Phase Angle and Ultrasound Assessment of the Rectus Femoris for Predicting Malnutrition and Sarcopenia in Patients with Esophagogastric Cancer: A Cross-Sectional Pilot Study

Erika Vieira Maroun ^{1, 2, 3}

María Argente Pla ^{1, 4}

María José Pedraza Serrano ⁵

Bianca Tabita Muresan ³

Agustín Ramos Prol ⁴

Eva Gascó Santana ⁴

Silvia Martín Sanchis ⁴

Ángela Durá De Miguel ⁴

Andrea Micó García ⁴

Anna Cebrián Vázquez ⁴

Alba Durbá Lacruz ⁴

Juan Francisco Merino-Torres ^{1, 2, 4}

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Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe, 46026 Valencia, Spain |

Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain |

Facultad Ciencias de la Salud, Universidad Europea de Valencia, 46010 Valencia, Spain |

⁴

Endocrinology and Nutrition Department, La Fe University and Polytechnic Hospital in Valencia, 46026 Valencia, Spain |

⁵

Independent Researcher, 46100 Valencia, Spain |

Publication type: Journal Article

Publication date: 2024-12-29

MDPI

Journal: Nutrients

scimago Q1

SJR: 1.301

CiteScore: 9.2

Impact factor: 4.8

ISSN: 20726643

DOI: 10.3390/nu17010091

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Abstract

Background: Disease-related malnutrition (DRM) and sarcopenia are prevalent conditions in gastrointestinal cancer patients, whose early diagnosis is essential to establish a nutritional treatment that contributes to optimizing adverse outcomes and improving prognosis. Phase angle (PhA) and rectus femoris ultrasound measurements are considered effort-independent markers of muscle wasting, which remains unrecognized in oncology patients. Objective: This study aimed to evaluate the potential utility of PhA, rectus femoris cross-sectional area (RFCSA), and rectus femoris thickness (RF-Y-axis) in predicting malnutrition and sarcopenia in patients with esophagogastric cancer (EGC). Methods: This was a cross-sectional study of patients diagnosed with EGC. PhA was obtained using bioelectrical impedance vector analysis (BIVA) along with ASMMI. The RFCSA and RF-Y-axis were measured using nutritional ultrasound (NU®). Muscle capacity was assessed using handgrip strength (HGS), and functionality by applying the Short Physical Performance Battery (SPPB). Malnutrition and sarcopenia were determined according to the GLIM and EWGSOP2 criteria, respectively. Results: Out of the 35 patients evaluated, 82.8% had malnutrition and 51.4% had sarcopenia. The RFCSA (r = 0.582) and RF-Y-axis (r = 0.602) showed significant, moderate correlations with ASMMI, unlike PhA (r = 0.439), which displayed a weak correlation with this parameter. However, PhA (OR = 0.167, CI 95%: 0.047–0.591, p = 0.006), RFCSA (OR = 0.212, CI 95%: 0.074–0.605, p = 0.004), and RF-Y-axis (OR = 0.002, CI 95%: 0.000–0.143, p = 0.004) all showed good predicting ability for sarcopenia in the crude models, but only the RF-Y-axis was able to explain malnutrition in the regression model (OR = 0.002, CI 95%: 0.000–0.418, p = 0.023). Conclusions: The RF-Y-axis emerged as the only independent predictor of both malnutrition and sarcopenia in this study, likely due to its stronger correlation with ASMMI compared to PhA and RFCSA.