Perioperative changes of body weight, skeletal muscle and fat mass in patients with benign and malignant gastrointestinal tumors and the comparison / 中华临床营养杂志

ABSTRACT

Objective:To describe and compare the perioperative changes of body weight, skeletal muscle and fat mass in patients with benign and malignant gastrointestinal tumors.Methods:All adult patients admitted to the surgery department of a referral hospital in Beijing with voluntary consent were included in the study. For all participants, preoperative medical history were collected and body composition measurements were performed 1-2 days prior to the surgery and 3-6 days after the surgery. Pathological results and tumor diagnosis were recorded.Results:A total of 80 participants completed the study. There was no significant difference in weight and body composition between patients with benign and malignant tumors before operation, but patients experiencing a weight loss of more than 5% in the past 6 months were dramatically more in malignant tumor group compared with benign tumor group (9.1% vs. 42.0%, P=0.024). With the parenteral and enteral nutrition support, there was no significant difference in the changes of weight, muscle, or fat mass between benign and malignant tumor patients in different stages (all P>.05). Patients with malignant tumors were divided into severe weight loss group and observational group with the percentage weight loss cut-off of 5%. Analysis showed that patients in the severe weight loss group had significantly decreased weight [(-4.3±1.6)kg vs. (-1.9±1.1)kg, P<0.01], BMI[(-1.3±0.9)kg/m 2vs. (-0.7±0.4)kg/m 2, P<0.01], muscle[(-1.2±2.0)kg vs. (-0.4±1.2)kg, P=0.046] and fat mass [(-2.6±2.0)kg vs. (-1.1±0.9)kg, P=0.018] compared with observational group, while visceral [(-0.5±0.6)kg vs. (-0.2±0.7)kg, P=0.107] and subcutaneous fat [(-2.2±1.9)kg vs. (-1.4±1.8)kg, P=0.235] of two groups had no significant difference. Univariate analysis revealed age as the only influencing factor for perioperative weight loss ( P=0.036). Fat loss was predominant in the overall weight loss compared with muscle loss ( P=0.026) among patients with gastrointestinal malignant tumors. Conclusion:With parenteral and enteral nutrition support, there is no significant difference in perioperative changes of weight, muscle or fat mass among patients with benign and malignant tumors. Muscle and fat loss both have contributed to the overall weight loss, which is noteworthy.