Exploring the relationship of self-reported lack of appetite to patient characteristics and symptom burden.

187 Background: Cancer anorexia-cachexia syndrome (CACS) in patients is associated with decreases in lean body mass and body weight. Self-reported lack of appetite may be an important indicator for early identification of CACS. The current analyses examined the relationship of perceived lack of appetite to patient characteristics and overall symptom burden in a large mixed cancer sample referred to a palliative care clinic. Methods: We conducted a retrospective review of patients newly referred to an outpatient palliative care clinic over a two-year period. Data on demographic and clinical characteristics and patient-reported symptom scores on the Edmonton Symptom Assessment Scale (ESAS) were abstracted. Pearson’s correlations and ANOVAs were used to assess relationships between variables. Multiple regression analysis was used to evaluate the relative contribution of variables that were significantly correlated with lack of appetite at the univariate level. Results: Data on 544 patients ( M=53.7 years) showed that older age (r=12, p<.01), not being married or in a marriage-like relationship (r=.09, p=.04), having insurance other than managed care insurance (r=.10, p=.02), lower body mass index (BMI; r=.11, p<.01), marijuana use (r=.18, p<.0001), and overall symptom burden (ESAS total score r=.52, p < .0001) were associated with worse lack of appetite ( M=3.5, SD=3.1). Patients who were underweight (BMI <18.5, 46.7%) reported significantly worse lack of appetite than patients who were normal weight, overweight, or obese ( M=3.9, SD=3.2, p<.01). The final hierarchical regression model accounted for 34% of the variance in lack of appetite, with age, marital status, BMI, marijuana use, and total symptom burden remaining significant independent correlates (p’ s <.01). Conclusions: Contrary to expectations, relatively few clinical correlates were associated with self-reported lack of appetite. Future research should explore inter-individual genetic factors to explain alterations in lean body mass and body weight that may contribute to poor appetite in patients. Such factors may be important indicators for early identification of CACS.

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The Relationship of Total Exchangeable Potassium and Chloride to Lean Body Mass, Red Cell Mass and Creatinine Excretion in Man

Journal of Clinical Investigation ◽

10.1172/jci103537 ◽

1957 ◽

Vol 36 (9) ◽

pp. 1375-1381 ◽

Cited By ~ 42

Author(s):

F. P. Muldowney ◽

J. Crooks ◽

M. M. Bluhm

Keyword(s):

Lean Body Mass ◽

Body Mass ◽

Cell Mass ◽

Red Cell ◽

Exchangeable Potassium ◽

Creatinine Excretion ◽

Red Cell Mass ◽

Relationship Of ◽

The Relationship

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In vivo determinations of lean body mass from K40 measurements and the relationship of these values to motor aptitude in preadolescent boys

The International Journal of Applied Radiation and Isotopes ◽

10.1016/0020-708x(64)90143-7 ◽

1964 ◽

Vol 15 (7) ◽

pp. 441-445 ◽

Cited By ~ 3

Author(s):

J.E. Christian ◽

A.H. Ismail ◽

W.V. Kessler

Keyword(s):

Lean Body Mass ◽

Body Mass ◽

Relationship Of ◽

The Relationship

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The Relationship of Lean Body Mass With Aging to the Development of Diabetes

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa043 ◽

2020 ◽

Vol 4 (7) ◽

Cited By ~ 3

Author(s):

Rita R Kalyani ◽

E Jeffrey Metter ◽

Qian-Li Xue ◽

Josephine M Egan ◽

Chee W Chia ◽

...

Keyword(s):

Lean Body Mass ◽

Body Mass ◽

Community Dwelling ◽

Incident Diabetes ◽

Oral Glucose ◽

Age Related ◽

Total Lean Body Mass ◽

Relationship Of ◽

The Relationship

Abstract Context Older adults have the greatest burden of diabetes; however, the contribution of age-related muscle loss to its development remains unclear. Objective We assessed the relationship of lean body mass with aging to incident diabetes in community-dwelling adults. Design and Setting We studied participants in the Baltimore Longitudinal Study of Aging with median follow-up of 7 years (range 1-16). Cox proportional hazard models with age as the time scale were used. Time-dependent lean body mass measures were updated at each follow-up visit available. Participants Participants included 871 men and 984 women without diabetes who had ≥ 1 assessment of body composition using dual x-ray absorptiometry. Main Outcomes Incident diabetes, defined as self-reported history and use of glucose-lowering medications; or fasting plasma glucose ≥ 126 mg/dL and 2-hour oral glucose tolerance test glucose ≥ 200 mg/dL either at the same visit or 2 consecutive visits. Results The baseline mean [standard deviation] age was 58.9 [17.3] years. Men and women with a higher percentage of total lean body mass had lower fasting and 2-hour glucose levels, and less prediabetes (all P < 0.01). Among men, comparing highest versus lowest quartiles, percentage of total lean body mass (hazard ratio [HR], 0.46; 95% confidence interval, 0.22-0.97), percentage leg lean mass (HR, 0.38; 0.15-0.96), and lean-to-fat mass ratio (HR, 0.39; 0.17-0.89) were inversely associated with incident diabetes after accounting for race and attenuated after adjustment for height and weight. Conversely, absolute total lean body mass was positively associated with incident diabetes among women, with similar trends in men. No associations were observed with muscle strength or quality. Conclusions Relatively lower lean body mass with aging is associated with incident diabetes in men and partially related to anthropometrics, but not so in women.

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The Relationship of Lean Body Mass with Vitamin D Level and Physical Performance

Turkish Journal of Osteoporosis ◽

10.4274/tod.galenos.2018.77699 ◽

2019 ◽

Vol 25 (1) ◽

pp. 1-5

Author(s):

Eylül Yağıcıbulut Eren ◽

Selda Sarıkaya ◽

Şenay Özdolap

Keyword(s):

Vitamin D ◽

Lean Body Mass ◽

Physical Performance ◽

Body Mass ◽

Relationship Of ◽

The Relationship

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Indexes of body cell mass: nitrogen versus potassium

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1983.244.3.e305 ◽

1983 ◽

Vol 244 (3) ◽

pp. E305-E310 ◽

Cited By ~ 5

Author(s):

S. H. Cohn ◽

D. Vartsky ◽

S. Yasumura ◽

A. N. Vaswani ◽

K. J. Ellis

Keyword(s):

Body Composition ◽

Neutron Activation ◽

Lean Body Mass ◽

Body Mass ◽

Cell Mass ◽

Body Cell Mass ◽

Body Cell ◽

Total Body ◽

Relationship Of ◽

The Relationship

In vivo neutron activation has provided investigators with a powerful tool for research on body composition. Total-body nitrogen (TBN), total-body potassium (TBK), and total-body water (TBW) were measured in 133 normal subjects. TBN, measured by neutron activation, is a measure of total-body protein, an index of body cell mass. TBK, also measured by a nuclear reaction, is an index of body cell mass as well as lean body mass. The mass and protein content of two compartments, muscle and nonmuscle lean tissue, were determined from the combined TBN-TBK data by compartmental analysis. In this study, nitrogen was separated into the actively metabolizing body cell mass component and the slowly metabolizing structural component. The TBK, which is 95% intracellular, was found to be more closely related to the actively metabolizing nitrogen than to TBN. The relationship of body cell mass, a concept originally proposed by Moore, to lean body mass, is shown through the relationship of TBN and TBK. The clinical significance of this study, is that TBK is the more sensitive and reliable indicator of changes in body cell mass. Maximum information on body composition, however, is obtained by the measurement of both TBK and TBN.

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Body mass index: a measure of fatness or leanness?

British Journal Of Nutrition ◽

10.1079/bjn19950055 ◽

1995 ◽

Vol 73 (4) ◽

pp. 507-516 ◽

Cited By ~ 43

Author(s):

Alan M. Nevill ◽

Roger L. Holder

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Lean Body Mass ◽

Body Mass ◽

Body Fat ◽

Normal Range ◽

Percentage Body Fat ◽

Distributional Properties ◽

Two Indices ◽

The Relationship

The relationship between body fat and stature-adjusted weight indices was explored. Assuming the term height2 is a valid indicator of a subject's lean body mass, height2/weight was shown to be an accurate measure of percentage lean body mass and, as such, a better predictor of percentage body fat than the traditional body mass index (BMI; weight/height2). The name, lean body mass index (LBMI), is proposed for the index height2/weight. These assumptions were confirmed empirically using the results from the Allied Dunbar National Fitness Survey (ADNFS). Using simple allometric modelling, the term heightp explained 74% of the variance in lean body mass compared with less than 40% in body weight. For the majority of ADNFS subjects the fitted exponent from both analyses was approximately p = 2, the only exception being the female subjects aged 55 years and over, where the exponent was found to be significantly less than 2. Using estimates of percentage body fat as the dependent variable, regression analysis was able to confirm that LBMI was empirically, as well as theoretically, superior to the traditional BMI. Finally, when the distributional properties of the two indices were compared, BMI was positively skewed and hence deviated considerably from a normal distribution. In contrast, LBMI was found to be both symmetric and normally distributed. When height and weight are recorded in centimetres and kilograms respectively, the suggested working normal range for LBMI is 300–500 with the median at 400.

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