scholarly journals P35: BODY COMPOSITION: ASSOCIATION WITH OPERATIVE AND ONCOLOGIC OUTCOMES IN THE MODERN MANAGEMENT OF RETROPERITONEAL SARCOMA – RESULTS OF A FEASIBILITY STUDY

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
TV McIntyre ◽  
JA Elliott ◽  
E Boyle ◽  
NE Donlon ◽  
M Barnes ◽  
...  

Abstract Introduction Sarcopenia and obesity in cancer may confer negative outcomes, but their prevalence and impact on modern regimens for retroperitoneal sarcoma (RPS) have not been systematically studied. Sarcopaenia and obesity measurements by computed tomography (CT) measurements at L3 may be confounded by the disease process itself. The aim of this study is to determine feasibility in providing the prevalence of sarcopenia and visceral obesity in the management of RPS to assess their potential impact on operative and oncologic outcomes. Method Consecutive sample patients undergoing treatment for RPS from our database were retrospectively studied. Total, subcutaneous and visceral fat areas (VFA), myosteatosis, skeletal muscle index (SMI) lean body mass and fat mass were determined at diagnosis by CT. Sarcopenia will be defined by CT at L3 as SMI <52.4 cm2/m2 for males and SMI <38.5 cm2/m2 for females, and visceral obesity as VFA >163.8cm2 for men and >80.1cm2 for women. Result 40 consecutive patients, 21 [52.5%] female, 56.7±15.1 years, were studied. The most common histologic types were leiomyosarcoma (8 [20.0%]), dedifferentiated liposarcoma (7 [17.5%]), well differentiated liposarcoma (7 [17.5%]), myxoid liposarcoma (4 [10.0%]). Mean±SD body composition measures were: lean body mass, 50.4±12.0 kg; total fat mass, 27.2±8.6 kg; visceral fat area, 148.5±120.2 cm2; subcutaneous fat area, 222.2±20.4 cm2; myosteatosis, 8.9±7.3 cm2. Conclusion Assessment of body composition among patients with RPS is feasible. Analysis to identify the prevalence and significance of sarcopenia and visceral obesity and its relationship to operative and oncologic outcomes is ongoing. Take-home message Assessment of body composition in RPS is feasible and its effect on outcomes is under investigation

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A16-A17
Author(s):  
John P H Wilding ◽  
Rachel L Batterham ◽  
Salvatore Calanna ◽  
Luc F Van Gaal ◽  
Barbara M McGowan ◽  
...  

Abstract Background: Central obesity is associated with increased risk of cardiometabolic disease. Weight loss reduces lean muscle mass, potentially impacting resting energy expenditure and/or physical functioning. This analysis of the STEP 1 trial evaluated the impact of subcutaneous (s.c.) semaglutide, a glucagon-like peptide-1 analogue, on body composition in adults with overweight/obesity using dual energy X-ray absorptiometry (DEXA). Methods: In STEP 1, 1961 adults aged ≥18 years with body mass index (BMI) ≥27 kg/m2 with ≥1 weight-related comorbidity or BMI ≥30 kg/m2, without diabetes, were randomized to s.c. semaglutide 2.4 mg once-weekly or matched placebo (2:1) for 68 weeks, plus lifestyle intervention. Participants with BMI ≤40 kg/m2 from 9 sites were eligible for the substudy. Total fat mass, total lean body mass and regional visceral fat mass were measured using DEXA at screening and week 68; visceral fat mass was calculated in the L4 region (both males/females), android region (males), or gynoid region (females), depending on site scanner methodology. Proportions of total fat and lean body mass are shown relative to total body mass; proportion of visceral fat mass is expressed relative to region assessed. Results: This analysis included 140 participants (semaglutide n=95; placebo n=45) (mean weight 98.4 kg, BMI 34.8 kg/m2; 76% female). Baseline body composition was similar in those receiving semaglutide and placebo (total fat mass proportion: 43.4% vs 44.6%; regional visceral fat mass proportion: 33.8% vs 36.3%; total lean body mass proportion: 53.9% vs 52.7%; respectively). Percentage change in body weight from baseline to week 68 was -15.0% with semaglutide vs -3.6% with placebo. This resulted in reductions from baseline with semaglutide in total fat mass (-19.3%) and regional visceral fat mass (-27.4%), leading to 3.5%-point and 2.0%-point reductions in the proportions of total fat mass and visceral fat mass, respectively. Total lean body mass decreased from baseline (-9.7%); however, the proportion relative to total body mass increased by 3.0%-points. An increasing improvement in lean body mass:fat mass ratio was seen with semaglutide with increasing weight loss from baseline to week 68 (continuous data). Overall, the ratio increased from baseline (1.34 [95% CI: 1.22, 1.47]) to week 68 by 0.23 [0.14, 0.32], with greater improvement in those with ≥15% weight loss (n=44; 0.41 [0.28, 0.53]) vs <15% weight loss (n=39; 0.03 [-0.05, 0.12]) (observed, dichotomized data; no imputation for missing data). There were no major changes in body composition with placebo from baseline to week 68. Conclusion: In adults with overweight/obesity, semaglutide 2.4 mg was associated with reduced total fat mass and regional visceral fat mass, and an increased proportion of lean body mass. Greater weight loss was associated with greater improvement in body composition (lean body mass:fat mass ratio).


2021 ◽  
pp. 1-27
Author(s):  
Masoome Piri Damaghi ◽  
Atieh Mirzababaei ◽  
Sajjad Moradi ◽  
Elnaz Daneshzad ◽  
Atefeh Tavakoli ◽  
...  

Abstract Background: Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of EAA can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soy and whey protein supplementation on body composition. Thus, we sought to perform a meta-analysis of published Randomized Clinical Trials that examined the effect of whey protein supplementation and soy protein supplementation on body composition (lean body mass, fat mass, body mass and body fat percentage) in adults. Methods: We searched PubMed, Scopus, and Google Scholar, up to August 2020, for all relevant published articles assessing soy protein supplementation and whey protein supplementation on body composition parameters. We included all Randomized Clinical Trials that investigated the effect of whey protein supplementation and soy protein supplementation on body composition in adults. Pooled means and standard deviations (SD) were calculated using random-effects models. Subgroup analysis was applied to discern possible sources of heterogeneity. Results: After excluding non-relevant articles, 10 studies, with 596 participants, remained in this study. We found a significant increase in lean body mass after whey protein supplementation weighted mean difference (WMD: 0.91; 95% CI: 0.15, 1.67. P= 0.019). Subgroup analysis, for whey protein, indicated that there was a significant increase in lean body mass in individuals concomitant to exercise (WMD: 1.24; 95% CI: 0.47, 2.00; P= 0.001). There was a significant increase in lean body mass in individuals who received 12 or less weeks of whey protein (WMD: 1.91; 95% CI: 1.18, 2.63; P<0.0001). We observed no significant change between whey protein supplementation and body mass, fat mass, and body fat percentage. We found no significant change between soy protein supplementation and lean body mass, body mass, fat mass, and body fat percentage. Subgroup analysis for soy protein indicated there was a significant increase in lean body mass in individuals who supplemented for 12 or less weeks with soy protein (WMD: 1.48; 95% CI: 1.07, 1.89; P< 0.0001). Conclusion: Whey protein supplementation significantly improved body composition via increases in lean body mass, without influencing fat mass, body mass, and body fat percentage.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2349
Author(s):  
Stephen Keenan ◽  
Matthew B. Cooke ◽  
Regina Belski

Diets utilising intermittent fasting (IF) as a strategic method to manipulate body composition have recently grown in popularity, however, dietary practices involving fasting have also been followed for centuries for religious reasons (i.e., Ramadan). Regardless of the reasons for engaging in IF, the impacts on lean body mass (LBM) may be detrimental. Previous research has demonstrated that resistance training promotes LBM accrual, however, whether this still occurs during IF is unclear. Therefore, the objective of this review is to systematically analyse human studies investigating the effects of variations of IF combined with resistance training on changes in LBM in previously sedentary or trained (non-elite) individuals. Changes in body weight and fat mass, and protocol adherence were assessed as a secondary objective. This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MEDLINE, CINAHL, PubMed and SportDiscus databases were searched for articles investigating IF, combined with resistance training that reported measures of body composition. Eight studies met the eligibility criteria. LBM was generally maintained, while one study reported a significant increase in LBM. Body fat mass or percentage was significantly reduced in five of eight studies. Results suggest that IF paired with resistance training generally maintains LBM, and can also promote fat loss. Future research should examine longer-term effects of various forms of IF combined with resistance training compared to traditional forms of energy restriction. Prospero registration CRD42018103867.


2018 ◽  
Vol 62 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Adam Lee Owen ◽  
Carlos Lago-Peñas ◽  
Gordon Dunlop ◽  
Rouissi Mehdi ◽  
Moktar Chtara ◽  
...  

AbstractThe primary aim of the investigation was to study the seasonal changes in body composition in elite European soccer players and identify key playing positional differences. Twenty-two players (age = 24 ± 3.7 years, body height = 180.45 ± 5.12 cm, body mass = 76.66 ± 5.34 kg) were tested. Players’ mass (kg), lean body mass (LBM), fat free mass (FFM), fat mass (FM), muscle girths (MG) and sum of 8 skinfolds (mm) were measured across 5 time points (T0 = Start of pre-season training; T1 = End of pre-season training; T2 = Mid-season; T3 = End of mid-season break; T4 = End of season). Players were divided into their tactical positional roles for analysis. The specific positions they were divided into included defenders (n = 8), midfielders (n = 8) and forwards (n = 6). Assessment of training and matchplay exposure were also recorded. Sites-4, Sites-7, Sites-8 and Fat Mass decreased dramatically from T0 to T1 and T2 in all playing positions (p < 0.01), while no remarkable differences were found between T2, T3 and T4. Except for defenders, calf girth and lean mass were higher in T2, T3 and T4 compared to T0 and T1 (p < 0.01). Midfielders were found to be leaner than forwards and defenders in all data collection time point sessions. Defenders showed higher values in calf girth and lean body mass than midfielders and forwards. It can be concluded from this investigation that there are large variances n positional body composition profiles amongst professional European soccer players. Furthermore, significant changes are prevalent and occur across the season from LBM, FFM, MG and skinfold assessment amongst European elite level soccer players.


2020 ◽  
Vol 182 (6) ◽  
pp. 539-548 ◽  
Author(s):  
Dorte Glintborg ◽  
Henrik Bjarke Vaegter ◽  
Louise Lehmann Christensen ◽  
Emma Bendix ◽  
Thomas Graven-Nielsen ◽  
...  

Background Hypogonadism is prevalent during opioid treatment, but the effect of testosterone replacement treatment (TRT) on body composition, pain perception, and adrenal function is unclear. Purpose To measure changes in body composition, pain perception, quality of life, and adrenal function after TRT or placebo in opioid-treated men with chronic non-malignant pain. Methods Double-blind, placebo-controlled study in 41 men (>18 years) with total testosterone <12 nmol/L were randomized to 24 weeks TRT (Testosterone undecanoate injection three times/6 months, n = 20) or placebo (placebo-injections, n = 21). Outcomes Body composition (lean body mass and fat mass assessed by DXA), clinical pain intensity (numerical rating scale), and experimental pain perception (quantitative sensory assessment), quality of life (SF36), and adrenocorticotrophic hormone (ACTH) test. Data were presented as median (quartiles). Mann–Whitney tests were performed on delta values (24–0 weeks) between TRT and placebo. Results The median age was 55 years (46; 59) and total testosterone before intervention was 6.8 (5.0; 9.3) nmol/L. TRT was associated with change of testosterone levels: 12.3 (7.0; 19.9) nmol/L (P < 0.001 vs placebo), increased lean body mass: 3.6 (2.3; 5.0) kg vs 0.1 kg (−2.1; 1.5) during TRT vs placebo and decreased total fat mass: −1.2 (−3.1; 0.7) kg vs 1.2 kg (−0.9; 2.5) kg, both P < 0.003. Changed pain perception, SF36, and ACTH-stimulated cortisol levels were non-significantly changed during TRT compared with placebo. Conclusions Six months of TRT improved body composition in men with opioid-induced hypogonadism without significant changes in outcomes of pain perception, quality of life, or adrenal function.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Jessie A Elliott ◽  
Noel E Donlon ◽  
Suzanne L Doyle ◽  
Sinead King ◽  
Peter Beddy ◽  
...  

Abstract   Obesity, in particular visceral obesity, is a risk factor for esophageal cancer, but its prevalence and impact on operative and oncologic outcomes is unclear. The aim of this study was to study adipose distribution in esophageal cancer (EC), and to assess its independent impact. Methods 11 consecutive patients undergoing treatment with curative intent for esophageal cancer were studied. Total (TFA), subcutaneous (SFA) and visceral fat areas (VFA), and fat mass (FM), were determined pre-treatment, preoperatively, and 1 year postoperatively. Visceral obesity was defined by CT at L3 as VFA greater than 163.8 cm2 for men and 80.1 cm2 for women. All complications were recorded prospectively, including comprehensive complications index, Clavien-Dindo, and pulmonary complications (PPC). Multivariable logistic and Cox proportional hazards regression were utilized to determine independent predictors of operative and oncologic outcome. Results Visceral obesity (VO) was evident in 290 patients (47.5%), and was associated with BMI-defined obesity, diabetes, metabolic syndrome, Barrett’s esophagus (P = 0.001), well-differentiated tumors (P = 0.027), and lower cN stage (P = 0.012). VO did not impact tumor regression grade (TRG) after neoadjuvant therapy. Postoperatively, VO independently predicted anastomotic leak (P = 0.033, OR2.42 [1.07-5.45]) and pneumonia (P = 0.046, OR1.53 [1.01–2.32]), but not in-hospital mortality (P = 0.466), which was 1% overall. VO was associated with significantly improved overall and disease-specific survival on univariable (P = 0.005, Figure), and multivariable analysis (P = 0.026, 0.74 [0.57–0.97]). In survivorship, VO significantly declined, and was evident in just 15.3% at one year postoperatively. Conclusion VO is linked with Barrett’s associated EC, and less aggressive tumour biology. Although it negatively impacted operative outcomes, VO was associated with improved oncologic outcomes, independent of BMI or fat mass, indicating a distinct biologic phenotype, and highlighting the importance of research elucidating the interaction between the visceral fat microenvironment, metabolic dysfunction, and the tumor microenvironment.


2016 ◽  
Vol 38 (12) ◽  
pp. 1574-1594 ◽  
Author(s):  
Mei-Ying Chang ◽  
Hsiao-Yu Chen

Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.


2021 ◽  
Vol 27 (3) ◽  
Author(s):  
Amita Attlee ◽  
◽  
Hayder Hasab ◽  
Latefa Mohammed Rashed ◽  
Muna Al-Haway ◽  
...  

Background: Data on postoperative follow-ups and bariatric surgery (BS) outcomes performed in the United Arab Emirates (UAE) are crucial for registry. This study assessed the one-year postoperative changes in body composition and metabolic profiles in BS patients. Methods: The medical and dietetics records of 51 adult patients who underwent BS in the largest public hospital in Sharjah, UAE were reviewed. Data on body weight and composition, as well as metabolic profile (blood glucose and lipid levels) from the initial until the last hospital visit were recorded. Results: The median (interquartile range) follow-up period was 6.0 (8.0) months. The patients had significant total weight loss [19.3 (12.6)%] and reduction in body mass index (BMI) [18.0 (13.6)%] of approximately 7 BMI points. Moreover, the patients’ body composition improved significantly; loss was the highest in fat mass [–30.9 (22.1)%] and the least in lean body mass [–8.6 (8.4)%]. There was a steady decline in all body composition variables with a longer duration of follow-up visits from 1–3 months to 10–12 months. The fat mass (–40.3%):lean body mass (–10.7%) loss ratio was 3.8:1 at 10–12 months. The patients’ metabolic status was normal during the last postoperative visit. Conclusions: Incremental improvements in body composition of patients were evident with longer follow-up visits up to one year after BS. Hence, patients should attend regular follow-up visits after BS. Moreover, accurate and complete documentations of medical and dietetics visits are mandated.


2000 ◽  
Vol 11 (7) ◽  
pp. 1303-1309 ◽  
Author(s):  
PETER STENVINKEL ◽  
BENGT LINDHOLM ◽  
FREDRIK LÖNNQVIST ◽  
KRASSIMIR KATZARSKI ◽  
OLOF HEIMBÜRGER

Abstract. Leptin, secreted from fat cells, functions as a lipostat mechanism through modulation of satiety signals. Markedly elevated leptin levels have been documented in uremic patients, especially in those who are treated by peritoneal dialysis (PD). However, the role of hyperleptinemia in uremic patients is not clear, and it is not known whether elevated leptin levels contribute to uremic anorexia and changes in body composition. In this prospective study, serum leptin, C-reactive protein (CRP), plasma insulin, and body composition (dual-energy x-ray absorptiometry) were measured in 36 patients (53 ± 1 yr) close to start and after about 1 yr of PD. In addition, markers of dialysis adequacy and urea kinetics were followed during treatment with PD. During PD, the total body fat mass (20.5 ± 1.0 to 22.9 ± 1.3 kg ;P< 0.01), truncal fat mass (11.5 ± 0.7 to 13.2 ± 0.9 kg ;P< 0.001), and serum leptin levels (20.1 ± 3.8 to 35.6 ± 6.8 ng/ml ;P< 0.01) increased markedly, especially in patients with diabetes mellitus. Twenty-five PD patients that lost lean body mass during PD had significantly (P< 0.05) elevated initial CRP levels (14 ± 2 mg/L) compared to 11 patients (<10 mg/L) who gained lean body mass during PD. A significant increase in serum leptin levels (20.9 ± 4.2 to 42.7 ± 4.0 ng/ml ;P< 0.001) was observed in those patients who lost lean body mass, whereas no such change (18.4 ± 8.4 to 19.2 ± 6.4 ng/ml) was observed in the patients that gained lean body mass during PD treatment. The present longitudinal results demonstrate that serum leptin level and body fat content increase markedly during PD, especially in diabetic patients. Patients that lost lean body mass during PD had higher initial CRP levels and increased their serum leptin levels significantly during PD compared to those patients that gained lean body mass. Additional studies are therefore needed to elucidate the role of hyperleptinemia and inflammation in causing anorexia, protein-malnutrition, and changes in body composition during treatment with PD.


Sign in / Sign up

Export Citation Format

Share Document