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Schofield C, Taaffe D, Newton R, Galvão D, Cohen P, Kim J, Meniawy T, Peddle‐McIntyre C. Assessing Sarcopenia in Advanced-Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Case Series. Cancer Rep (Hoboken) 2024; 7:e2155. [PMID: 39118235 PMCID: PMC11310097 DOI: 10.1002/cnr2.2155] [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: 03/13/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVES In ovarian and other cancers, low muscle mass and density are associated with poorer clinical outcomes. However, screening for cancer-related sarcopenia (typically defined as low muscle mass) is not routinely conducted. The European Working Group on Sarcopenia in Older People (EWGSOP) recommends an algorithm for sarcopenia screening and diagnosis in clinical settings, with sarcopenia based on muscle strength and mass, and severity on physical performance. We explored the application of the EWGSOP2 algorithm to assess sarcopenia in six ovarian cancer patients receiving neoadjuvant chemotherapy. METHODS We assessed sarcopenia risk with the SARC-F screening questionnaire (at risk ≥4 points), muscle strength with a handgrip strength test (cut point <16 kg) and five times sit-to-stand test (cut point >15 s), muscle mass by skeletal muscle index (SMI in cm2/m2 from a single computed tomography [CT] image; cut point <38.5 cm2/m2), and physical performance with a 4-m gait speed test (cut point ≤0.8 m/s). RESULTS Of six participants, none were identified as "at risk" for sarcopenia based on SARC-F scores. Two participants were severely sarcopenic based on EWGSOP2 criteria (had low muscle strength, mass, and physical performance), and five participants were sarcopenic based on muscle mass only. DISCUSSION Ovarian cancer patients with low muscle mass during neoadjuvant chemotherapy may not be identified as sarcopenic based on the EWGSOP2 diagnostic algorithm. While lacking a universally accepted definition for cancer-related sarcopenia and cancer-specific recommendations for the screening, diagnosis, and treatment of sarcopenia, ovarian cancer clinicians should focus on the diagnosis and treatment of low muscle mass and density.
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Affiliation(s)
- Christelle Schofield
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Dennis R. Taaffe
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Robert U. Newton
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Daniel A. Galvão
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Paul A. Cohen
- School of MedicineUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- St John of God HospitalSubiacoWestern AustraliaAustralia
| | - Jin‐Soo Kim
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Tarek Meniawy
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of MedicineUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- St John of God HospitalSubiacoWestern AustraliaAustralia
- Sir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Carolyn Peddle‐McIntyre
- Exercise Medicine Research InstituteEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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Soares JDP, Siqueira JM, Brito FDSB, Pimentel GD. A Randomized Controlled Trial on the Effects of Leucine-Supplement Combined with Nutritional Counseling on Body Composition in Mix Cancer Older Men. Nutrients 2024; 16:210. [PMID: 38257103 PMCID: PMC10818878 DOI: 10.3390/nu16020210] [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: 11/06/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Malnutrition and metabolic alterations of cancer cachexia are often associated with negative weight loss and muscle mass wasting. In this sense, protein supplementation can be a strategy to help counteract the loss and/or maintenance of mass in these patients. The aim of this study was to evaluate the effect of leucine supplementation on body composition in outpatients with gastrointestinal tract cancer. METHODS It was a randomized, blinded, controlled, parallel trial, performed in male patients with a cancer diagnosis of the gastrointestinal tract and appendix organs undergoing chemotherapy. All the patients were allocated to one of the protocol groups: L-leucine supplement or the control group, during 8 weeks of intervention. We evaluated the body composition through bioelectrical impedance analysis, the cancer cachexia classification, and the diet intake before and after the intervention protocol. The intention-to-treat approach was performed to predict the missing values for all patients who provide any observation data. RESULTS The patients were an average age of 65.11 ± 7.50 years old. In the body composition analysis with patients who finished all the supplementation, we observed a significant gain in body weight (61.79.9 ± 9.02 versus 64.06 ± 9.45, p = 0.01), ASMM (7.64 ± 1.24 versus 7.81 ± 1.20, p = 0.02) in the Leucine group, whereas patients in the control did not present significant variation in these parameters. There was no significant intergroup difference. While in the analysis included the patients with intention-to-treat, we found a significant increase in body weight (p = 0.01), BMI (p = 0.01), FFM (p = 0.03), and ASMM (p = 0.01) in the Leucine group. No significant intergroup differences. These results also similar among cachectic patients. CONCLUSION A balanced diet enriched with free-Leucine supplementation was able to promotes gains in body weight and lean mass in older men diagnosticated with gastrointestinal and appendix organs of digestion cancer after 8 weeks. However, the fact that most men are non-cachectic or pre-cachectic is not clear if the increase in muscle mass was due to a high intake of leucine, since no difference between groups was detected. Moreover, we know that benefits on body composition are due to adequate calorie and macronutrients consumption and that balanced feeding according to nutrition Guidelines seems crucial and must be advised during the oncological treatment.
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Affiliation(s)
- Jéssika D. P. Soares
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
| | - Jéssika M. Siqueira
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
| | - Flávia dos S. B. Brito
- Institute of Nutrition, Estadual University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil;
| | - Gustavo D. Pimentel
- Faculty of Nutrition, Federal University of Goias, Goiania 74605-080, Brazil; (J.D.P.S.)
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Yajima S, Fukushima H, Oda S, Yasujima R, Hirose K, Okubo N, Umino Y, Kataoka M, Nakanishi Y, Koga F, Masuda H. The significance of SARC-F scores in predicting postoperative outcomes of older adults undergoing elective major surgery for urologic cancer. Clin Nutr 2023; 42:1537-1544. [PMID: 37478808 DOI: 10.1016/j.clnu.2023.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND & AIMS Recently, the strength, assistance with walking, rise from a chair, climb stairs, and falls (SARC-F) questionnaire has been developed to screen patients with signs of sarcopenia. However, its clinical benefit remains uncertain in elderly patients undergoing elective major surgeries. This study aimed to explore the role of the SARC-F questionnaire as a screening tool for patients who plan to undergo elective major surgery for urologic cancer and to also evaluate correlations of SARC-F scores with established indicators of sarcopenia. METHODS This retrospective observational study enrolled 815 patients over 40 years of age undergoing elective major surgery for urologic cancer and who were screened with the SARC-F questionnaire, preoperatively. The primary endpoint was an association between SARC-F scores and postoperative ambulation failure. Here we define postoperative ambulation failure as a condition where a patient is unable to walk independently within 2 days after surgery and required physical rehabilitation or was transferred to other hospitals in a bedridden state. The secondary endpoint was an association between SARC-F scores and overall survival (OS). Psoas muscle density (PMD) and psoas muscle index (PMI) were calculated from abdominal computed tomography images, and their correlations with SARC-F scores grouped by sex. RESULTS Of the 815 patients, 738 (91%) were male and the median age was 72 years. Although SARC-F scores weakly correlated with PMD in males and moderately correlated in females (ρ = -0.222 and ρ = -0.474, respectively), their correlation with PMI was negligible (ρ = -0.179 and ρ = -0.084, respectively). SARC-F scores successfully discriminate postoperative ambulation failure in both males and females with the respective area under the receiver operating characteristic curve of 0.856 and 0.813. Multivariate analysis also showed that SARC-F scores greater than 4 are an independent risk factor of postoperative ambulation failure along with older age, lower PMD, and poor performance status. SARC-F scores greater than 4 were significantly associated with a shorter OS in the whole cohort (P < 0.001) and a subgroup of patients undergoing radical cystectomy (P = 0.03; median follow-up of 515 days). CONCLUSIONS The SARC-F questionnaire might be applicable to identify elderly patients at a higher risk of unfavourable outcomes after major urologic cancer surgery. A randomised controlled trial is necessary to confirm this finding.
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Affiliation(s)
- Shugo Yajima
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Hiroshi Fukushima
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Shioto Oda
- National Cancer Center Hospital East, Department of Radiology, Chiba, Japan
| | - Rikuto Yasujima
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Kohei Hirose
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Naoya Okubo
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Yosuke Umino
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Madoka Kataoka
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Yasukazu Nakanishi
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
| | - Fumitaka Koga
- Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hitoshi Masuda
- National Cancer Center Hospital East, Department of Urology, Chiba, Japan
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Systemic inflammation with sarcopenia predicts survival in patients with gastric cancer. J Cancer Res Clin Oncol 2023; 149:1249-1259. [PMID: 35435489 DOI: 10.1007/s00432-022-03925-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/12/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The levels of platelet-related inflammation indicators and sarcopenia have been reported to affect the survival of patients with cancer. To evaluate the prognostic influence of platelet count (PLT), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII), and SII combined with sarcopenia on the survival of patients with gastric cancer (GC). METHODS A total of 1133 patients with GC (812 male and 321 female, average age: 59.43 years) were evaluated. Receiver-operating characteristic curves were used to determine the best cutoff values of PLT, PLR, and SII, and univariate and multivariate Cox risk regression models were used to evaluate whether SII is an independent predictor of overall survival (OS). The prognostic SS (SII-sarcopenia) was established based on SII and sarcopenia. Finally, a comprehensive analysis of the prognostic SS was performed. RESULTS SII had the strongest prognostic effect. The SII and OS of patients with GC were in an inverted U-shape (adjusted HR = 1.07; 95% CI 0.97-1.19; adjusted P = 0.179). In patients with SII > 1800, SII was negatively correlated with OS (adjusted HR = 0.57; 95% CI 0.29-1.12; adjusted P = 0.102), however, there is no statistical difference. Interestingly, a high SS was associated with a poorer prognosis. The higher the SS score was, the worse the OS (P < 0.001). CONCLUSION SII is an independent prognostic indicator of GC, and high SII is related to poor prognosis. A higher SS score had worse survival. Thus, the prognostic SS is a reliable predictor of OS in patients with GC.
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Verwaaijen EJ, van der Torre P, Vormoor J, Pieters R, Fiocco M, Hartman A, van den Heuvel-Eibrink MM. Novel Adaption of the SARC-F Score to Classify Pediatric Hemato-Oncology Patients with Functional Sarcopenia. Cancers (Basel) 2023; 15:cancers15010320. [PMID: 36612316 PMCID: PMC9818846 DOI: 10.3390/cancers15010320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
Sarcopenia in pediatric hemato-oncology patients is undesirable because of the consequences it may have for treatment continuation and outcome, physical abilities and participation in daily life. An easy-to-use screening tool for sarcopenia will facilitate the identification of children at risk who need interventions to prevent serious physical deterioration. In the elderly, the use of the SARC-F score as a case-finding tool for sarcopenia is recommended. The aim of this cross-sectional study was to investigate the accuracy of the pediatric SARC-F (PED-SARC-F) for identifying sarcopenia in pediatric hemato-oncology patients, including the determination of a cut-off point for clinical use. Patients 3−20 years of age, under active treatment or within 12 months after treatment cessation were eligible. Patients had a physiotherapy assessment including a PED-SARC-F (0−10) and measurements of muscle strength (handheld dynamometry), physical performance (various tests) and/or muscle mass (bio-impedance analysis), as part of the standard of care. Spearman’s correlation coefficient (rs) between the PED-SARC-F and physiotherapy outcomes were calculated. Structural sarcopenia was defined as low appendicular skeletal muscle mass (ASMM) in combination with low muscle strength and/or low physical performance. Functional sarcopenia indicated low muscle strength combined with low physical performance. Multiple logistic regression models were estimated to study the associations between the PED-SARC-F and structural/functional sarcopenia. To evaluate which cut-off point provides the most accurate classification, the area under the receiver operating characteristic curve (AUCs), sensitivity and specificity per point were calculated. In total, 215 assessments were included, 62% were performed in boys and the median age was 12.9 years (interquartile range: 8.5−15.8). The PED-SARC-F scores correlated moderately with the measurements of muscle strength (rs = −0.37 to −0.47, p < 0.001) and physical performance (rs = −0.45 to −0.66, p < 0.001), and weakly with ASMM (rs = −0.27, p < 0.001). The PED-SARC-F had an AUC of 0.90 (95% confidence interval (CI) = 0.84−0.95) for functional sarcopenia and 0.79 (95% CI = 0.68−0.90) for structural sarcopenia. A cut-off point of ≥5 had the highest specificity of 96% and a sensitivity of 74%. In conclusion, we adapted the SARC-F to a pediatric version, confirmed its excellent diagnostic accuracy for identifying functional sarcopenia and defined a clinically useful cut-off point in pediatric hemato-oncology patients.
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Affiliation(s)
- Emma J. Verwaaijen
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Correspondence: ; Tel.: +31-650006739
| | | | - Josef Vormoor
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
- Utrecht Cancer Center, University Medical Center Utrecht, 3584CX Utrecht, The Netherlands
| | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Mathematical Institute, Leiden University, 2333CA Leiden, The Netherlands
- Department of Biomedical Data Science, Section Medical Statistics, Leiden University Medical Center, 2333ZA Leiden, The Netherlands
| | - Annelies Hartman
- Department of Pediatric Physiotherapy, Erasmus Medical Center-Sophia Children’s Hospital, 3015CN Rotterdam, The Netherlands
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Division of Child Health, Wilhelmina Children’s Hospital, 3584EA Utrecht, The Netherlands
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Faria IA, Siqueira JM, Soares JDP, Teixeira BH, Pimentel GD. MSRA has low concordance with skeletal muscle mass index in mixed cancer patients: A preliminary and feasibility study. Clin Nutr ESPEN 2022; 52:245-249. [PMID: 36513460 DOI: 10.1016/j.clnesp.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/04/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Currently, there are no studies evaluating the agreement between the Mini Sarcopenia Risk Assessment (MSRA) questionnaire and skeletal muscle mass index (SMI) in cancer patients. Thus, this study aimed to evaluate the agreement of the MSRA questionnaire with SMI in cancer patients. METHODS Cross-sectional study with 132 unselected cancer patients. The risk of sarcopenia was determined using the MSRA of 5 and 7 questions. Men and women were divided into subgroups with and without risk of sarcopenia, according to MSRA. SMI was assessed by the muscle mass divided by heigh using the Lee's formula. The ROC curve was used to estimate sensitivity, specificity, and area under the curve between MSRA 5 and 7 versus SMI. The Kappa index was used to assess the agreement between them. RESULTS MSRA 5 and 7 showed better sensitivity values in women when compared to men. However, better specificity values were obtained in men when compared to women. Although, there was better agreement between MSRA 5/7 and SMI in women, kappa values indicated low agreement in both sexes (MSRA 5: women: 0.36 vs. men: 0.07 and MSRA 7: women: 0.22 vs. men: - 0.07). CONCLUSION MSRA 5 and 7 questionnaires has low agreement with SMI to identify risk of sarcopenia in unselected cancer patients.
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Affiliation(s)
- Isadora A Faria
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
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Kouvari M, Polyzos SA, Chrysohoou C, Skoumas J, Pitsavos CS, Panagiotakos DB, Mantzoros CS. Skeletal Muscle Mass and Abdominal Obesity are Independent Predictors of Hepatic Steatosis and Interact to Predict Ten-Year Cardiovascular Disease Incidence: Data from the ATTICA Cohort Study. Clin Nutr 2022; 41:1281-1289. [DOI: 10.1016/j.clnu.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/28/2022] [Accepted: 03/20/2022] [Indexed: 11/03/2022]
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Mori N, Maeda K, Fukami Y, Matsuyama R, Nonogaki T, Kato R, Ishida Y, Shimizu A, Ueshima J, Nagano A. High SARC-F score predicts poor survival of patients with cancer receiving palliative care. Support Care Cancer 2022; 30:4065-4072. [PMID: 35064824 DOI: 10.1007/s00520-022-06845-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/18/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE A high score determined by SARC-F, a simple screening questionnaire for sarcopenia, has been reportedly associated with worse medical outcomes. However, information regarding whether high SARC-F scores are associated with a poor prognosis in patients with advanced cancer remains limited. We clarified whether a SARC-F score ≥ 4 predicts poor prognosis in patients with cancer receiving palliative care. METHODS We conducted a retrospective cohort study of patients with cancer who received palliative care at a university hospital between May 2019 and April 2020. Patient characteristics including age, sex, height, weight, cancer type, serum albumin level, C-reactive protein level, presence of edema, Eastern Cooperative Oncology Group-Performance Status (ECOG-PS), SARC-F score, history of anticancer therapy, and clinical outcomes were collected from electronic medical records. RESULTS Of 304 patients, 188 had a SARC-F score < 4, and 116 patients had a SARC-F score ≥ 4. The overall survival of patients with a SARC-F score ≥ 4 was 40 days (95% CI 29-47), which was significantly worse than 121 days (95% CI 95-156) for patients with a SARC-F score < 4 (p < 0.001). SARC-F score ≥ 4 (hazard ratio: HR 1.56), edema (HR 1.94), head and neck cancer (HR 0.51), C-reactive protein (HR 1.05), ECOG-PS ≥ 3 (HR 1.47), and radiotherapy (HR 0.52) were associated with overall survival. The ability to climb stairs was a SARC-F sub-item significantly associated with mortality (HR 1.59). CONCLUSION The SARC-F questionnaire is a useful predictor of prognosis for patients with cancer receiving palliative care because a SARC-F ≥ 4 score predicts worse overall survival.
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Affiliation(s)
- Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yasuyuki Fukami
- Department of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Tomoyuki Nonogaki
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Ryoko Kato
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yuria Ishida
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Nutrition, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Akio Shimizu
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Clinical Nutrition and Food Services, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Ayano Nagano
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
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Nozoe M, Kubo H, Kanai M, Yamamoto M. Relationships between Pre-Stroke SARC-F Scores, Disability, and Risk of Malnutrition and Functional Outcomes after Stroke-A Prospective Cohort Study. Nutrients 2021; 13:nu13103586. [PMID: 34684587 PMCID: PMC8537569 DOI: 10.3390/nu13103586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
SARC-F is a screening tool for sarcopenia; however, it has not yet been established whether SARC-F scores predict functional outcomes. Therefore, we herein investigated the relationship between SARC-F scores and functional outcomes in stroke patients. The primary outcome in the present study was the modified Rankin Scale (mRS) 3 months after stroke. The relationship between SARC-F scores and poor functional outcomes was examined using a logistic regression analysis. Furthermore, the applicability of SARC-F scores to the assessment of poor functional outcomes was analyzed based on the area under the receiver operating curve (ROC). Eighty-one out of the 324 patients enrolled in the present study (25%) had poor functional outcomes (mRS ≥ 4). The results of the multivariate analysis revealed a correlation between SARC-F scores (OR = 1.29, 95% CI = 1.05–1.59, p = 0.02) and poor functional outcomes. A cut-off SARC-F score ≥ 4 had low-to-moderate sensitivity (47.4%) and high specificity (87.3%). The present results suggest that the measurement of pre-stroke SARC-F scores is useful for predicting the outcomes of stroke patients.
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Affiliation(s)
- Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
- Correspondence: ; Tel.: +81-78-413-3584
| | - Hiroki Kubo
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
| | - Masashi Kanai
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Japan;
| | - Miho Yamamoto
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, Itami 664-0028, Japan; (H.K.); (M.Y.)
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Hanai T, Hiraoka A, Shiraki M, Sugimoto R, Taniki N, Hiramatsu A, Nakamoto N, Iwasa M, Chayama K, Shimizu M. Utility of the SARC-F Questionnaire for Sarcopenia Screening in Patients with Chronic Liver Disease: A Multicenter Cross-Sectional Study in Japan. J Clin Med 2021; 10:3448. [PMID: 34362231 PMCID: PMC8348368 DOI: 10.3390/jcm10153448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022] Open
Abstract
Diagnosing sarcopenia is challenging. This multicenter cross-sectional study aimed to evaluate the utility of the SARC-F score system for identifying sarcopenia in patients with chronic liver disease (CLD). We enrolled 717 patients from five participating centers who completed the SARC-F between November 2019 and March 2021. Sarcopenia was diagnosed based on the Japan Society of Hepatology Working Group on Sarcopenia in Liver Disease Consensus. Muscle strength was estimated using a grip dynamometer, and muscle mass was assessed using computed tomography or bioelectrical impedance analysis. The association between SARC-F and sarcopenia was analyzed using a logistic regression model. The optimal SARC-F cutoff value for identifying sarcopenia was determined using receiver operating characteristic (ROC) curve analysis. Of the 676 eligible patients, 15% were diagnosed with sarcopenia. The SARC-F distribution was 0 points in 63% of patients, 1 point in 17%, 2 points in 7%, 3 points in 4%, and ≥4 points in 8%. The SARC-F items of "Strength" (odds ratio (OR), 1.98; 95% confidence interval (CI), 1.03-3.80) and "Falls" (OR, 2.44; 95% CI, 1.48-4.03) were significantly associated with sarcopenia. The SARC-F value of 1 point showed a higher discriminative ability for identifying sarcopenia than the 4 points that are conventionally used (p < 0.001), with an area under the ROC curve of 0.68, sensitivity of 0.65, specificity of 0.68, positive predictive value of 0.27, and negative predictive value of 0.92. SARC-F is useful for identifying patients with CLD who are at risk of sarcopenia.
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Affiliation(s)
- Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
| | - Atsushi Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan;
| | - Makoto Shiraki
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
| | - Ryosuke Sugimoto
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (R.S.); (M.I.)
| | - Nobuhito Taniki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (N.N.)
| | - Akira Hiramatsu
- Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Nobuhiro Nakamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (N.N.)
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (R.S.); (M.I.)
| | - Kazuaki Chayama
- Collaborative Research Laboratory of Medical Innovation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan; (M.S.); (M.S.)
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