Assessment of sarcopenia and obesity by bioelectrical impedance analysis in transplant and hepatobiliary populations
Konel J, Kitajima T, Arevalo L, Murray N, Pietrowsky T, Venkat D, Gonzalez H, Samaniego M, Abouljoud M, and Nagai S. Assessment of sarcopenia and obesity by bioelectrical impedance analysis in transplant and hepatobiliary populations. American Journal of Transplantation 2020; 20:56.
Am J Transplant
Bioelectrical impedance analysis (BIA) can measure body composition, including assessment of sarcopenia and obesity. This study aimed to evaluate the clinical utility of BIA in transplant and hepatobiliary populations. Methods: We conducted a single-center study of 60 patients (5 living donor candidates, 10 early postoperative, 7 benign liver disease, 14 chronic kidney disease, 5 early cirrhosis, 7 post-transplant, 6 early malignancy, and 6 advanced malignancy). Sarcopenia was defined as a calculated whole-body muscle mass (kg)/body surface area below the 25th percentile. Obesity was defined as fat percentage of >25% and >30% in males and females, respectively. Patients were categorized into 4 groups: (1) not sarcopenic/not obese, (2) sarcopenic/not obese, (3) not sarcopenic/obese, and (4) sarcopenic/obese. Clinical characteristics and BIA measurements were compared. Results: Among the 60 participants, 28 were not sarcopenic/not obese, 1 was sarcopenic/not obese, 17 were not sarcopenic/obese, and 14 were sarcopenic/obese. There were no significant differences in BMI, albumin, total protein, and absolute lymphocyte count. Sarcopenic/obese patients showed significantly lower Karnofsky score (median 55% [IQR, 50-82.5%]), compared to not sarcopenic/obese patients (median 80% [IQR, 60-92.5%], p = 0.037). All advanced malignancy patients were either sarcopenic/not obese or sarcopenic/obese. Conclusion: Sarcopenic-obesity patients showed significantly lower performance status than obese patients without sarcopenia. BIA may be useful tool in identifying high-risk patients and improving surgical outcomes.