Association of an Overhydrated State With the Liver Fibrosis and Prognosis of Cirrhotic Patients

Kishino, Kyohei; Enomoto, Hirayuki; Shimono, Yoshihiro; Moriwaki, Ei-Ichiro; Nishikawa, Hiroki; Nishimura, Takashi; Iwata, Yoshinori; Iijima, Hiroko; Nishiguchi, Shuhei

doi:10.21873/invivo.11912

Cited by 6 publications

(5 citation statements)

References 21 publications

(26 reference statements)

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“…Among the BIA parameters, the extracellular water to total body water ratio (ECW/TBW) is a useful indicator for nutritional assessments (7,9), as it measures the body's water balance in the blood and interstitial fluid (i.e., an edema index), with malnutrition being reflected in an increased proportion of extracellular water (9). A high ECW/TBW is also reportedly useful for identifying a poor general condition and predicting clinical outcomes among patients with chronic liver diseases (10)(11)(12), renal disorders (13,14), heart failure (15,16), and critical illness (9). However, we are not aware of any data regarding the relationship between ECW/TBW and lung cancer outcomes.…”

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confidence: 99%

The Association Between Extracellular Water-to-Total Body Water Ratio and Therapeutic Durability for Advanced Lung Cancer

Noda¹,

Suzuki²,

Kanai³

et al. 2020

Anticancer Res

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Background/Aim: Extracellular water-to-total body water ratio (ECW/TBW) measured by bioelectrical impedance analysis (BIA) reportedly predicts clinical outcomes of various diseases. The aim of this retrospective study was to examine the association between ECW/TBW and therapeutic durability of chemotherapy and/or immune checkpoint inhibitors in advanced lung cancer. Patients and Methods: Patients with advanced lung cancer underwent BIA before chemotherapy and/or treatment with immune checkpoint inhibitors at our hospital between June 2018 and November 2019. Results: Of 75 patients, 18 with ECW/TBW ≥0.4 were assigned to the overhydrated group (OH-G) and 57 patients ECW/TBW <0.4 were assigned to the non-overhydrated group (NOH-G). The median time-to-treatment failure was significantly shorter in the OH-G than in the NOH-G (p=0.003). Multivariate analysis revealed that ECW/TBW ≥0.4 predicted treatment failure [hazard ratio (HR)=2.508, 95% confidence interval (CI)=1.19-5.27; p=0.01]. Conclusion: The ECW/TBW may be an objective parameter for predicting therapeutic durability in advanced lung cancer.

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confidence: 99%

The Association Between Extracellular Water-to-Total Body Water Ratio and Therapeutic Durability for Advanced Lung Cancer

Noda¹,

Suzuki²,

Kanai³

et al. 2020

Anticancer Res

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“…Elevated ECW to TBW ratio was an independent factor associated with both the presence of sarcopenia and frailty. ECW to TBW ratio defines the extracellular fluid status (water homeostasis) in the whole body and the liver functional reserve (46,47). Excessive extracellular fluid in CLDs may also lead to the physical functional decline as well as a cognitive decline, which can be linked to our current results (48)(49)(50).…”

Section: Comparison Of Baseline Characteristics (Numerical Parametersmentioning

confidence: 61%

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Nishikawa

Enomoto

Iwata

et al. 2020

In Vivo

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Aim: To elucidate the common and different points between sarcopenia and frailty in chronic liver damage (CLD). Patients and Methods: Patients with both grip strength decline and skeletal muscle index decline were regarded as sarcopenia. Frailty was defined as a syndrome in which 3 or more of the following criteria were met: i) exhaustion, ii) body weight loss, iii) slow walking speed, iv) muscle weakness, and v) low physical activity. Results: Sarcopenia and frailty were identified in 52 patients (15.2%) and 46 (13.5%), respectively. The prevalence of sarcopenia and frailty was well stratified according to age and the liver cirrhosis (LC) status. In the multivariate analysis, we identified significant factors for sarcopenia: i) age, ii) LC, iii) body mass index and iv) extracellular water (ECW) to total body water (TBW) ratio, while only the ECW to TBW ratio was significant for frailty. Conclusion: Sarcopenia and frailty in CLD should be separately evaluated. In individuals with chronic liver damage (CLD), metabolic functions are frequently damaged leading to several nutritional disorders, including protein-energy-malnutrition, or muscle abnormalities (1). Since sarcopenia, as assessed by muscle mass decrease and muscle strength impairment in patients with CLD, can be related to falls, poor quality of life or poor prognosis, it has become a very interesting topic to examine for physicians (2-8). Sarcopenia is one of the most common consequences found in patients with liver cirrhosis (LC), affecting 30% to 70% of LC patients, and it can be a main determinant for the incidence of hepatic encephalopathy in LC patients (1, 9, 10-13). Japanese CLD patients can now be found in aging populations, and this fact is also a crucial public health issue since aging itself can cause sarcopenia (14-16). To avoid unfavorable consequences related to sarcopenia one needs to assess this disease as a condition with a systemic involvement (17-19). Improving physical activity or nutrition and adequately managing any underlying diseases are essential steps for avoiding sarcopenia (6). Frailty is a concept globally used in geriatrics that precedes disability, and is defined as a condition of increased vulnerability associated with physiological decline (20-22). Originally, it was proposed to identify elderly people at an elevated risk of adverse health outcomes, dependencies, falls, disabilities, and mortality (20-22). Frailty is determined based on the evaluation of physical, functional and cognitive abilities. The frailty phenotype is defined as the presence of 3 or more of the following criteria: i) body weight (BW) loss, ii) self-reported exhaustion, iii) skeletal muscle function decline, iv) slow walking speed (WS) and v) low physical activity (23, 24). Sarcopenia is an important component of frailty (22). Aging is indeed closely linked to changes in body composition, especially skeletal muscle mass decline, resulting in disability and mortality (14, 16, 24). While any chronic organ dysfunction can also lead to physiological vulne...

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“…In type 2 diabetes, a higher ECW/TBW was associated with poorer cognitive function [ 34 ]. Increased in ECW/TBW has been associated with progressive liver fibrosis and malnutrition and is related to the prognosis of cirrhotic patients [ 35 ]. In the hemodialysis population, ECW/TBW reference values from 0.390 to 0.410 are the most promising (based on InBody S10) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Extracellular water to total body water ratio predicts survival in cancer patients with sarcopenia: a multi-center cohort study

Ruan

Zhang

et al. 2022

Nutr Metab (Lond)

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Background Body water measured by bioelectrical impedance analysis (BIA) predicts the outcomes of many diseases. This study aimed to evaluate the relationship between body water and the prognosis of cancer patients with sarcopenia. Methods This study employed 287 cancer patients with sarcopenia underwent BIA from a prospective multicenter study of patients with cancer in China from 2013 to 2020. The primary outcome of interest was all-cause mortality presented as the longest time to follow-up available. Eight indicators of body water [total body water, extracellular water, intracellular water, free fat mass, active cell mass, extracellular water/intracellular water, extracellular water/total body water (ECW/TBW), and intracellular water/total body water] were included in the research. Neutrophil–lymphocyte ratio (NLR) = neutrophil (× 109)/lymphocyte (× 109). The discriminatory ability and prediction accuracy of each factor were assessed using the C-index. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. Results The median age was 65 years old, and 138 (48%) patients were men. During a mean follow-up of 46 months, 140 deaths were recorded, resulting in a rate of 204.6 events per 1000 patient-years. ECW/TBW showed the best predictive accuracy (C-index = 0.619) compared to the other indicators [p = 0.004, adjusted HR (95% CI) 1.70 (1.18,2.44)]. In the middle tertile (0.385–0.405), ECW/TBW had a strong independent negative association with patient survival [adjusted HR (95% CI) 2.88 (1.39–5.97), p = 0.004]. Patients who had a high ECW/TBW (ECW/TBW ≥ 0.395) combined with a high NLR had 3.84-fold risk of mortality (p < 0.001, 95% CI 1.99,7.38). Conclusions ECW/TBW was better than other indicators in predicting survival of cancer patients with sarcopenia. High ECW/TBW combined with high NLR would further increase the risk of mortality. Trial registration: The Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) (Chinese Clinical Trial Registry: ChiCTR1800020329, URL of registration: http://www.chictr.org.cn/showprojen.aspx?proj=31813).

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Association of an Overhydrated State With the Liver Fibrosis and Prognosis of Cirrhotic Patients

Cited by 6 publications

References 21 publications

The Association Between Extracellular Water-to-Total Body Water Ratio and Therapeutic Durability for Advanced Lung Cancer

The Association Between Extracellular Water-to-Total Body Water Ratio and Therapeutic Durability for Advanced Lung Cancer

Sarcopenia and Frailty in Chronic Liver Damage: Common and Different Points

Extracellular water to total body water ratio predicts survival in cancer patients with sarcopenia: a multi-center cohort study

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