Preoperative body composition and its correlation with postoperative hypoalbuminemia in gastrointestinal tumor patients

Jiang Han; Nai Yongjun; Dai Chun

doi:10.16689/j.cnki.cn11-9349/r.2026.03.011

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (3) : 400-406. DOI: 10.16689/j.cnki.cn11-9349/r.2026.03.011

Original Articles

Preoperative body composition and its correlation with postoperative hypoalbuminemia in gastrointestinal tumor patients

¹Jiang Han, ²Nai Yongjun, ¹Dai Chun

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Abstract

Objective To investigate the correlation of preoperative body composition indicators on postoperative hypoproteinemia in patients with gastrointestinal cancer, so as to provide evidence for the assessment and intervention of nutritional risk during the perioperative period. Method A retrospective analysis was conducted on 245 patients who underwent radical surgery for gastrointestinal malignancies at Nanjing First Hospital between December 2023 and July 2025. Preoperative body composition data were obtained using bioelectrical impedance analysis (BIA). Relevant laboratory indicators were recorded both preoperatively and postoperatively. Factors influencing the occurrence of postoperative hypoproteinemia in patients with gastrointestinal malignancies were identified. The predictive ability of these factors was evaluated using the receiver operating characteristic (ROC) curve, and the stability of the prediction was validated using Bootstrap with 1000 resampling iterations. Result Among the 245 patients who underwent radical gastrointestinal surgery, 183 (75%) developed hypoproteinemia within 48 hours postoperatively. Multivariate logistic regression analysis indicated that the skeletal muscle mass index (SMI) was an independent influencing factor for postoperative hypoproteinemia (P<0.05). The area under the ROC curve (AUC) for SMI in predicting postoperative hypoproteinemia was 0.713 (95%CI=0.635-0.790), with a Bootstrap validation value of 0.712, demonstrating good stability of the predictive indicator. According to the Youden index, the optimal cutoff value of SMI for predicting postoperative hypoproteinemia was 7.4 kg/m² (sensitivity 79.2%, specificity 56.5%). Conclusion SMI measured by BIA has predictive value for postoperative hypoalbuminemia, and an SMI < 7.4 kg/m² may serve as a reference cut-off point for identifying high-risk individuals.

Key words

Body composition analysis / Gastrointestinal tumor / Postoperative hypoproteinemia / Influencing factors / Skeletal muscle mass index / Bioelectrical impedance analysis / Nutritional risk / Perioperative period

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Jiang Han, Nai Yongjun, Dai Chun. Preoperative body composition and its correlation with postoperative hypoalbuminemia in gastrointestinal tumor patients[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(3): 400-406 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.03.011

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