Association and Agreement between Nutrition-Focused Physical Examination-Assessed and Bioelectrical Impedance Analysis-Derived Muscle and Fat Status in Patients with Breast Cancer
Main Article Content
Abstract
Background: Breast cancer, one of the most common cancers among women in Malaysia, may contribute to the development of sarcopenia through chronic inflammation, which activates muscle protein degradation pathways. Nutrition-focused physical examination (NFPE) has gained increasing attention in clinical settings for body composition assessment, as it enables bedside evaluation without dependence on bioelectrical impedance analysis (BIA), which may be affected by hydration status and limited device availability. This study aimed to assess the association and agreement between NFPE-assessed and BIA-derived muscle and fat status in patients with breast cancer.
Methods: This cross-sectional study included 74 women. NFPE evaluated upper- and lower-body muscle mass and subcutaneous fat stores using inspection and palpation techniques. Body composition was measured using BIA, with participants lying in the supine position as a low-level electrical current was applied. Associations and agreement between muscle and fat status assessed by NFPE and BIA were evaluated using McNemar’s test and Cohen’s kappa analysis, respectively. Statistical significance was set at P < 0.05.
Results: NFPE-assessed muscle and fat status were significantly associated with BIA-derived appendicular skeletal muscle index and total body fat, respectively (both P < 0.001). Agreement between the two methods was slight by kappa interpretation, with unweighted Cohen’s kappa coefficients of 0.033 for muscle status and 0.011 for fat status.
Conclusion: Although agreement between the two methods was limited, NFPE remains clinically relevant as an accessible and cost-effective first-line screening approach, especially in settings with limited access to BIA.
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