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da Silva Nascimento ML, Alves Bennemann N, de Sousa IM, de Oliveira Bezerra MR, Villaça Chaves G, Moreira Lima Verde SM, Fernandes Maurício S, Barreto Campello Carvalheira J, Santos Mendes MC, Miranda AL, da Costa Pereira JP, Gonzalez MC, Prado CM, Fayh APT. Examining variations in body composition among patients with colorectal cancer according to site and disease stage. Sci Rep 2024; 14:10829. [PMID: 38734789 PMCID: PMC11088614 DOI: 10.1038/s41598-024-61790-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/09/2024] [Indexed: 05/13/2024] Open
Abstract
Patients with colorectal cancer (CRC) often exhibit changes in body composition (BC) which are associated with poorer clinical outcomes. Many studies group colon and rectal cancers together, irrespective of staging, potentially affecting assessment and treatment strategies. Our study aimed to compare BC in patients with CRC focusing on tumor location and metastasis presence. A total of 635 individuals were evaluated, with a mean age of 61.8 ± 12.4 years and 50.2% female. The majority had rectal cancer as the primary cancer site (51.0%), and 23.6% had metastatic disease. The first regression model showed tumor site and metastasis as independent factors influencing skeletal muscle (SM), skeletal muscle index (SMI), and visceral adipose tissue variability (all p values < 0.05). The second model, adjusted for BMI, indicated tumor site as the primary factor affecting SMI variations (adjusted R2 = 0.50 p < 0.001), with colon tumors inversely associated with SM (standardized β - 2.15(- 3.3; - 0.9) p < 0.001). A third model, considering all the confounders from the directed acyclic graphs, was constructed and the found association remained independent. Our findings highlight significant BC variations in patients with CRC, influenced by tumor location and metastases presence, underscoring the need for location-specific assessment in CRC management.
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Affiliation(s)
- Mayra Laryssa da Silva Nascimento
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Nithaela Alves Bennemann
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Iasmin Matias de Sousa
- Health Sciences Center, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, No 3000, Natal, RN, 59078-970, Brazil
| | - Mara Rubia de Oliveira Bezerra
- Health Sciences Center, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, No 3000, Natal, RN, 59078-970, Brazil
| | | | | | | | - José Barreto Campello Carvalheira
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Maria Carolina Santos Mendes
- Division of Oncology, Department of Anesthesiology, Oncology and Radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ana Lucia Miranda
- Health Sciences Center, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, No 3000, Natal, RN, 59078-970, Brazil
- Liga Norteriograndense Contra o Câncer, Natal, Rio Grande do Norte, Brazil
| | | | | | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Ana Paula Trussardi Fayh
- PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, RN, Brazil.
- Health Sciences Center, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, No 3000, Natal, RN, 59078-970, Brazil.
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Kim MC, Kim KO. Reply to "The causal association between sarcopenia and colorectal cancer: a Mendelian randomization analysis". Korean J Intern Med 2023; 38:269-270. [PMID: 36800671 PMCID: PMC9993093 DOI: 10.3904/kjim.2023.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 02/21/2023] Open
Affiliation(s)
- Min Cheol Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Abe S, Nozawa H, Sasaki K, Murono K, Emoto S, Yokoyama Y, Matsuzaki H, Nagai Y, Yoshioka Y, Shinagawa T, Sonoda H, Ishihara S. Sarcopenia is Associated With Oncological Prognosis and the Incidence of Secondary Cancer in Patients With Middle/Lower Rectal Cancer. Clin Colorectal Cancer 2023; 22:143-152. [PMID: 36418196 DOI: 10.1016/j.clcc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study evaluated the clinical implications of sarcopenia for patients with rectal cancer according to cancer progression. SUMMARY BACKGROUND DATA The negative impact of body composition on long-term outcome has been demonstrated for various malignancies. METHODS We retrospectively reviewed 708 patients with rectal cancer who underwent curative resection at our institution between 2003 and 2020. Factors contributing to long-term outcomes and the incidence of secondary cancer (ISC) were analyzed. Psoas muscle mass index (PMI) was assessed using preoperative computed tomography. Sarcopenia was defined using the PMI cut-off values for Asian adults (6.36 cm2/m2 for males and 3.92 cm2/m2 for females). RESULTS Sarcopenia was identified in 306 patients (43.2%). Sarcopenia was associated with advanced age, low body mass index, smoking history, and advanced T-stage. Multivariate analysis showed sarcopenia was an independent poor prognostic factor for OS (HR 1.71; P = .0102) and cancer-specific survival (HR 1.64; P = .0490). Patients with sarcopenia had significantly higher mortality due to cancer-related death in stages III and IV, whereas non-rectal cancer-related death, including secondary cancer, was markedly increased in stage 0-II sarcopenic rectal patients. Five-year cumulative ISC in patients with and without sarcopenia was 11.8% and 5.9%, respectively. Multivariate analysis revealed that sarcopenia was an independent predictive factor for ISC (HR 2.05; P = .0063). CONCLUSIONS Sarcopenia helps predict survival outcomes and cause of death according to cancer stage for patients with middle/lower rectal cancer who underwent radical surgery. Furthermore, sarcopenia increased the development of secondary cancer in those patients.
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Affiliation(s)
- Shinya Abe
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Koji Murono
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuichiro Yokoyama
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Matsuzaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuzo Nagai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuichiro Yoshioka
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahide Shinagawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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4
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Basto DL, de Souza Vieira G, Andrade-Losso RM, Almeida PN, Riccardi VM, Rozza-de-Menezes RE, Cunha KS. Head circumference and anthropometric changes and their relation to plexiform and skin neurofibromas in sporadic and familial neurofibromatosis 1 Brazilian adults: a cross-sectional study. Orphanet J Rare Dis 2022; 17:341. [PMID: 36064430 PMCID: PMC9446792 DOI: 10.1186/s13023-022-02482-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a common autosomal dominant syndrome with complete penetrance and highly variable expressivity. The cutaneous neurofibroma (Cnf) and plexiform neurofibroma (Pnf), café-au-lait spots, and freckle-like lesions are common in NF1, but many other manifestations can occur. We aimed to evaluate head circumference, height, weight, body mass index (BMI), head circumference-to-height ratio (HCHR) and waist–hip ratio (WHR) in adult NF1 Brazilian individuals versus a paired control group and investigate their correlation with the presence of clinically visible Pnfs, and number of “skin neurofibromas” (Snf), which include both cutaneous and subcutaneous neurofibromas. Methods A case–control study was conducted with 168 individuals, 84 with NF1 and 84 without NF1, paired by sex and age. Head circumference and anthropometric measurements, Snf quantification, evaluation of clinically visible Pnf and familial inheritance were accessed. Results Prevalence of macrocephaly was significantly higher in NF1 women. Height and weight were significantly lower in both males and females with NF1. HCHR was higher in the NF1 group than in the control group for both sexes. BMI was significantly lower in men with NF1. Waist and hip circumferences were significantly reduced in NF compared with the controls, but the mean WHR was significantly lower only in NF1 women. No correlation was found between the Snf and head circumference and anthropometric measurements, sex or family history. The presence and larger size of clinically visible plexiform neurofibromas were associated with normal stature (p = 0.037 and p = 0.003, respectively). Conclusions NF1 individuals have increased prevalence of macrocephaly, short stature, low BMI, and reduced abdominal fat. There is no relation between head circumference and anthropometric data with family history, or neurofibromas.
Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02482-8.
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Affiliation(s)
- Diogo Lisbôa Basto
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Raquel M Andrade-Losso
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | - Paula Nascimento Almeida
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil.,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Cunha
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. .,Neurofibromatosis National Center, Rio de Janeiro, RJ, Brazil. .,Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês Do Paraná, 303, 4oandar, sala 01. Centro, Niterói, RJ, 24033-900, Brazil.
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Clinical Relevance of Myopenia and Myosteatosis in Colorectal Cancer. J Clin Med 2022; 11:jcm11092617. [PMID: 35566740 PMCID: PMC9100218 DOI: 10.3390/jcm11092617] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/01/2023] Open
Abstract
Sarcopenia was initially described as a decrease in muscle mass associated with aging and subsequently also as a consequence of underlying disease, including advanced malignancy. Accumulating evidence shows that sarcopenia has clinically significant effects in patients with malignancy, including an increased risk of adverse events associated with medical treatment, postoperative complications, and a poor survival outcome. Colorectal cancer (CRC) is one of the most common cancers worldwide, and several lines of evidence suggest that preoperative sarcopenia negatively impacts various outcomes in patients with CRC. In this review, we summarize the current evidence in this field and the clinical relevance of sarcopenia in patients with CRC from three standpoints, namely, the adverse effects of medical treatment, postoperative infectious complications, and oncological outcomes.
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6
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Monaco-Ferreira DV, Magro DO, Coy CSR. Evaluation of different tools for body composition assessment in colorectal cancer - a systematic review. ARQUIVOS DE GASTROENTEROLOGIA 2022; 59:296-303. [PMID: 35830044 DOI: 10.1590/s0004-2803.202202000-52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The nutritional status of patients with colorectal cancer (CRC) impacts on treatment response and morbidity. An effective evaluation of the body composition includes the measurements of fat and visceral fat-free mass and is currently being used in the diagnosis of the nutritional status. The better understanding regarding nutritional tools for body composition evaluation in CRC patients may impact on the outcome. METHODS Systematic review conducted according to Preferred Items of Reports for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed using the BVS (LILACS), PubMed, Embase, Cochrane, Scopus, and Web of Science databases. RESULTS For the initial search, 97 studies were selected and 51 duplicate manuscripts were excluded. Thus, 46 were reviewed and seven studies included with a total of 4,549 patients. Among them were one clinical trial, one prospective study (cohort), two retrospective cohort and two cross-sectional studies. All studies included body composition evaluated by computed tomography, one with bioelectrical impedance, one with handgrip strength, and two employed mid-arm muscle circumference and body mass index. CONCLUSION Current evidence suggests that computed tomography has better accuracy in the diagnosis of sarcopenia, visceral fat, and myopenia among individuals with CRC. Further studies are needed to identify cutoff points for these changes aggravated by CRC.
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7
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Kim MC, Kim KO, Kang MK. Prevalence and associated risk of advanced colorectal neoplasia in adults with sarcopenia. Korean J Intern Med 2022; 37:294-303. [PMID: 34905817 PMCID: PMC8925942 DOI: 10.3904/kjim.2020.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/01/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND/AIMS Although several studies have shown that sarcopenia is associated with poor outcomes in colorectal cancer patients, the impact of sarcopenia on the development of colorectal neoplasia remains unclear. We aimed to evaluate the prevalence and association of colorectal neoplasia, especially advanced colorectal neoplasia, in adults with sarcopenia. METHODS We retrospectively analyzed the data for 10,676 adults who underwent firsttime colonoscopy and bioelectrical impedance analysis (BIA) on the same day in a health screening program at a single center. Sarcopenia was diagnosed using established BIA-based criteria as adjusted appendicular skeletal muscle mass (ASM) divided by body mass index (BMI) (ASM/BMI), height (ASM/height2), or weight (ASM/weight). Prevalence of overall and advanced colorectal neoplasia and their association with sarcopenia, as established by the aforementioned diagnostic criteria, were evaluated. RESULTS Among 10,676 subjects, 583 were diagnosed with sarcopenia using ASM/ BMI. Subjects with sarcopenia had a higher prevalence of colorectal neoplasia than those without. In the multivariate analysis after adjusting for confounding factors, sarcopenia was an independent risk factor for any colorectal neoplasia (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.09 to 1.56) and advanced colorectal neoplasia (OR, 1.97; 95% CI, 1.27 to 3.06). The association between sarcopenia and advanced colorectal neoplasia remained significant for all sarcopenia measures including ASM/height2 (OR, 2.19; 95% CI, 1.24 to 3.85) and ASM/weight (OR, 2.41; 95% CI, 1.54 to 3.77). CONCLUSION Prevalence of overall and advanced colorectal neoplasia was higher in subjects with sarcopenia than in those without. Sarcopenia was a significant risk factor for colorectal neoplasia, especially for advanced colorectal neoplasia.
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Affiliation(s)
- Min Cheol Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Kyeong Ok Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Min Kyu Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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8
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Does sarcopenia affect outcomes in pediatric surgical patients? A scoping review. J Pediatr Surg 2021; 56:2099-2106. [PMID: 33500162 DOI: 10.1016/j.jpedsurg.2021.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/06/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Adults with sarcopenia have a greater risk of postoperative complications, a higher rate of ICU admission, and an increased length of hospital stay. Few studies have explored the prevalence or importance of sarcopenia in the pediatric population. This study reviews the published literature on sarcopenia in the pediatric population, including pediatric surgery. METHODS Original studies related to sarcopenia in children were identified using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and the PubMed database. RESULTS A total of 390 articles were screened, with 28 meeting inclusion criteria. Twenty (71%) studies provided a means to define abnormal and 18 studies (64%) showed that a specific disease process could impact lean muscle mass in children. Only 4 (14%) studies associated the change in muscle mass with an outcome. Two studies investigated sarcopenia and outcomes in the pediatric surgical patient and demonstrated associations with worse outcomes. CONCLUSION Despite studies showing an association between sarcopenia and negative outcomes in the adult surgical population, there remains a paucity of evidence regarding the impact of sarcopenia on the pediatric population. Future studies are needed to ascertain the relationship between muscle mass and outcomes in pediatric surgical patients.
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Zhang S, Zhang J, Kim Y, Zhang W. Prevalence of Colorectal Polyps Based on Cardiorespiratory Fitness, Muscle Strength, Health Behavior, and Abdominal Obesity in Asymptomatic Elderly. Healthcare (Basel) 2021; 9:1400. [PMID: 34683079 PMCID: PMC8535689 DOI: 10.3390/healthcare9101400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/14/2021] [Accepted: 10/17/2021] [Indexed: 01/06/2023] Open
Abstract
Colorectal polyps are precursor lesions of colorectal cancer and are known to be associated with obesity, low physical activity, and unhealthy behavior. This cross-sectional study analyzed the prevalence of colorectal polyps based on cardiorespiratory fitness (CRF), muscle strength, and health behavior in older adults. Participants were asymptomatic and included 1024 men and 472 women aged 65-80 years who visited the health care center. Colonoscopy was performed under conscious sedation, and cardiorespiratory fitness was measured as the maximum oxygen uptake using gas analysis. Muscle strength was determined using isokinetic equipment, and physical activity, alcohol consumption, and smoking status were investigated using questionnaires. Waist circumference was measured at the thickest part of the middle of the abdomen. Logistic regression analysis was used to calculate the prevalence of colorectal polyps using odds ratios (ORs) based on the variables. The incidence of colorectal polyps was 65.2% in men and 48.5% in women. The ORs of colorectal polyps for obesity were 1.151 (95% confidence interval [CI], 1.010-2.291) and 1.178 (95% CI, 1.015-2.612) in men and women, respectively. The OR for colorectal polyps in male current smokers was 1.884. The ORs for low CRF were 1.985 and 1.841 in men and women, respectively, compared with high CRF. The prevalence of polyps increased with low muscle strength (men's OR 1.343 women's OR 1.440) and physical activity in both men (OR 1.693) and women (OR 1.861). In conclusion, lower CRF and muscle strength were associated with an increased prevalence of colorectal polyps in men and women. In both sexes, high waist circumference and low physical activity increased the prevalence of colorectal polyps.
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Affiliation(s)
- Shiyu Zhang
- School of Physical Education in Main Campus, Zhengzhou University, Zhengzhou 450001, China; (S.Z.); (J.Z.)
| | - Junyong Zhang
- School of Physical Education in Main Campus, Zhengzhou University, Zhengzhou 450001, China; (S.Z.); (J.Z.)
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Korea;
| | - Wangyang Zhang
- School of Physical Education in Main Campus, Postdoctoral Mobile Station of Public Administration, Zhengzhou University, Zhengzhou 450001, China
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Body composition among patients undergoing surgery for colorectal cancer. GASTROENTEROLOGY REVIEW 2021; 16:47-55. [PMID: 33986888 PMCID: PMC8112268 DOI: 10.5114/pg.2021.104736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 04/24/2020] [Indexed: 01/06/2023]
Abstract
Introduction Nutritional status assessment is an important part of preoperative patient evaluation, but the standard anthropometric parameters do not appear to be adequate. Aim To determine the changes in the values of bioelectrical impedance analysis (BIA) parameters in patients 3 months after undergoing surgery for colorectal cancer (CRC). Material and methods BIA and nutritional status assessment parameters were determined in 80 patients prior to undergoing surgery for CRC. The results 3 months after surgery for 64 of those patients were then compared with their initial assessments. Results According to standard WHO ranges, 54% of the patients were diagnosed as being overweight and 29% as obese. The percentage of patients categorized as obese amounted to 56% when this was defined as high fat mass. Moderate sarcopaenia, defined as a low skeletal muscle index (SMI) or low percentage of skeletal muscle mass, was diagnosed in 21% and 29% of patients, respectively. Patients with postoperative weakness that made it impossible for them to attend the control visit had a lower preoperative skeletal muscle mass (p = 0.01) and SMI value (p = 0.001). Parameters of BIA did not discriminate patients with postoperative complications, which occurred in 23% of individuals enrolled. Conclusions A significant proportion of the patients undergoing surgery for CRC were overweight or obese, which could mask the sarcopaenia that presented in 21–29% of them. Sarcopaenia was the only parameter predictive of a postoperative decrease in performance status.
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Kim SH, Jeong JB, Kang J, Ahn DW, Kim JW, Kim BG, Lee KL, Oh S, Yoon SH, Park SJ, Lee DH. Association between sarcopenia level and metabolic syndrome. PLoS One 2021; 16:e0248856. [PMID: 33739984 PMCID: PMC7978348 DOI: 10.1371/journal.pone.0248856] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/06/2021] [Indexed: 12/13/2022] Open
Abstract
Aims Metabolic syndrome (MetS) increases the risk of diabetes mellitus (DM), cardiovascular disease (CVD), cancer, and mortality. Sarcopenia has been reported as a risk factor for MetS, non-alcoholic fatty liver disease, and CVD. To date, the association between sarcopenia and MetS has been investigated. However, there have been few studies on the dose-response relationship between sarcopenia and MetS. We investigated the association between sarcopenia and the prevalence of MetS. We also aimed to analyze the dose-response relationship between skeletal muscle mass and the prevalence of MetS. Methods We enrolled 13,620 participants from October 2014 to December 2019. Skeletal muscle mass was measured using bioelectrical impedance analysis (BIA). Appendicular skeletal muscle mass (ASM) was divided by body weight (kg) and was expressed as a percentage (ASM x 100/Weight, ASM%). The quartiles of ASM% were calculated for each gender, with Q1 and Q4 being the lowest and highest quartiles of ASM%, respectively. The quartiles of ASM% were calculated for each gender, with Q1 and Q4 being the lowest and highest quartiles of ASM%, respectively. Linear regression and logistic regression analyses were used to compare the clinical parameters according to ASM%, adjusted for age, sex, obesity, hypertension (HT), DM, dyslipidemia (DL), smoking, alcohol intake, and C-reactive protein (CRP). Multiple logistic regression analysis was performed to determine the risk of MetS in each group. Results A dose-response relationship was identified between ASM% and MetS. Sarcopenia was associated with an increased prevalence of MetS. After adjustment for age, sex, obesity, HT, DM, DL, smoking, alcohol intake, and CRP, sarcopenia remained significantly associated with MetS. For each 1 quartile increment in ASM%, the risk of MetS decreased by 56% (P< 0.001). After adjusting for age, sex, obesity, HT, DM, DL, smoking, alcohol intake, and CRP, the risk of MetS decreased by 25% per 1Q increment in ASM% (P < 0.001). Conclusions Sarcopenia by BIA is independently associated with the risk of MetS and has a dose-response relationship.
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Affiliation(s)
- Su Hwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Health Care Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ji Bong Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- * E-mail:
| | - Jinwoo Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Dong-Won Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Byeong Gwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Kook Lae Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Joon Park
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Doo Hee Lee
- Department of Research and Development, MEDICALIP Co, Ltd., Seoul, Korea
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12
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Pan X, Liu H, Feng G, Xiao J, Wang M, Liu H, Xie X, Rong Z, Wu J, Liu M. Role of Muscle Mass and Nutritional Assessment Tools in Evaluating the Nutritional Status of Patients With Locally Advanced Nasopharyngeal Carcinoma. Front Nutr 2021; 8:567085. [PMID: 33763439 PMCID: PMC7982395 DOI: 10.3389/fnut.2021.567085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/12/2021] [Indexed: 01/04/2023] Open
Abstract
Objective: This study was to explore the role and necessity of muscle mass [fat-free mass index (FFMI) and appendicular skeletal muscle index (ASMI) measured by bioelectrical impedance analysis (BIA)] in nutritional status evaluation of patients with locally advanced (III, IVa) nasopharyngeal carcinoma (NPC). Methods: One hundred and thirty locally advanced NPC patients were recruited. Their nutritional status was assessed by albumin (ALB), body mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), Patient generated-Subjective Global Assessment (PG-SGA), and muscle mass. Consistency test and McNemar test were used to evaluate the consistency of muscle mass with ALB, BMI, NRS 2002, and PG-SGA, and correlation analysis was performed on muscle mass and PG-SGA or BMI. Results: 61/130 (46.9%) of the patients had nutritional risks according to NRS 2002, 68/130 (53.1%) of the patients had malnutrition according to PG-SGA assessment. FFMI and ASMI could determine the loss of muscle mass that cannot be detected by albumin (30.2 and 65.6%), BMI (28.0 and 35.3%), NRS 2002 (26.1 and 25.0%), and PG-SGA (18.6 and 55.6%). McNemar test showed that the malnutrition results assessed by FFMI and BMI were inconsistent (P <0.001), but further Pearson correlation analysis showed that BMI was positively correlated with FFMI (rs = 0.300, P = 0.001). Conclusion: The commonly used nutritional assessment scale/parameters cannot identify the muscle mass loss in patients with locally advanced NPC. Analysis of human body composition is important for nutritional assessment in patients with locally advanced NPC.
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Affiliation(s)
- Xi Pan
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hong Liu
- Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guo Feng
- Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jie Xiao
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Meng Wang
- Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hua Liu
- Department of Central Sterile Supply, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xueyi Xie
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhipeng Rong
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jinru Wu
- Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Min Liu
- Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China
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13
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Yoo KM, Yang HJ, Park SK, Jung YS, Park JH, Park DI, Sohn CI. Skeletal muscle mass and risk of advanced adenoma in surveillance colonoscopy. J Gastroenterol Hepatol 2020; 35:2088-2095. [PMID: 32350914 DOI: 10.1111/jgh.15082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Sarcopenia has been suggested to be associated with chronic inflammation and insulin resistance. This study aimed to evaluate whether low muscle mass is associated with the incidence and recurrence of advanced colorectal adenoma. METHODS We conducted a cohort study including 14 701 participants who underwent first-time screening colonoscopy between 2003 and 2012 and follow-up colonoscopy until 2017. Skeletal muscle mass was measured using a bioelectrical impedance analyzer and divided by body weight to calculate the skeletal muscle mass index (SMI). RESULTS During a median 47 (interquartile range, 35-58) months of follow-up, overall and advanced adenoma developed in 2988 (20.3%) and 207 (1.41%) participants, respectively. In multivariate analysis using models adjusted for baseline adenoma risk, lifestyle factors, markers for insulin resistance and chronic inflammation, and metabolic syndrome, decreasing SMI quartiles were associated with increased risk of occurrence of advanced adenoma and overall adenoma. The adjusted hazard ratios (95% confidence intervals) comparing SMI quartiles 3, 2, and 1 to quartile 4 were 1.57 (1.03-2.41), 1.22 (0.78-1.92), and 1.77 (1.13-2.76), respectively, for advanced adenoma (P for trend = 0.049) and 1.05 (0.95-1.17), 1.09 (0.98-1.21), and 1.26 (1.13-1.41), respectively, for overall adenoma (P for trend < 0.001). CONCLUSIONS In this large cohort with long-term colonoscopy follow-up, low relative muscle mass was associated with increased risk of occurrence of advanced adenoma and overall adenoma at follow-up colonoscopy, independent of metabolic and inflammatory markers. Timely and thorough surveillance colonoscopy may be emphasized in such populations.
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Affiliation(s)
- Kyung Mo Yoo
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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14
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Ahn DW, Jeong JB, Kang J, Kim SH, Kim JW, Kim BG, Lee KL, Oh S, Yoon SH, Park SJ, Lee DH. Fatty liver is an independent risk factor for gallbladder polyps. World J Gastroenterol 2020; 26:6979-6992. [PMID: 33311944 PMCID: PMC7701938 DOI: 10.3748/wjg.v26.i44.6979] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/28/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gallbladder polyps (GBPs) are known to be associated with obesity and metabolic diseases. However, to date, the relationship between GBPs and abnormal body fat distribution, such as fatty liver, visceral obesity, or sarcopenia, has not yet been established.
AIM To evaluate whether GBPs are associated with fatty liver, visceral obesity, or sarcopenia.
METHODS We retrospectively reviewed the medical records of subjects who underwent various laboratory tests, body composition measurement with a non-invasive body composition analyzer, and abdominal ultrasonography during health checkups. A total of 1405 subjects with GBPs were compared with 2810 age- and sex-matched controls.
RESULTS The mean age of the subjects was 46.8 ± 11.7 years, and 63.8% were male. According to multiple logistic regression analysis, the presence of fatty liver [odds ratio (OR) 1.413; 95% confidence interval (CI) 1.218-1.638; P < 0.001] was an independent risk factor for GBP, together with low levels of alanine aminotransferase (OR 0.993; 95%CI 0.989-0.996; P < 0.001). Additionally, fatty liver showed both independent (OR 1.629; 95%CI, 1.335-1.988; P < 0.001) and dose-dependent (moderate to severe fatty liver; OR 2.137; 95%CI, 1.662-2.749; P < 0.001) relationship with large GBPs (≥ 5 mm). The presence of sarcopenia and high visceral fat area were not significantly associated with GBPs.
CONCLUSION Fatty liver was found to be closely associated with GBPs irrespective of sarcopenia and visceral obesity.
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Affiliation(s)
- Dong-Won Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Ji Bong Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Jinwoo Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Su Hwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Byeong Gwan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Kook Lae Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Sohee Oh
- Department of Biostatistics, Medical Research Collaborating Center, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, South Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, South Korea
| | - Sang Joon Park
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 03080, South Korea
| | - Doo Hee Lee
- Department of Research and Development, MEDICALIP Co. Ltd., Seoul 03127, South Korea
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15
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Lee HJ, Lee JY, Lee MJ, Kim HK, Kim N, Kim GU, Lee JS, Park HW, Chang HS, Yang DH, Choe J, Byeon JS. Association of low skeletal muscle mass with the presence of advanced colorectal neoplasm: integrative analysis using three skeletal muscle mass indices. Colorectal Dis 2020; 22:1293-1303. [PMID: 32363686 DOI: 10.1111/codi.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/14/2020] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to evaluate an association between colorectal neoplasm (CRN) and skeletal muscle mass using three widely accepted skeletal muscle mass indices (SMIs) in a large population at average risk. METHOD We performed a cross-sectional study using a screening colonoscopy database of 33 958 asymptomatic subjects aged 40-75 years. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analyser. ASM adjusted for height squared (ASM/ht2 ), weight (ASM/wt) and body mass index (ASM/BMI) were used as indices for muscle mass. Logistic regression models were used to evaluate the association between SMIs and CRN. RESULTS In a multivariable-adjusted model, the risk of an advanced CRN increased linearly with decreasing quartiles for all three SMIs. The adjusted odds ratios (ORs) for advanced CRN in quartiles 1, 2 and 3 of ASM/wt compared with that in quartile 4 were 1.279, 1.196 and 1.179, respectively (Ptrend = 0.017); for ASM/BMI, ORs were 1.307, 1.144 and 1.091, respectively (Ptrend = 0.002); and for ASM/ht2 , ORs were 1.342, 1.169 and 1.062, respectively (Ptrend = 0.002). The risk of distally located advanced CRN was higher in quartile 1 than in quartile 4 for all three SMIs (ASM/wt, OR = 1.356; ASM/BMI, OR = 1.383; ASM/ht2 , OR = 1.430). CONCLUSION Our study demonstrated that low skeletal muscle mass was consistently associated with the presence of advanced CRN in a population at average risk regardless of the operational definition of the SMI, and it was particularly associated with distal advanced CRN.
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Affiliation(s)
- H J Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Y Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - M J Lee
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-K Kim
- Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - N Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G-U Kim
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Lee
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H W Park
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - H-S Chang
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - D-H Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Choe
- Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-S Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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16
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Goto S, Arimoto J, Higurashi T, Takahashi K, Ohkubo N, Kawamura N, Tamura T, Tomonari H, Iwasaki A, Taniguchi L, Chiba H, Atsukawa K, Saigusa Y, Nakajima A. Efficacy and safety of colorectal endoscopic submucosal dissection in patients with sarcopenia. Surg Endosc 2020; 35:5489-5496. [PMID: 32989535 DOI: 10.1007/s00464-020-08041-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) for early-stage colorectal cancer (CRC) has become a common and useful treatment. Although sarcopenia has been identified as an independent risk factor for complications after surgery for CRC, whether sarcopenia is also an independent risk factor for complications after colorectal ESD remains to be clarified. The aim of this study was to compare the outcomes of colorectal ESD in patients with and those without sarcopenia. METHODS This is a retrospective cohort study. A total of 334 patients underwent colorectal ESD for 361 neoplasms at Hiratsuka City Hospital from March 2012 to October 2018. The neoplasms were divided into two groups depending on the presence or absence of sarcopenia in the patients. RESULTS Overall, 334 patients underwent colorectal ESD for 361 neoplasms during the study period. We excluded 90 patients (90 neoplasms), and 244 patients (277 neoplasms) were included in the final analysis (134 from the sarcopenia group, 137 from the non-sarcopenia group). The en-bloc resection rate was high and was not significantly different between the sarcopenia group [126/134 (94.1%)] and the non-sarcopenia group [133/137 (97.1%)], P = 0.1778). The rate of perforation and the rate of delayed bleeding were not significantly different between the sarcopenia group and the non-sarcopenia group [6/134 (4.5%) vs. 9/137 (6.6%), P = 0.314, 4/134 (3%) vs. 6/137 (4.4%), P = 0.3885, respectively]. CONCLUSIONS The presence of sarcopenia did not influence the rate of complications after ESD. Colorectal ESD is safe and effective even in patients with sarcopenia. Prospective multicenter studies are necessary to confirm our results.
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Affiliation(s)
- Shungo Goto
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Jun Arimoto
- Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kota Takahashi
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Naoki Ohkubo
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Nobuyoshi Kawamura
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Tetsuya Tamura
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Hisakuni Tomonari
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Akito Iwasaki
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Leo Taniguchi
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Hideyuki Chiba
- Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
| | - Kazuhiro Atsukawa
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
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17
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Yee ML, Hau R, Taylor A, Guerra M, Guerra P, Darzins P, Gilfillan C. Sarcopenia in women with hip fracture: A comparison of hormonal biomarkers and their relationship to skeletal muscle mass and function. Osteoporos Sarcopenia 2020; 6:139-145. [PMID: 33102808 PMCID: PMC7573494 DOI: 10.1016/j.afos.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/13/2020] [Accepted: 06/21/2020] [Indexed: 12/22/2022] Open
Abstract
Objectives Sarcopenia is a decline in skeletal muscle mass and function. It is associated with adverse outcomes and increased mortality. Sarcopenia is also reported to be prevalent in the hip fracture population. Our aims in this study are to compare the hormonal profile in women with hip fracture to controls, and to assess the relationship between hormonal biomarkers to skeletal muscle mass and function in these women. Methods A cross sectional study was performed enrolling women above age 60 years old with hip fracture as a study group. For comparison healthy women from the community were recruited. Peripheral blood samples were obtained for analysis of hormonal profiles. Measures of skeletal muscle mass and function by muscle area on computed tomography, dual energy X-ray absorptiometry, bioelectrical impedance analysis, and grip strength was performed. Results A high proportion of sarcopenic individuals were detected in the hip fracture group (60%). Women with hip fracture compared to controls were older (P = 0.073), had lower serum albumin levels (P < 0.001), serum insulin-like growth factor-1 (IGF-1) (P < 0.001), insulin-like growth factor binding protein -3 (IGFBP-3) (P < 0.001), free testosterone levels (P = 0.001), and impaired beta cell function by homeostasis model assessment (HOMA beta) (P = 0.038). Conclusions There is a high proportion of sarcopenic individuals in the hip fracture group. Lowered serum levels of IGF-1 and IGFBP-3, HOMA beta cell function, and free testosterone levels were detected in this group and may serve as potential biomarkers of sarcopenia.
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Affiliation(s)
- Ming Li Yee
- Eastern Health Clinical School, Monash University, Victoria, Australia.,Department of Endocrinology, Eastern Health, Victoria, Australia
| | - Raphael Hau
- Eastern Health Clinical School, Monash University, Victoria, Australia.,Department of Orthopaedic Surgery, Eastern Health, Victoria, Australia
| | - Alison Taylor
- Department of Orthopaedic Surgery, Eastern Health, Victoria, Australia
| | - Mark Guerra
- Department of Physiotherapy, Eastern Health, Victoria, Australia
| | - Peter Guerra
- Department of Physiotherapy, Eastern Health, Victoria, Australia
| | - Peteris Darzins
- Eastern Health Clinical School, Monash University, Victoria, Australia
| | - Christopher Gilfillan
- Eastern Health Clinical School, Monash University, Victoria, Australia.,Department of Endocrinology, Eastern Health, Victoria, Australia
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18
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Prognostic value of sarcopenia in patients with colorectal liver metastases undergoing hepatic resection. Sci Rep 2020; 10:6459. [PMID: 32296122 PMCID: PMC7160152 DOI: 10.1038/s41598-020-63644-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
The prognostic significance of sarcopenia has been widely studied in different cancer patients. This study aimed to analyze the influence of sarcopenia on long-term survival in patients with colorectal liver metastasis (CRLM) undergoing hepatic resection. A retrospective analysis of 182 patients undergoing hepatic resection for CRLM was performed. Sarcopenia was determinedusing the Hounsfield unit average calculation (HUAC), a measure of muscle quality-muscledensity at preoperative abdominal computed tomography scans. Sarcopenia was defined as an HUAC score of less than 22 HU calculated using receiver operating characteristic analysis. The prognostic relevance of clinical variables and overall survival (OS) and recurrence-free survival (RFS) was evaluated. Patients with sarcopenia were older (p < 0.001) and had higher prevalence of diabetics (p = 0.004), higher body mass index (BMI) (p < 0.001) and neutrophil-to-lymphocyte ratio (p = 0.026) compared to those without. Sarcopenia was not significantly associated with OS and RFS. Multivariate Cox’s regression analysis showed that multinodularity (>3) (hazard ratio (HR) 2.736; 95% confidence interval (CI), 1.631–4.589; p < 0.001), high CEA level (≥20 ng/ml) (HR 1.793; 95% CI, 1.092–2.945; p = 0.021) and blood loss (≥300 cc) (HR1.793; 95% CI, 1.084–2.964; p = 0.023) were independent factors associated with OS. In subgroup analyses, sarcopenia was a significant factor of poor OS in the patients with multinodularity by univariate (p = 0.002) and multivariate analyses(HR 3.571; 95% CI, 1.508–8.403; p = 0.004). Multinodularity (>3) (HR 1.750; 95% CI, 1.066–2.872; p = 0.027), high aspartate aminotransferase level (HR 1.024; 95% CI, 1.003–1.046; p = 0.025) and male gender (HR 1.688; 95% CI, 1.036–2.748; p = 0.035) were independent factors of RFS. In conclusion, despite no significance in whole cohort, sarcopenia was predictive of worse OS in patients with multiple CRLM after partial hepatectomy.
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19
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Vergara-Fernandez O, Trejo-Avila M, Salgado-Nesme N. Sarcopenia in patients with colorectal cancer: A comprehensive review. World J Clin Cases 2020; 8:1188-1202. [PMID: 32337193 PMCID: PMC7176615 DOI: 10.12998/wjcc.v8.i7.1188] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 02/05/2023] Open
Abstract
Colorectal cancer (CRC) is the third most commonly diagnosed cancer globally and the second cancer in terms of mortality. The prevalence of sarcopenia in patients with CRC ranges between 12%-60%. Sarcopenia comes from the Greek "sarx" for flesh, and "penia" for loss. Sarcopenia is considered a phenomenon of the aging process and precedes the onset of frailty (primary sarcopenia), but sarcopenia may also result from pathogenic mechanisms and that disorder is termed secondary sarcopenia. Sarcopenia diagnosis is confirmed by the presence of low muscle quantity or quality. Three parameters need to be measured: muscle strength, muscle quantity and physical performance. The standard method to evaluate muscle mass is by analyzing the tomographic total cross-sectional area of all muscle groups at the level of lumbar 3rd vertebra. Sarcopenia may negatively impact on the postoperative outcomes of patients with colorectal cancer undergoing surgical resection. It has been described an association between sarcopenia and numerous poor short-term CRC outcomes like increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care and physical disability. Sarcopenia may also negatively impact on overall survival, disease-free survival, recurrence-free survival, and cancer-specific survival in patients with non-metastatic and metastatic colorectal cancer. Furthermore, patients with sarcopenia seem prone to toxic effects during chemotherapy, requiring dose deescalations or treatment delays, which seems to reduce treatment efficacy. A multimodal approach including nutritional support (dietary intake, high energy, high protein, and omega-3 fatty acids), exercise programs and anabolic-orexigenic agents (ghrelin, anamorelin), could contribute to muscle mass preservation. Addition of sarcopenia screening to the established clinical-pathological scores for patients undergoing oncological treatment (chemotherapy, radiotherapy or surgery) seems to be the next step for the best of care of CRC patients.
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Affiliation(s)
- Omar Vergara-Fernandez
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
| | - Mario Trejo-Avila
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
| | - Noel Salgado-Nesme
- Department of Colorectal Surgery, Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubirán”, Mexico 14080, Mexico
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20
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Moon JH, Kim YJ, Oh YH, Kong MH, Kim HJ. Association between Colorectal Adenoma and Hand Grip Strength in the Elderly. J Bone Metab 2019; 26:161-167. [PMID: 31555613 PMCID: PMC6746666 DOI: 10.11005/jbm.2019.26.3.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/17/2019] [Accepted: 07/29/2019] [Indexed: 12/16/2022] Open
Abstract
Background Obesity is known as an important risk factor for colorectal adenoma. However, for the elderly with changes in body composition, reduced muscle, and increased fat, the body mass index (BMI), one of the most commonly used indicators of obesity, is limited in predicting a link to colorectal cancer. This study aimed to investigate the relationship between colorectal adenoma and grip strength that can predict muscle reduction in the elderly. Methods This study included 262 participants aged ≥65 years who underwent medical examination between June 2015 and August 2018. The control group comprised participants with normal findings or hyperplasia and other benign lesions, except adenoma on colonoscopy, whereas the adenoma group consisted of participants with more than one adenoma. Grip strength was alternately measured twice for each hand using a hydraulic dynamometer. Results The grip strength was statistically lower in the adenoma group than in the control group among women (P=0.042). For both sexes, grip strength was significantly lower in participants with ≥5 adenomas than in those with <5 adenomas (P=0.021, P=0.007). Similarly, men with large adenomas (≥7 mm) exhibited significantly lower grip strength than did those with small adenomas (<7 mm) (P=0.004). Even after correction for age, BMI, smoking status, alcohol consumption, exercise, insulin resistance, hypertension, and diabetes, the negative correlation between grip strength and number of adenomas among men and women remained (P=0.034, P=0.019). Conclusions A significant relationship between hand grip strength and number of colorectal adenomas was noted.
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Affiliation(s)
- Ji Hyun Moon
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea.,Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Ye Ji Kim
- Jeju National University School of Medicine, Jeju, Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
| | - Mi Hee Kong
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea.,Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea.,Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
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21
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Circadian rhythm disruption is associated with an increased risk of sarcopenia: a nationwide population-based study in Korea. Sci Rep 2019; 9:12015. [PMID: 31427694 PMCID: PMC6700184 DOI: 10.1038/s41598-019-48161-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/29/2019] [Indexed: 12/22/2022] Open
Abstract
Reduced sleep quality is associated with an increased risk of sarcopenia. However, the potential effects of disturbing the regular circadian rhythm, as occurs with shift work, on the risk of sarcopenia have not been established. Data from 9105 workers from the 2008–2011 Korean National Health and Nutrition Examination Survey were analyzed. Sarcopenia, measured by dual-energy X-ray absorptiometry, was defined as one standard deviation below the mean of the appendicular skeletal muscle/body mass index value of a young reference group. Compared to the group that had never experienced shift work, the odds ratio (OR) for sarcopenia with a 95% confidence interval (95% CI) for the shift work group was 1.7 (1.5–1.9); the association remained even after adjusting for confounding variables, including age, sex, total fat mass, insulin resistance profile, smoking, alcohol intake, diet, and physical activity. The results of the subgroup analysis indicated that the highest risk of sarcopenia was among workers engaging in shift work with an irregular schedule (OR 1.8, 95% CI 1.3–2.4). Disruption of circadian rhythm by shift work was associated with increased risk of sarcopenia. Intervention strategies are needed to prevent sarcopenia in shift workers.
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da Cunha LP, Silveira MN, Mendes MCS, Costa FO, Macedo LT, de Siqueira NS, Carvalheira JBC. Sarcopenia as an independent prognostic factor in patients with metastatic colorectal cancer: A retrospective evaluation. Clin Nutr ESPEN 2019; 32:107-112. [PMID: 31221274 DOI: 10.1016/j.clnesp.2019.04.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/11/2019] [Accepted: 04/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Sarcopenia has been associated with poor prognosis in a number of malignancies. However, whether sarcopenia is associated with colorectal cancer (CRC) prognosis in a metastatic setting remains unclear. The aim of the study presented was to evaluate the impact of sarcopenia on progression-free survival (PFS) and overall survival (OS) in patients with metastatic CRC. METHODS We retrospectively studied 72 patients with stage IV CRC treated at the University of Campinas between 2009 and 2015. Computed tomography images were analyzed to assess body composition. The Kaplan-Meier and multivariate Cox proportional hazards regression were used for survival analysis and to evaluate the influence of sarcopenia on PFS and OS. RESULTS Median PFS for sarcopenic patients (n = 32) was 7.2 months, which was significantly different from non-sarcopenic patients (n = 40), which was 15.2 months (hazard ratio [HR]: 1.78; 95% confidence interval [CI], 1.00-3.14; P = 0.048). Sarcopenia was also a significant predictor of OS. Median OS for sarcopenic patients was 12.5 months versus 36.7 months for non-sarcopenic patients (HR: 1.86; 95% CI, 1.02-3.38; P = 0.043), after adjustment for number of metastatic lesions, metastasectomy, and performance status. CONCLUSIONS Sarcopenia was associated with worse CRC PFS and OS. These findings require prospective trials to validate this association.
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Affiliation(s)
- Lorena Pires da Cunha
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - Marina Nogueira Silveira
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - Maria Carolina Santos Mendes
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - Felipe Osório Costa
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - Lígia Traldi Macedo
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - Nádia Sclearuc de Siqueira
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
| | - José Barreto Campello Carvalheira
- Division of Oncology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), MA: 13083-970, Campinas, São Paulo, Brazil.
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23
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Hong JT, Kim TJ, Pyo JH, Kim ER, Hong SN, Kim YH, Ahn HS, Sohn I, Chang DK. Impact of sarcopenia on the risk of advanced colorectal neoplasia. J Gastroenterol Hepatol 2019; 34:162-168. [PMID: 29877584 DOI: 10.1111/jgh.14309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/15/2018] [Accepted: 05/29/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Sarcopenia is a pathological condition characterized by the progressive loss of muscle mass and increased amount of visceral fat. Recent evidence has revealed that sarcopenia is associated with certain diseases. However, the impact of sarcopenia on colorectal neoplasia has not been documented clearly. We studied the association between sarcopenia and advanced colorectal neoplasia in a large screening population. METHODS This cross-sectional study included 14 024 asymptomatic adults who underwent first-time screening colonoscopy. Sarcopenia (class II) was defined as an appendicular skeletal muscle mass (ASM)/bodyweight (%) value more than two standard deviations below the mean for healthy young adults. ASM was estimated using bioelectrical impedance analysis. RESULTS In a multivariable model adjusted for age, sex, obesity (body mass index ≥ 25), smoking status, alcohol intake, regular exercise, and family history of colorectal cancer, the odds ratio (OR) for advanced colorectal neoplasia on comparing participants with sarcopenia (class II) to those without sarcopenia (class I + II) was 1.52 (95% confidence interval [CI], 1.23-1.86). Further adjustment for metabolic parameters attenuated this association, but the association was still significant (OR, 1.34; 95% CI, 1.07-1.68). Furthermore, the multivariable (traditional risk factors)-adjusted OR associated with a 1% decrease on the introduction of ASM/weight% as a continuous variable in regression models was 1.04 (95% CI, 1.01-1.07) for advanced colorectal neoplasia. CONCLUSIONS Our findings indicate that sarcopenia is significantly and progressively associated with the risk of advanced colorectal neoplasia. This association might be explained by metabolic factors that could be potential mediators of the effect of sarcopenia.
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Affiliation(s)
- Ji Taek Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Jun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeung Hui Pyo
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ho Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeon Seon Ahn
- Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Insuk Sohn
- Statistics and Data Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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24
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Gonzalez MC, Barbosa-Silva TG, Heymsfield SB. Bioelectrical impedance analysis in the assessment of sarcopenia. Curr Opin Clin Nutr Metab Care 2018; 21:366-374. [PMID: 29957677 DOI: 10.1097/mco.0000000000000496] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW Bioelectrical impedance analysis (BIA) is an accepted technique to estimate low muscle mass for sarcopenia diagnosis. However, muscularity assessment from BIA relies on prediction equations, estimating different compartments according to the calibration method. Low muscle mass can be defined using different approaches. RECENT FINDINGS There is a lack of standardization on how low muscularity is defined in the context of sarcopenia. Recent studies have shown discrepant results for the estimation of low muscle mass when different prediction equations are used in the same BIA device. Different sarcopenia prevalence rates are observed if different definitions are used to identify low muscle mass. Most of the studies using BIA for diagnosing sarcopenia use the incorrect combination of specific population cut-off or a different device from the original equation. SUMMARY The lack of standardization of BIA use for assessing muscularity results in a wide range of sarcopenia prevalence rates among studies, even when conducted in the same population. As BIA equations and cut-off values are population and device-specific, results should be interpreted with caution when data from different devices are applied in equations or using cut-off values from a different population.
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Affiliation(s)
- M Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Thiago G Barbosa-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
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