恶性肿瘤患者相位角与肌肉质量的相关性研究

Correlation between phase angle and muscle mass in malignant tumor patients

目的探讨恶性肿瘤患者相位角与肌肉数量及肌肉力量的相关性。方法纳入2022年5月至7月在河北医科大学第一医院肿瘤科接受治疗的恶性肿瘤患者为病例组,同期纳入在河北医科大学第一医院住院的非恶性肿瘤患者为对照组,利用生物电阻抗技术对两组受检者进行人体成分检测。同时测量两组受检者的握力并进行5次坐立试验、6分钟步行试验及6m正常步速试验。对比分析两组受检者的各项指标。结果本研究病例组与对照组最终各纳入受检者80例。恶性肿瘤患者的相位角明显低于非恶性肿瘤患者(P<0.05);恶性肿瘤患者存在营养风险及营养不良比例高于非恶性肿瘤患者(P<0.05);恶性肿瘤患者的去脂体重、肌肉量、骨骼肌总质量与各部分骨骼肌质量以及四肢骨骼肌质量指数均低于非恶性肿瘤患者(P<0.05);恶性肿瘤患者的握力、步速及6分钟步行试验所行走的距离均低于非恶性肿瘤患者(P<0.05),而5次坐立试验所用时间长于非恶性肿瘤患者(P<0.05);恶性肿瘤患者相位角与去脂体重(r=0.948,P<0.05)、肌肉量(r=0.888,P<0.05)、骨骼肌总量(r=0.984,P<0.05)与各部分骨骼肌质量以及四肢骨骼肌质量指数(r=0.685,P<0.05)均呈正相关;恶性肿瘤患者的相位角与握力(r=0.438,P<0.05)呈正相关。多元Logistic回归分析结果显示,恶性肿瘤患者肌肉减少与低相位角(OR=0.247,95%CI=0.088~0.692,P<0.05)和增龄(OR=1.154,95%CI=1.045~1.275,P<0.05)有关。结论恶性肿瘤患者的相位角低于非恶性肿瘤患者。恶性肿瘤患者的低相位角与肌肉数量的减少及肌肉力量的降低有关,同时相位角可作为评价恶性肿瘤患者肌肉质量的指标。

Objective To investigate the correlation between phase angle and muscle mass and muscle strength in patients with malignant tumors.Methods Patients with malignant tumors who were treated in the oncology department of the First Hospital of Hebei Medical University from May to July 2022 were included as the case group,and patients with non-malignant tumors who were hospitalized in the First Hospital of Hebei Medical University were recruited as the control group during the same period.Body composition of the two groups of subjects were detected by bioelectrical impedance analysis.At the same time,the hand grip strength,5 times of sitting test,6-minute walking test and 6-meter normal pace test were tested and compared in two groups.Results In this study,80 subjects were included in the case group and the control group respectively.The phase angle of malignant tumor patients was significantly lower than non-malignant tumor patients(P<0.05).The percentage of nutritional risk and malnutrition were significantly higher in the patients with malignancy compared to patients without malignancy(P<0.05).The fat free mass,muscle mass,the total and each part skeletal muscle mass,and appendicular skeletal muscle index of malignant tumor patients were lower than non-malignant tumor patients(P<0.05).The hand grip strength,gait speed and walking distance of the 6-minute walking test in the malignant tumor patients were lower(P<0.05),while the time spent in the 5-time sit-up test was higher than non-malignant tumor patients(P<0.05).The phase angle of patients with malignant tumor were positively correlated with fat free mass(r=0.948,P<0.05),muscle mass(r=0.888,P<0.05),skeletal muscle mass(r=0.984,P<0.05),skeletal muscle mass of each part,and appendicular skeletal muscle index(r=0.685,P<0.05).The phase angle of patients with malignant tumor was positively correlated with hand grip strength(r=0.438,P<0.05).The results of multiple regression analysis showed that decrease of muscle mass in malignancy patients was related to low phase angle(OR=0.247,95%CI=0.088-0.692,P<0.05)and aging(OR=1.154,95%CI=1.045-1.275,P<0.05).Conclusions The phase angle of malignant tumor patients is lower than non-malignant tumor patients.Low phase angle in patients with malignancy may be associated with decreased muscle mass and muscle strength.Phase angle could be used as an index to evaluate the muscle quantity and quality of patients with malignant tumor.