{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:03:31Z","timestamp":1792598611193,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T00:00:00Z","timestamp":1725753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Objectives: The aim of this investigation was to evaluate the discrepancies between bioelectrical impedance analysis (BIA) and computed tomography (CT) in assessing skeletal muscle mass and identifying low muscle mass in patients with colorectal cancer. Methods: This study recruited 137 patients with colorectal cancer from February 2028 to December 2023. CT scans were analyzed at the Lumbar 3 vertebral level to determine the area of skeletal muscle, which was then utilized to estimate whole-body skeletal muscle mass. [BIA] was also employed to measure skeletal muscle. Both skeletal muscle mass values [kg] were divided by height2 [m2] to calculate the skeletal muscle index [SMI, kg\/m2], denoted as SMI-CT and SMI-BIA, respectively. Results: The median age was 69.8 + 9.5 years, with the sex ratio being 88\/49 [male\/female]. Whereas more than one-third of the patients were classified as malnourished based on the Global Leadership Initiative on Malnutrition GLIM-CT criteria using L3-SMI [n = 36.5%], fewer patients were classified as malnourished based on GLIM-BIA using SMI-BIA [n = 19.0%]. According to the CT analysis [low SMI-L3], 52 [38.0%] patients were diagnosed as having poor muscle mass, whereas only 18 [13.1%] patients were identified as having low muscle mass using BIA [low SMIBIA]. The measured SMI showed a positive association with SMI-CT in all patients [r = 0.63, p &lt; 0.001]. Using Bland\u2013Altman evaluation, a significant mean bias of 0.45 + 1.41 kg\/m2 [95% CI 0.21\u20130.70; p &lt; 0.001] between SMI-BIA and SMI-CT was reported. Receiver operating characteristic (ROC) curves were generated to detect poor muscle mass using SMI-BIA with CT as the gold standard. The area under the curve (AUC) for SMI-BIA in identifying poor muscle mass was 0.714 (95% CI: 0.624\u20130.824), with a good cut-off value of 8.1 kg\/m2, yielding a sensitivity of 68.3% and a specificity of 66.9%. Conclusions: BIA generally overestimates skeletal muscle mass in colorectal cancer patients when contrasted to CT. As a result, BIA may underestimate the prevalence of poor muscle mass and malnutrition according to the GLIM criteria in this patient population.<\/jats:p>","DOI":"10.3390\/nu16173035","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T04:15:01Z","timestamp":1725855301000},"page":"3035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Evaluation of Muscle Mass and Malnutrition in Patients with Colorectal Cancer Using the Global Leadership Initiative on Malnutrition Criteria and Comparing Bioelectrical Impedance Analysis and Computed Tomography Measurements"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1745-9315","authenticated-orcid":false,"given":"Daniel","family":"de Luis Roman","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda and Nutrici\u00f3n, Facultad de Medicina, Universidad de Valladolid, 47003 Valladolid, Spain"},{"name":"Departamento de Endocrinolog\u00eda y Nutricion, Hospital Clinico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"L\u00f3pez G\u00f3mez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda and Nutrici\u00f3n, Facultad de Medicina, Universidad de Valladolid, 47003 Valladolid, Spain"},{"name":"Departamento de Endocrinolog\u00eda y Nutricion, Hospital Clinico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marife","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Unidad de Apoyo a la Investigaci\u00f3n, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Primo","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda and Nutrici\u00f3n, Facultad de Medicina, Universidad de Valladolid, 47003 Valladolid, Spain"},{"name":"Departamento de Endocrinolog\u00eda y Nutricion, Hospital Clinico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olatz","family":"Izaola","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n of Endocrinolog\u00eda and Nutrici\u00f3n, Facultad de Medicina, Universidad de Valladolid, 47003 Valladolid, Spain"},{"name":"Departamento de Endocrinolog\u00eda y Nutricion, Hospital Clinico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Svo. Radiolog\u00eda, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1016\/j.clnu.2019.10.021","article-title":"Muscle mass, assessed at diagnosis by L3-CT scan as a prognostic marker of clinical out-comes in patients with gastric cancer: A systematic review and meta-analysis","volume":"39","author":"Rinninella","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM criteria for the diagnosis of malnutrition: A consensus report from the global clinical nutrition community","volume":"10","author":"Jensen","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1016\/j.clnu.2022.02.001","article-title":"Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition [GLIM] diagnosis of malnutrition","volume":"41","author":"Barazzoni","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Beaudart, C., McCloskey, E., Bruy\u00e8re, O., Cesari, M., Rolland, Y., Rizzoli, R., Araujo De Carvalho, I., Amuthavalli Thiyagarajan, J., Bautmans, I., and Berti\u00e8re, M.-C. (2016). Sarcopenia in daily practice: Assessment and management. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0349-4"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ageing\/afz046","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.nut.2018.11.028","article-title":"Current technologies in body composition assessment: Advantages and disadvantages","volume":"62","author":"Ceniccola","year":"2019","journal-title":"Nutrition"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.clnu.2004.09.012","article-title":"Bioelectrical impedance analysis-part II: Utilization in clinical practice","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/ejcn.2014.203","article-title":"Bioelectrical impedance analysis to estimate body composition in surgical and oncological patients: A systematic review","volume":"69","author":"Haverkort","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.radonc.2021.03.005","article-title":"Bioelectrical impedance analysis as a quantitative measure of sarcopenia in head and neck cancer patients treated with radiotherapy","volume":"159","author":"Grossberg","year":"2021","journal-title":"Radiother. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1016\/j.clnu.2019.07.020","article-title":"Identifying critically ill patients with low muscle mass: Agreement between bioelectrical impedance analysis and computed tomography","volume":"39","author":"Looijaard","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1038\/s41430-017-0034-5","article-title":"Percentiles for skeletal muscle index, area and radiation attenuation based on computed tomography imaging in a healthy Caucasian population","volume":"72","author":"Langius","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/ajcn\/41.4.810","article-title":"Assessment of fat-free mass using bioelectrical impedance measurements of the human body","volume":"41","author":"Lukaski","year":"1985","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1152\/japplphysiol.00744.2004","article-title":"Total body skeletal muscle and adipose tissue volumes: Estimation from a single abdominal cross-sectional image","volume":"97","author":"Shen","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/tbj.12952","article-title":"Beyond sarcopenia: Characterization and integration of skeletal muscle quantity and radiodensity in a curable breast cancer population","volume":"24","author":"Weinberg","year":"2018","journal-title":"Breast J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/ans.15106","article-title":"Decreased total psoas muscle area after neoadjuvant therapy is a predictor of increased mortality in patients undergoing oesophageal cancer resection","volume":"89","author":"Yassaie","year":"2019","journal-title":"ANZ J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"987","DOI":"10.21873\/anticanres.13203","article-title":"Adverse effects of preoperative sarcopenia on postoperative complications of patients with gastric cancer","volume":"39","author":"Tamura","year":"2019","journal-title":"Anticancer Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Contreras-Bol\u00edvar, V., S\u00e1nchez-Torralvo, F.J., Ruiz-Vico, M., Gonz\u00e1lez-Almendros, I., Barrios, M., Pad\u00edn, S., Alba, E., and Olveira, G. (2019). GLIM criteria using hand grip strength adequately predict six-month mortality in cancer inpatients. Nutrition, 11.","DOI":"10.3390\/nu11092043"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1007\/s00520-017-3661-4","article-title":"Nutritional and functional factors as prognostic of surgical cancer patients","volume":"25","author":"Harter","year":"2017","journal-title":"Support. Care Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.clnu.2012.05.008","article-title":"Bioelectrical phase angle and impedance vector analysis-clinical relevance and applicability of imped- ance parameters","volume":"31","author":"Norman","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.clnesp.2021.04.021","article-title":"Measurement of body composition: Agreement between methods of measurement by bioimpedance and computed tomography in patients with non-small cell lung cancer","volume":"44","author":"Hansen","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1016\/j.clnu.2018.12.002","article-title":"Comparative assessment of skeletal muscle mass using computerized tomography and bioelectrical impedance analysis in critically ill patients","volume":"38","author":"Kim","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"112363","DOI":"10.1016\/j.nut.2024.112363","article-title":"Comparison of bioelectrical impedance analysis and computed tomography for the assessment of muscle mass in patients with gastric cancer","volume":"121","author":"Zuo","year":"2024","journal-title":"Nutrition"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.clnu.2020.08.009","article-title":"Nutritional status and body composition assessment in patients with a new diagnosis of advanced solid tumour: Exploratory comparison of computed tomography and bioelectrical impedance analysis","volume":"40","author":"Casirati","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1080\/01635581.2019.1659381","article-title":"Measurement of Muscle Mass and Sarcopenia Using Anthropometry, Bioelectrical Impedance, and Computed Tomography in Surgical Patients with Colorectal Malignancy: Comparison of Agreement Between Methods","volume":"72","author":"Jones","year":"2020","journal-title":"Nutr. Cancer."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Meza-Valderrama, D., Marco, E., D\u00e1valos-Yerovi, V., Muns, M.D., Tejero-S\u00e1nchez, M., Duarte, E., and S\u00e1nchez-Rodr\u00edguez, D. (2021). Sarcopenia, malnutrition, and cachexia: Adapting definitions and terminology of nutritional disorders in older people with cancer. Nutrients, 13.","DOI":"10.3390\/nu13030761"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1634\/theoncologist.2019-0600","article-title":"Bio- electrical impedance analysis for the assessment of sarcopenia in patients with cancer: A systematic review","volume":"25","author":"Aleixo","year":"2020","journal-title":"Oncologist"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1159\/000526563","article-title":"Evaluation of skeletal muscle mass in patients with chronic liver disease shows different results based on bioelectric impedance analysis and computed tomography","volume":"78","author":"Kikuchi","year":"2022","journal-title":"Ann. Nutr. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.3892\/or.2015.4475","article-title":"Low skeletal muscle density is associated with poor survival in patients who receive chemotherapy for metastatic gastric cancer","volume":"35","author":"Hayashi","year":"2016","journal-title":"Oncol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3596","DOI":"10.1245\/s10434-018-6728-7","article-title":"Optimal cutoff values of skeletal muscle index to define sarcopenia for prediction of survival in patients with advanced gastric cancer","volume":"25","author":"Nishigori","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1002\/jso.24015","article-title":"Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes","volume":"112","author":"Tegels","year":"2015","journal-title":"J. Surg. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"74","DOI":"10.5230\/jgc.2017.17.e8","article-title":"Body composition as a prognostic factor of neoadjuvant chemotherapy toxicity and outcome in patients with locally advanced gastric cancer","volume":"17","author":"Palmela","year":"2017","journal-title":"J. Gastric Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Sammarco, G., Gallo, G., Vescio, G., Picciariello, A., De Paola, G., Trompetto, M., Curr\u00f2, G., and Ammendola, M. (2020). Mast Cells, microRNAs and Others: The Role of Translational Research on Colorectal Cancer in the Forthcoming Era of Precision Medicine. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092852"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Abedin, K., Lean, Q.Y., and Wheelwright, S. (2024). Nutritional self-management in colorectal cancer patients and survivors: A scoping review. Colorectal Dis.","DOI":"10.1111\/codi.17108"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Soria-Utrilla, V., S\u00e1nchez-Torralvo, F.J., Palmas-Candia, F.X., Fern\u00e1ndez-Jim\u00e9nez, R., Mucarzel-Suarez-Arana, F., Guirado-Pel\u00e1ez, P., Olveira, G., Garc\u00eda-Almeida, J.M., and Burgos-Pel\u00e1ez, R. (2024). AI-Assisted Body Composition Assessment Using CT Imaging in Colorectal Cancer Patients: Predictive Capacity for Sarcopenia and Malnutrition Diagnosis. Nutrients, 16.","DOI":"10.3390\/nu16121869"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.clnesp.2024.01.001","article-title":"The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients","volume":"60","author":"Berg","year":"2024","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/codi.15997","article-title":"Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): A nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group","volume":"24","author":"Degiuli","year":"2022","journal-title":"Colorectal Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"8451","DOI":"10.1002\/cam4.4354","article-title":"Skeletal muscle gauge as a prognostic factor in patients with colorectal cancer","volume":"10","author":"Park","year":"2021","journal-title":"Cancer Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1590\/s0004-2803.202202000-52","article-title":"Evaluation of different tools for body composition assessment in colorectal cancer\u2014A systematic review","volume":"59","author":"Magro","year":"2022","journal-title":"Arq. Gastroenterol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/17\/3035\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:51:38Z","timestamp":1760111498000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/17\/3035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,8]]},"references-count":38,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["nu16173035"],"URL":"https:\/\/doi.org\/10.3390\/nu16173035","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,8]]}}}