Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs

ObjectiveThis study aims to examine the factors contributing to the increase in extracellular water to total body water ratio (ECW/TBW) among tumor patients without visible edema, and to offer insights into the diagnosis and prompt management of early water retention in such patients.MethodsA cohort...

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Main Authors: Heling Zhu, Panpan Gan, Hao Jiang, Liangliang Bao, Chengjiang Liu, Jiawen Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1642980/full
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author Heling Zhu
Panpan Gan
Hao Jiang
Liangliang Bao
Chengjiang Liu
Jiawen Yu
Jiawen Yu
author_facet Heling Zhu
Panpan Gan
Hao Jiang
Liangliang Bao
Chengjiang Liu
Jiawen Yu
Jiawen Yu
author_sort Heling Zhu
collection DOAJ
description ObjectiveThis study aims to examine the factors contributing to the increase in extracellular water to total body water ratio (ECW/TBW) among tumor patients without visible edema, and to offer insights into the diagnosis and prompt management of early water retention in such patients.MethodsA cohort of 274 tumor patients admitted to Anqing First People’s Hospital, affiliated with Anhui Medical University between December 2020 and December 2022, were selected, excluding those with clinically observable edema. General clinical data, main laboratory test outcomes, and body composition indices were gathered. Valuable variables were identified for linear regression analysis using ECW/TBW, based on professional knowledge and univariate analysis results.ResultsAge, gender, hemoglobin, serum sodium, serum potassium, and phase angle (PA) were determined as independent influencing factors for elevated ECW/TBW. ECW/TBW increased with age (partial regression coefficient B = 0.009, p = 0.001), was higher in males than in females (B = −0.349, p < 0.001), and was negatively affected by hemoglobin (Hgb) (B = −0.003, p = 0.039). Serum sodium had a positive influence on ECW/TBW (B = 0.019, p = 0.011), while serum potassium exhibited a negative effect (B = −0.180, p = 0.001). PA was the most influential factor among all independent variables affecting ECW/TBW (B = −1.006, p < 0.001). Nonetheless, Performance Status (PS) score, Patient-Generated Subjective Global Assessment (PG-SGA) score, tumor stage, prealbumin, albumin, and body fat percentage were not identified as independent factors influencing elevated ECW/TBW.ConclusionThe early factors influencing water retention in tumor patients primarily stem from abnormal cell membrane function, but are also impacted by age, gender, anemia, and electrolyte levels. Timely body composition testing can assist in subsequent intervention decision-making.
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spelling doaj-art-c96bf5e4a5d441b9b60d460dd032ded32025-08-20T03:39:09ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16429801642980Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signsHeling Zhu0Panpan Gan1Hao Jiang2Liangliang Bao3Chengjiang Liu4Jiawen Yu5Jiawen Yu6Department of Oncology, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of Oncology, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of Oncology, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of Oncology, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of General Medicine, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of Oncology, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaDepartment of Clinical Nutrition, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaObjectiveThis study aims to examine the factors contributing to the increase in extracellular water to total body water ratio (ECW/TBW) among tumor patients without visible edema, and to offer insights into the diagnosis and prompt management of early water retention in such patients.MethodsA cohort of 274 tumor patients admitted to Anqing First People’s Hospital, affiliated with Anhui Medical University between December 2020 and December 2022, were selected, excluding those with clinically observable edema. General clinical data, main laboratory test outcomes, and body composition indices were gathered. Valuable variables were identified for linear regression analysis using ECW/TBW, based on professional knowledge and univariate analysis results.ResultsAge, gender, hemoglobin, serum sodium, serum potassium, and phase angle (PA) were determined as independent influencing factors for elevated ECW/TBW. ECW/TBW increased with age (partial regression coefficient B = 0.009, p = 0.001), was higher in males than in females (B = −0.349, p < 0.001), and was negatively affected by hemoglobin (Hgb) (B = −0.003, p = 0.039). Serum sodium had a positive influence on ECW/TBW (B = 0.019, p = 0.011), while serum potassium exhibited a negative effect (B = −0.180, p = 0.001). PA was the most influential factor among all independent variables affecting ECW/TBW (B = −1.006, p < 0.001). Nonetheless, Performance Status (PS) score, Patient-Generated Subjective Global Assessment (PG-SGA) score, tumor stage, prealbumin, albumin, and body fat percentage were not identified as independent factors influencing elevated ECW/TBW.ConclusionThe early factors influencing water retention in tumor patients primarily stem from abnormal cell membrane function, but are also impacted by age, gender, anemia, and electrolyte levels. Timely body composition testing can assist in subsequent intervention decision-making.https://www.frontiersin.org/articles/10.3389/fmed.2025.1642980/fullECW/TBWtumorbody compositionphase angleedema
spellingShingle Heling Zhu
Panpan Gan
Hao Jiang
Liangliang Bao
Chengjiang Liu
Jiawen Yu
Jiawen Yu
Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
Frontiers in Medicine
ECW/TBW
tumor
body composition
phase angle
edema
title Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
title_full Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
title_fullStr Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
title_full_unstemmed Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
title_short Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
title_sort analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs
topic ECW/TBW
tumor
body composition
phase angle
edema
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1642980/full
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