Body composition as a predictor of sunitinib toxicity in patients with renal cell carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15566-e15566
Author(s):  
Samantha Cushen ◽  
Aoife M Ryan ◽  
MinYuen Teo ◽  
Peter MacEneaney ◽  
Patrick McLaughlin ◽  
...  

e15566 Background: Sunitinib is a standard first-line option for metastatic renal cell cancer (mRCC). Identification of biomarkers associated with outcome or toxicity is a challenge. Body composition is a prognostic factor in cancer and sarcopenia is associated with treatment toxicity and survival. We investigated if body composition by CT scan predicted dose limiting toxicity (DLT) from sunitinib in mRCC. Methods: Patients (pts) with mRCC receiving sunitinib 50mg as 1stline therapy between 2007-2012 were included. Ethical approval was obtained and prospectively maintained databases analysed. Skeletal muscle cross-sectional area at L3 was measured by CT. Sarcopenia was defined using published cut offs. Toxicity was assessed after 4 cycles of drug (CTCAE, v4.0). Results: 55 pts (43 male), mean age 64yrs (±10.6) were included. 67% were overweight/obese (BMI>25kg/m2). Sarcopenia was present in 33% (56% of normal BMI, 44% overweight group). Overall 40 pts (73%) experienced DLT (51% M, 100% F, p<0.016). DLT occurred in <6 months in 53% (44% M vs 83% F, p<0.016) and these pts were older (mean 68 yrs vs 60 yrs, p<0.01), had lower skeletal muscle mass (51.8 cm2/m2 vs 59.4 cm2/m2, p<0.012), and fat free mass (FFM) (51.4kg vs 57.7kg, p<0.03), and received higher drug dose in mg/kg FFM (1.01 vs 0.89, p<0.02). Common toxicities were GI (65%) and fatigue (47%). Of pts <25th percentile skeletal muscle mass 92% experienced DLT, higher than pts >75th percentile (p<0.05). Pts <25th percentile had an average of 5 toxicities vs 2 in those >75th percentile (p<0.003). All toxicities were more common in muscle wasted patients (p<0.05). 77% (n=10) of pts receiving a drug dose >75th percentile (1.105mg/FFM) experienced DLT in <6 months vs 44% (n=17) receiving a dose <75thpercentile (<1.099mg/FFM; p<0.037). Conclusions: Sarcopenia is prevalent in patients with mRCC, is easily measured, is an occult condition in pts with normal/high BMI, and is a significant predictor of DLT in pts receiving 1st line sunitinib. Our results highlight the potential use of baseline body composition to predict toxicity. The role of sarcopenia in targeted therapy is evolving and its potential to predict toxicity should be further studied.

2016 ◽  
Vol 41 (6) ◽  
pp. 611-617 ◽  
Author(s):  
Jameason D. Cameron ◽  
Ronald J. Sigal ◽  
Glen P. Kenny ◽  
Angela S. Alberga ◽  
Denis Prud’homme ◽  
...  

There has been renewed interest in examining the relationship between specific components of energy expenditure and the overall influence on energy intake (EI). The purpose of this cross-sectional analysis was to determine the strongest metabolic and anthropometric predictors of EI. It was hypothesized that resting metabolic rate (RMR) and skeletal muscle mass would be the strongest predictors of EI in a sample of overweight and obese adolescents. 304 post-pubertal adolescents (91 boys, 213 girls) aged 16.1 (±1.4) years with body mass index at or above the 95th percentile for age and sex OR at or above the 85th percentile plus an additional diabetes risk factor were measured for body weight, RMR (kcal/day) by indirect calorimetry, body composition by magnetic resonance imaging (fat free mass (FFM), skeletal muscle mass, fat mass (FM), and percentage body fat), and EI (kcal/day) using 3 day food records. Body weight, RMR, FFM, skeletal muscle mass, and FM were all significantly correlated with EI (p < 0.005). After adjusting the model for age, sex, height, and physical activity, only FFM (β = 21.9, p = 0.007) and skeletal muscle mass (β = 25.8, p = 0.02) remained as significant predictors of EI. FFM and skeletal muscle mass also predicted dietary protein and fat intake (p < 0.05), but not carbohydrate intake. In conclusion, with skeletal muscle mass being the best predictor of EI, our results support the hypothesis that the magnitude of the body’s lean tissue is related to absolute levels of EI in a sample of inactive adolescents with obesity.


2021 ◽  
Author(s):  
Aliyu Tijani Jibril ◽  
Atieh Mirzababaei ◽  
Farideh Shiraseb ◽  
Niloufar Rasaei ◽  
Khadijeh Mirzaei

Abstract Objectives Obesity is a major risk factor for metabolic syndrome, with its prevalence has increased over the past decade. Major changes in body composition with aging have a significant effect on many clinical outcomes. Sarcopenic obesity consists of both the presence of abnormal adipose tissue with a deficit of muscle mass. Results Of the 241 subjects in this study (average age 35.32 years), 176 (73.03%) were classified as MUO phenotype. Based on this study, the prevalence of sarcopenic obesity was 7.88%. We found that high fat-free mass was more strongly and significantly associated with MUO phenotype. Furthermore, we found that individuals with high fat-free mass and high skeletal muscle mass had a significantly low prevalence of MUO phenotype. A significant positive correlation between metabolic phenotypes and sarcopenic obesity was also observed after all potential covariates were adjusted for. These results of this study suggest that increased adiposity and decreased skeletal muscle mass are associated with unfavorable metabolic traits among overweight and obese Iranian women. SO was also found to be associated with a greater risk of developing MUO phenotype.


2020 ◽  
Author(s):  
Aliyu Tijani Jibril ◽  
Atieh Mirzababaei ◽  
Farideh Shiraseb ◽  
Niloufar Rasaei ◽  
Khadijeh - Mirzaei

Abstract Background Obesity is a major risk factor for metabolic syndrome, with its prevalence has increased over the past decade. Major changes in body composition with aging have a significant effect on many clinical outcomes. Sarcopenic obesity consists of both the presence of abnormal adipose tissue with a deficit of muscle mass. Methods This cross-sectional study was conducted among a total of 241 overweight/obese women aged between 18–48 years in Tehran, Iran, registered by the use of the multistage cluster random sampling method. Blood samples were taken following standard procedures. Body composition was assessed through a multi-frequency bioelectrical impedance analyzer. The metabolic risk was assessed according to Karelis criteria and the subjects were classified as either MHO or MUO phenotypes. Results Of the 241 subjects in this study (average age 35.32 years), 176 (73.03%) were classified as MUO phenotype. Based on this study, the prevalence of sarcopenic obesity was 7.88%. We found that high fat-free mass was more strongly and significantly associated with MUO phenotype. Furthermore, we found that individuals with high fat-free mass and high skeletal muscle mass had a significantly low prevalence of MUO phenotype. A significant positive correlation between metabolic phenotypes and sarcopenic obesity was also observed after all potential covariates were adjusted for. Conclusion These results of this study suggest that increased adiposity and decreased skeletal muscle mass are associated with unfavorable metabolic traits among overweight and obese Iranian women. SO was also found to be associated with a greater risk of developing MUO phenotype.


2021 ◽  
Vol 5 (2) ◽  
pp. 127
Author(s):  
Aprilia Kusumawardhani ◽  
Farapti Farapti ◽  
Mahmud Aditya Rifqi ◽  
Sri Adiningsih

ABSTRAK Latar Belakang :Gizi olahraga merupakan aspek penting dalam mengatur asupan makanan dan komposisi tubuh untuk mencapai performa yang optimal. Studi epidemiologis menunjukkan sebagian besar asupan atlet tidak adekuat dan dapat mempengaruhi komposisi tubuh yang ideal.Tujuan :Tujuan dari penelitian ini adalah untuk menganalisis pengaruh pendampingan gizi olahraga terhadap komposisi tubuh dan asupan energi atlet bela diri.Metode :Pendampingan gizi intensif dilakukan selama empat bulan (Juni- September 2019). Pengukuran komposisi tubuh  dilakukan 2 kali, yakni sebelum dan sesudah intervensi dengan menganalisis hasil pengukuran dari alat BIA (Bio Impadance Analyzer) tipe MBCA (Medical Body Compotiton Analyzer) 515/514 merk seca©. Variabel yang dianalisis diantaranya, total asupan kalori sehari diukur menggunakan instrumen Recall-24 jam, komposisi tubuh diukur dengan alat BIA yakni Fat Mass (FM), Fat Free Mass (FFM) dan Skeletal Muscle Mass (SMM). Pendampingan gizi dilakukan oleh ahli gizi olahraga yang mengunjungi 24 responden setiap bulan dan memberikan materi pendidikan gizi, memberikan makanan sehat dan memberikan konseling permasalahan gizi atlet.Hasil : Hasil penelitian ini menunjukkan adanya peningkatan secara signifikan pada asupan energi total (1496,2±654,4 menjadi 1688,5±679,8, p= 0,002). Pada komposisi tubuh terjadi peningkatan pada FFM dan SMM yakni (56,57 ± 9,91 kg vs 57,01 ± 9,53, p = 0,032) dan (27,49 ± 5,58 vs 27,75 ± 5,31, p = 0,005) dan tidak ada perbedaan signifikan dalam variabel  FM.Kesimpulan : Kesimpulan dari percobaan ini adalah pendampingan gizi secara intensif dapat meningkatkan asupan energi total, FFM dan SMM pada atlet bela diri. Kata Kunci : Komposisi tubuh, pendampingan gizi, asupan energiABSTRACTBackground :Sports nutrition is very urgent to improve nutrition knowledge, dietary intake and body composition to achieve an optimum athletic performance. Epidemiological studies showed most athletes lack of getting adequate intake and maintaining an ideal body composition.Objective :This study aims to analyze the effect of sport nutrition education on body composition and energy intake among elite combat sport athletes.Methods :Intensive sport nutrition was conducted for four months June until September 2019. Body composition was assessed  for 2 times, before and after intervention using bioelectric impedance analysis (BIA), with seca© brand 515/514 type of stainless steel electrodes.Measurement of energy intake with recall 24 hours before and after the intervention. The variables studied were Fat Mass (FM), Fat Free Mass (FFM), Skeletal Muscle Mass (SMM) and energy intake.The professional sport nutritionist and dietitians visited 24 subjects every month by teaching nutrition education, bringing the healthy food, and facilitating the counseling about sport nutrition.Result :Energy intake increased significantly (1496,2±654,4 to 1688,5±679,8, p= 0,002). FFM and SMM increased significantly pre to post (56.57±9.91 kg vs 57.01±9.53, p=0.032) and (27.49±5.58 vs 27.75±5.31, p=0.005) respectively, meanwhile no significant differences in FM variable.Conclusion : Our findings indicate that intensive sport nutritionimproved energy intake, FFM and SMM among elite combat sport athletes. Keywords : Body compotition, sport nutririon education, energy intake


2016 ◽  
Vol 195 (2) ◽  
pp. 270-276 ◽  
Author(s):  
Sarah P. Psutka ◽  
Stephen A. Boorjian ◽  
Michael R. Moynagh ◽  
Grant D. Schmit ◽  
Brian A. Costello ◽  
...  

2019 ◽  
Vol 106 (4) ◽  
pp. 331-342 ◽  
Author(s):  
A. A. Welch ◽  
A. Jennings ◽  
E. Kelaiditi ◽  
J. Skinner ◽  
C. J. Steves

AbstractThe prevalence of sarcopenia is increasing in aging populations, so prevention is critical. Vitamins (A, C, E and carotenoids) modify skeletal muscle via protein and collagen synthesis and anti-inflammatory activities. Previous studies have not investigated intake of these vitamins in relation to sarcopenic indices in both younger and older-aged women. Indices of skeletal muscle mass (as fat-free mass (FFM) relative to body size) were measured using DXA and leg explosive power (LEP) using the Nottingham Power Rig in 2570 women aged 18–79 years. Adjusted measures of skeletal muscle were calculated according to quintiles of vitamin C, E, retinol and carotenoid intake, derived from Food Frequency Questionnaires, after stratification by age. Higher vitamin C intake was associated with significantly higher indices of FFM and LEP, (Q5-Q1 = 2.0–12.8%, P < 0.01–0.02). Intakes of total and individual carotenoids were significantly associated with indices of FFM and LEP (Q5-Q1 = 1.0–7.5%). Vitamin E was significantly associated with FFM% and FFMBMI only. In mutually adjusted analysis with vitamin C, total carotene, vitamin E and protein in the model, the strongest associations were with vitamin C. These associations were stronger in younger women (< 65 years). For the first time, our research shows higher dietary intakes of antioxidant vitamins, particularly vitamin C, is associated with higher skeletal muscle mass and power in free-living women. These findings have relevance for the treatment and prevention of frailty and sarcopenia throughout adulthood.


2017 ◽  
Vol 10 (2) ◽  
pp. 28
Author(s):  
Ha Cao Thi Thu ◽  
Satoshi Kurose ◽  
Yaeko Fukushima ◽  
Nana Takao ◽  
Natsuko Nakamura ◽  
...  

This study evaluated the impact of exercise training with amino acid and vitamin D supplementation on muscle and bone mass in participants with low muscle volume. Twenty-nine Japanese participants (56-84 years old) were enrolled and assigned into the supplement (n=15) and non-supplement (n=14) groups. All participants underwent a 6-month exercise program. Supplements and nutrition support were provided to the participants in the supplement group for 12 weeks. Body composition and whole bone mineral density (BMD) were measured using dual energy x-ray absorptiometry. The outcomes, including body composition, whole BMD, and skeletal muscle mass index (SMI), were evaluated twice: pre- and post-intervention. The SMI was 6.51(6.28; 7.14) and 5.58 (5.24; 6.05) (kg/m2) in men and women, respectively. The average SMI change was 0.13% (-0.05%; 0.31%) and 2.33% (-0.88%; 5.48%); [mean (lower; upper quartile)]. The average BMD loss in the non-supplement group was -2.78%, and the BMD increased in the supplement group by 4.34%; there was an absolute difference between the two groups (p<0.05). After the intervention, serum myostatin was changed (p=0.001, non-supplement>supplement), serum vitamin D was increased (p=0.03; supplement>non-supplement), and BMD was maintained (p=0.03, supplement>non-supplement). There was a significant difference in the serum myostatin level at baseline and at 6-month in the non-supplement group, with a mean difference of 483.78 ng/ml (p=0.01). There was no significant improvement in the total lean mass, and handgrip strength. Resistance exercise combined with an amino acid supplement affects muscle and bone mass in the short-term intervention.


2017 ◽  
Vol 135 (5) ◽  
pp. 434-443 ◽  
Author(s):  
Ricardo Aurélio Carvalho Sampaio ◽  
Priscila Yukari Sewo Sampaio ◽  
Luz Albany Arcila Castaño ◽  
João Francisco Barbieri ◽  
Hélio José Coelho Júnior ◽  
...  

2015 ◽  
Vol 114 (11) ◽  
pp. 1838-1844 ◽  
Author(s):  
Min Jung Ko ◽  
Sungha Yun ◽  
Kyungwon Oh ◽  
Kirang Kim

AbstractThe objective of this study was to examine whether high serum 25-hydroxyvitamin D (25(OH)D) concentration was associated with high skeletal muscle mass, taking into account the effects of sex and age among the participants of the Korea National Health and Nutrition Examination Survey (KNHANES) aged 40 years or older. This was a cross-sectional study using data from the 2009 to 2010 KNHANES; a total of 8406 subjects (3671 men and 4735 women) were included. The appendicular skeletal muscle mass index (ASMMI, kg/m2) was estimated to measure the skeletal muscle mass. Hypovitaminosis was classified when the level of serum 25(OH)D was <20 ng/ml. The general linear model adjusted for confounding factors was used to determine differences in means of ASMMI by 25(OH)D status. The mean values of ASMMI were higher for men when compared with women. Women had a greater proportion of hypovitaminosis (71·1 %) compared with men (53·2 %). After adjusting for multiple factors, men were seen to have significant differences in ASMMI based on 25(OH)D status regardless of age, showing a lower mean value of ASSMI in those with hypovitaminosis. However, there was no difference in ASMMI by 25(OH)D status among women in both younger and older age groups. In conclusion, we found that there might be a positive relationship between 25(OH)D and skeletal muscle mass in men, indicating that interventions to improve 25(OH)D levels that are aimed at increasing muscle mass could be beneficial for men with more rapid decreased rate of skeletal muscle mass.


2017 ◽  
Vol 117 (8) ◽  
pp. 1181-1188 ◽  
Author(s):  
Hui-yuan Tian ◽  
Rui Qiu ◽  
Li-peng Jing ◽  
Zhan-yong Chen ◽  
Geng-dong Chen ◽  
...  

AbstractResearches have suggested Mediterranean diet might lower the risk of chronic diseases, but data on skeletal muscle mass (SMM) are limited. This community-based cross-sectional study examined the association between the alternate Mediterranean diet score (aMDS) and SMM in 2230 females and 1059 males aged 40–75 years in Guangzhou, China. General information and habitual dietary information were assessed in face-to-face interviews conducted during 2008–2010 and 3 years later. The aMDS was calculated by summing the dichotomous points for the items of higher intakes of whole grain, vegetables, fruits, legumes, nuts, fish and ratio of MUFA:SFA, lower red meat and moderate ethanol consumption. The SMM of the whole body, limbs, arms and legs were measured using dual-energy X-ray absorptiometry during 2011–2013. After adjusting for potential covariates, higher aMDS was positively associated with skeletal muscle mass index (SMI, SMM/height2, kg/m2) at all of the studied sites in males (all Ptrend<0·05). The multiple covariate-adjusted SMI means were 2·70 % (whole body), 2·65 % (limbs), 2·50 % (arms) and 2·70 % (legs) higher in the high (v. low) category aMDS in males (all P<0·05). In females, the corresponding values were 1·35 % (Ptrend=0·03), 1·05, 0·52 and 1·20 %, (Ptrend>0·05). Age-stratified analyses showed that the favourable associations tended to be more pronounced in the younger subjects aged less than the medians of 59·2 and 62·2 years in females and males (Pinteraction>0·10). In conclusion, the aMDS shows protective associations with SMM in Chinese adults, particularly in male and younger subjects.


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