificity but low sensitivity. PG-SGA-SF modestly correlated with all muscle-mass measures (ranging from -0.17 to -0.43). Of all patients with low muscle mass, 62% were also classified with a PG-SGA-SF score of >= 4 points. Although CT remains the first choice, since both BIA and MAMC are easy to perform by dieticians, they have the potential to be used to detect low muscle mass in clinical practice.

Original languageEnglish
Article number2350
Number of pages14
JournalNutrients
Volume13
Issue number7
DOIs
Publication statusPublished - Jul-2021

Keywords

  • body composition
  • anthropometry
  • muscle mass
  • sarcopenia
  • computed tomography
  • bioelectrical impedance analysis
  • mid-upper arm muscle circumference
  • patient generated-subjective global assessment short form
  • advanced cancer
  • SUBJECTIVE GLOBAL ASSESSMENT
  • ASSESSMENT PG-SGA
  • BODY-COMPOSITION
  • SKELETAL-MUSCLE
  • CANCER-PATIENTS
  • NUTRITIONAL-STATUS
  • NEOADJUVANT CHEMOTHERAPY
  • COLORECTAL-CANCER
  • SARCOPENIA
  • CACHEXIA

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