Application of sarcopenia index in the diagnosis of malnutrition in patients with colorectal cancer_West China Medical Journal

Authors：

CHEN Guoyong ¹ , TANG Hehan ¹ , DAI Tingting ² , RAO Zhiyong ² ,  LI Xuemei ²

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Xuemei, Email: susanleechengdu@foxmail.com

Keywords：

Malnutrition; Sarcopenia index; Body mass index; Colorectal cancer

DOI：

10.7507/1002-0179.202003095

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.Methods A retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.Results The detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).Conclusion Using SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.

Citation： CHEN Guoyong, TANG Hehan, DAI Tingting, RAO Zhiyong, LI Xuemei. Application of sarcopenia index in the diagnosis of malnutrition in patients with colorectal cancer. West China Medical Journal, 2020, 35(6): 684-687. doi: 10.7507/1002-0179.202003095 Copy

1.	郑荣寿, 孙可欣, 张思维, 等. 2015 年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
2.	Álvaro Sanz E, Garrido Siles M, Rey Fernández L, et al. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: early intervention protocol. Nutrition, 2019, 57: 148-153.
3.	Li XM, Zhou JD, Ci C, et al. Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy. Head Neck, 2019, 41(10): 3525-3534.
4.	Seretis C, Kaisari P, Wanigasooriya K, et al. Malnutrition is associated with adverse postoperative outcome in patients undergoing elective colorectal cancer resections. J BUON, 2018, 23(1): 36-41.
5.	Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition: an ESPEN Consensus Statement. Clin Nutr, 2015, 34(3): 335-340.
6.	Ryan AM, Power DG, Daly L, et al. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc, 2016, 75(2): 199-211.
7.	van Vugt JL, Levolger S, Gharbharan A, et al. A comparative study of software programmes for cross-sectional skeletal muscle and adipose tissue measurements on abdominal computed tomography scans of rectal cancer patients. J Cachexia Sarcopenia Muscle, 2017, 8(2): 285-297.
8.	Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol, 2008, 9(7): 629-635.
9.	Maggio M, Lauretani F. Prevalence, incidence, and clinical impact of cognitive-motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019. J Cachexia Sarcopenia Muscle, 2019, 10(5): 953-955.
10.	Jung HW, Kim JW, Kim JY, et al. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer, 2015, 23(3): 687-694.
11.	Recker R, Lips P, Felsenberg D, et al. Alendronate with and without cholecalciferol for osteoporosis: results of a 15-week randomized controlled trial. Curr Med Res Opin, 2006, 22(9): 1745-1755.
12.	Reisinger KW, Jeroen LV, Tegels JW, et al. Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Ann Surg, 2015, 261(2): 345-352.
13.	Hopkins JJ, Reif RL, Bigam DL, et al. The impact of muscle and adipose tissue on long-term survival in patients with stage i to iii colorectal cancer. Dis Colon Rectum, 2019, 62(5): 549-560.
14.	Takeda Y, Akiyoshi T, Matsueda K, et al. Skeletal muscle loss is an independent negative prognostic factor in patients with advanced lower rectal cancer treated with neoadjuvant chemoradiotherapy. PLoS One, 2018, 13(4): e0195406.
15.	Candyce HK, Carla MP, Meyerhardt JA, et al. Muscle radiodensity and mortality in patients with colorectal cancer. Cancer, 2018, 124(14): 3008-3015.
16.	Daly LE, Prado CM, Ryan AM. A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes. Proc Nutr Soc, 2018, 77(2): 135-151.
17.	Dreyer HC, Fujita S, Cadenas JG, et al. Resistance exercise increases AMPK activity and reduces 4E-BP1 phosphorylation and protein synthesis in human skeletal muscle. J Physiol, 2006, 576(2): 613-624.
18.	Cherin P, Voronska E, Fraoucene N, et al. Prevalence of sarcopenia among healthy ambulatory subjects: the sarcopenia begins from 45 years. Aging Clin Exp Res, 2014, 26(2): 137-146.
19.	Shimokata H, Ando F, Yuki A, et al. Age-related changes in skeletal muscle mass among community-dwelling Japanese: a 12-year longitudinal study. Geriatr Gerontol Int, 2014(Suppl 1): 85-92.
20.	Janssen I, Heymsfield SB, Wang ZM, et al. Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr. J Appl Physiol, 2000, 89(1): 81-88.
21.	Weissberger AJ, Ho KK. Activation of the somatotropic axis by testosterone in adult males: evidence for the role of aromatization. J Clin Endocrinol Metab, 1993, 76(6): 1407-1412.
22.	Yeap BB. Are declining testosterone levels a major risk factor for ill-health in aging men?. Int J Impot Res, 2009, 21(1): 24-36.
23.	Kaplan SA, Lee JY, O’Neill EA, et al. Prevalence of low testosterone and its relationship to body mass index in older men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Aging Male, 2013, 16(4): 169-172.
24.	Xiao JJ, Bette JC, Cespedes feliciano EM, et al. The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer. Am J Clin Nutr, 2019, 109(3): 615-625.
25.	Fearon K, Arends J, Baracos V. Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol, 2013, 10(2): 90-99.

1. 郑荣寿, 孙可欣, 张思维, 等. 2015 年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2019, 41(1): 19-28.
2. Álvaro Sanz E, Garrido Siles M, Rey Fernández L, et al. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: early intervention protocol. Nutrition, 2019, 57: 148-153.
3. Li XM, Zhou JD, Ci C, et al. Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy. Head Neck, 2019, 41(10): 3525-3534.
4. Seretis C, Kaisari P, Wanigasooriya K, et al. Malnutrition is associated with adverse postoperative outcome in patients undergoing elective colorectal cancer resections. J BUON, 2018, 23(1): 36-41.
5. Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition: an ESPEN Consensus Statement. Clin Nutr, 2015, 34(3): 335-340.
6. Ryan AM, Power DG, Daly L, et al. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc, 2016, 75(2): 199-211.
7. van Vugt JL, Levolger S, Gharbharan A, et al. A comparative study of software programmes for cross-sectional skeletal muscle and adipose tissue measurements on abdominal computed tomography scans of rectal cancer patients. J Cachexia Sarcopenia Muscle, 2017, 8(2): 285-297.
8. Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol, 2008, 9(7): 629-635.
9. Maggio M, Lauretani F. Prevalence, incidence, and clinical impact of cognitive-motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019. J Cachexia Sarcopenia Muscle, 2019, 10(5): 953-955.
10. Jung HW, Kim JW, Kim JY, et al. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer, 2015, 23(3): 687-694.
11. Recker R, Lips P, Felsenberg D, et al. Alendronate with and without cholecalciferol for osteoporosis: results of a 15-week randomized controlled trial. Curr Med Res Opin, 2006, 22(9): 1745-1755.
12. Reisinger KW, Jeroen LV, Tegels JW, et al. Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Ann Surg, 2015, 261(2): 345-352.
13. Hopkins JJ, Reif RL, Bigam DL, et al. The impact of muscle and adipose tissue on long-term survival in patients with stage i to iii colorectal cancer. Dis Colon Rectum, 2019, 62(5): 549-560.
14. Takeda Y, Akiyoshi T, Matsueda K, et al. Skeletal muscle loss is an independent negative prognostic factor in patients with advanced lower rectal cancer treated with neoadjuvant chemoradiotherapy. PLoS One, 2018, 13(4): e0195406.
15. Candyce HK, Carla MP, Meyerhardt JA, et al. Muscle radiodensity and mortality in patients with colorectal cancer. Cancer, 2018, 124(14): 3008-3015.
16. Daly LE, Prado CM, Ryan AM. A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes. Proc Nutr Soc, 2018, 77(2): 135-151.
17. Dreyer HC, Fujita S, Cadenas JG, et al. Resistance exercise increases AMPK activity and reduces 4E-BP1 phosphorylation and protein synthesis in human skeletal muscle. J Physiol, 2006, 576(2): 613-624.
18. Cherin P, Voronska E, Fraoucene N, et al. Prevalence of sarcopenia among healthy ambulatory subjects: the sarcopenia begins from 45 years. Aging Clin Exp Res, 2014, 26(2): 137-146.
19. Shimokata H, Ando F, Yuki A, et al. Age-related changes in skeletal muscle mass among community-dwelling Japanese: a 12-year longitudinal study. Geriatr Gerontol Int, 2014(Suppl 1): 85-92.
20. Janssen I, Heymsfield SB, Wang ZM, et al. Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr. J Appl Physiol, 2000, 89(1): 81-88.
21. Weissberger AJ, Ho KK. Activation of the somatotropic axis by testosterone in adult males: evidence for the role of aromatization. J Clin Endocrinol Metab, 1993, 76(6): 1407-1412.
22. Yeap BB. Are declining testosterone levels a major risk factor for ill-health in aging men?. Int J Impot Res, 2009, 21(1): 24-36.
23. Kaplan SA, Lee JY, O’Neill EA, et al. Prevalence of low testosterone and its relationship to body mass index in older men with lower urinary tract symptoms associated with benign prostatic hyperplasia. Aging Male, 2013, 16(4): 169-172.
24. Xiao JJ, Bette JC, Cespedes feliciano EM, et al. The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer. Am J Clin Nutr, 2019, 109(3): 615-625.
25. Fearon K, Arends J, Baracos V. Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol, 2013, 10(2): 90-99.

West China Medical Journal

Application of sarcopenia index in the diagnosis of malnutrition in patients with colorectal cancer

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