Phase angle as a marker for muscle abnormalities and function in patients with colorectal cancer

Abstract

Considering the applicability of phase angle (PhA) as a marker of muscle mass and function, we aimed to investigate whether PhA is a predictor of muscle abnormalities and function in patients with cancer. Methods: In a sample of patients with colorectal cancer (CRC), PhA was obtained from measurements of resistance and reactance from bioelectrical impedance analysis. Computerized tomography imaging at the third lumbar vertebra was used to evaluate muscle abnormalities by quantifying skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD). Muscle function was assessed by handgrip strength (HGS) and gait speed (GS). Results: This cross-sectional study included 190 participants (X±SD), mean age 60.5 ± 11.3 years; 57% men; 78% had cancer stages III to IV. PhA was highly correlated with SMI (r ¼ 0.70) and moderately correlated with HGS (r ¼ 0.54). PhA explained 48% of the SMI variability (R2 ¼ 0.485), 21% of the SMD variability (R2 ¼ 0.214), 26% of HGS (R2 ¼ 0.261) and 9.8% of GS (R2 ¼ 0.098). In the multivariate model adjusted for age, sex, body mass index, performance status, comorbidities and cancer stage, 1-degree decrease in PhA was associated with low SMI (Odds Ratio (OR) ¼ 6.56, 95% CI: 2.90e14.86) and with low SMI and HGS combined (OR ¼ 11.10, 95% CI: 2.61e47.25). In addition, Receiving Operating Charac teristics curve analysis showed that PhA had a good diagnostic accuracy for detecting low SMI, low SMI and SMD combined, low SMD and HGS and low SMI and HGS combined (AUC ¼ 0.81, 95% CI: 0.74e0.88; AUC ¼ 0.88, 95% CI: 0.81e0.95; AUC ¼ 0.80, 95% CI: 0.70e0.91; AUC ¼ 0.82, 95% CI: 0.74e0.89; respectively). Conclusions: PhA was a predictor of muscle abnormalities and function and had a good diagnostic ac curacy for detecting low muscle mass, low muscle mass and radiodensity, low muscle radiodensity and strength, and low muscle mass and strength in patients with CRC.