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Evaluating the Role of Mitochondrial Function in Cancer-related Fatigue
Published on: May 17, 2018
Phase Angle as an Early Functional Biomarker of Cancer-Related Fatigue in Pediatric Oncology: A Prospective
Luís Carlos Lopes-Junior1,2, Luiz Claudio Barreto Silva Neto1, Fabiano Kenji Haraguchi2
1Program of Post-Graduation in Public Heath, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil.
Insights
Pediatric cancer patients show declining nutritional status and worsening fatigue during early treatment. Phase angle (PhA), a marker of cellular integrity, is independently linked to fatigue severity in children and adolescents undergoing cancer therapy.
Area of Science:
- Oncology
- Nutrition Science
- Biophysics
Background:
- Pediatric cancer is a significant global health challenge, with treatment often negatively impacting patients' nutritional status, body composition, and causing cancer-related fatigue (CRF).
- Phase angle (PhA), a noninvasive bioelectrical impedance analysis (BIA) marker reflecting cellular integrity, is recognized for its association with functional status, but its specific role in pediatric oncology requires further investigation.
Purpose of the Study:
- To longitudinally assess changes in nutritional status and CRF in pediatric cancer patients during the initial three months of treatment.
- To determine the relationship between PhA and CRF in this patient population over the same period.
Main Methods:
- A prospective longitudinal study involving children and adolescents (0-18 years) newly diagnosed with cancer or CNS tumors.
- Data on clinical/sociodemographic characteristics, nutritional status (anthropometry/STRONGkids), body composition, and CRF (PedsQLMFS) were collected at diagnosis (T0), 1 month (T1), and 3 months (T2) post-treatment initiation.
- Statistical analyses included repeated measures and linear mixed-effects models.
Main Results:
- The study included 23 patients (mean age 5.7 years; 65.2% female).
- Significant decreases in body mass index (p=0.044), PhA (p=0.013), and lean mass (p=0.037) were observed over time.
- Self-reported fatigue increased, with notable worsening in the general fatigue domain (p=0.043). Significant correlations were found between fatigue and body composition indicators, including calf circumference, body fat mass, and PhA (r=0.521-0.752).
- Linear mixed-effects models revealed that PhA was independently associated with total fatigue over time (β=19.97; p=0.011).
Conclusions:
- Children and adolescents with cancer experience early declines in nutritional status and body composition, alongside increased CRF during treatment.
- Fatigue severity is consistently linked to PhA and lean mass indicators, suggesting body composition and cellular integrity are important factors.
- PhA shows promise as a noninvasive marker for fatigue, independently associated with its progression over time, supporting its use in comprehensive nutritional assessments for early risk identification.
Background:
Pediatric cancer remains a leading cause of morbidity and mortality worldwide, particularly in low-and middle-income countries. Cancer treatment may impair nutritional status, alter body composition, and exacerbate cancer-related fatigue (CRF). Phase angle (PhA), a bioelectrical impedance-derived marker of cellular integrity, has emerged as a potential noninvasive indicator associated with functional status, yet its role in pediatric oncology remains underexplored.
Objective:
To investigate longitudinal changes in nutritional status and CRF and to examine the association between PhA and CRF in children/adolescents with cancer during the first 3 months of treatment.
Methods:
Prospective longitudinal study included children/adolescents (0-18 years) newly diagnosed with cancer or central nervous system (CNS) tumors. Participants were assessed at diagnosis-[T0], 1 month-[T1], and 3 months-[T2] after treatment initiation. Data collected included clinical/sociodemographic characteristics, nutritional status (anthropometry/STRONGkids), body composition, and CRF (PedsQLMFS). Repeated measures analyses and linear mixed models were performed, with α = 5%.
Results:
A total of 23 patients (mean age 5.7 years old; 65.2% female) were included. Over time, significant reductions were observed in body mass index (p = 0.044), PhA (p = 0.013), and lean mass (p = 0.037). Self-reported fatigue worsened, particularly in the general fatigue domain (p = 0.043). Correlation analyses demonstrated significant associations between fatigue and body composition indicators, particularly calf circumference (r = 0.809-0.861), body fat mass (r = 0.756-0.844), and PhA (r = 0.521-0.752) in self-reports. In linear mixed-effects models, PhA was independently associated with total fatigue over time (β = 19.97; p = 0.011).
Conclusions:
Children and adolescents undergoing cancer treatment experience early deterioration in nutritional status and body composition, accompanied by worsening CRF. Fatigue was consistently associated with PhA and lean mass-related indicators, suggesting that body composition and cellular integrity may be associated with fatigue severity during treatment. PhA emerged as a particularly promising noninvasive marker, independently associated with fatigue over time. These findings support the incorporation of PhA and comprehensive nutritional assessment beyond conventional weight- and height-based measures to improve the early identification of patients at risk.
