Sarcopenia and Physical Function: In Overweight Patients with Advanced Cancer

Publication: Canadian Journal of Dietetic Practice and Research
17 May 2013

Abstract

Advanced cancer is associated with numerous metabolic abnormalities that may lead to significant body composition changes, particularly muscle loss or sarcopenia. Sarcopenia in cancer has been associated with poor clinical outcomes, including poor physical function. Accurate tools to assess body composition are expensive and not readily available in clinical settings. Unfortunately, little is known about the efficacy of affordable and portable techniques to assess functional status in patients with cancer. We investigated the prevalence of sarcopenia and its association with different portable and low-cost functional status measurement tools (i.e., handgrip strength testing, a two-minute walking test, and a self-report questionnaire) in overweight/obese patients (body mass index ≥ 25 kg/m2) with advanced cancer. Twenty-eight patients (68% men) aged 64.5 ± 9.5 years with advanced lung or colorectal cancer were included. Sarcopenia was assessed by measuring appendicular skeletal muscle (ASM) adjusted by height (ASM index), using dual energy X-ray absorptiometry. Approximately 36% of patients had sarcopenia. Average handgrip strength was greater in men without sarcopenia than in men with it (p=0.035). In men, ASM index was positively correlated with average (r=0.535, p=0.018) and peak handgrip strength (r=0.457, p=0.049). No differences were observed among female patients. Handgrip strength was associated with sarcopenia in male patients with advanced cancer, and therefore it may be used as a portable and simple nutritional screening tool.

Résumé

Le cancer évolué est associé à de nombreuses anomalies du métabolisme qui peuvent provoquer des changements significatifs de la composition corporelle, particulièrement la perte musculaire ou la sarcopénie. La sarcopénie liée au cancer a été associée à de piètres résultats cliniques, y compris à de faibles fonctions physiques. Les outils précis permettant d’évaluer la composition corporelle sont chers et difficilement accessibles en milieu clinique. Malheureusement, il existe peu d’information sur l’efficacité des techniques abordables et portables visant à évaluer l’état fonctionnel des patients atteints de cancer. Nous avons examiné la prévalence de sarcopénie et son association avec différents outils portables et peu coûteux visant à mesurer l’état fonctionnel (c.-à-d. test de la force de préhension, test de marche de deux minutes, et questionnaire d’auto-évaluation) de patients en excès de poids/obèses (indice de masse corporelle ≥ 25 kg/m2) souffrant d’un cancer évolué. Vingt-huit patients (68 % d’hommes) âgés de 64,5 ± 9,5 ans atteints d’un cancer évolué des poumons ou colorectal ont été inclus. La sarcopénie a été évaluée au moyen de la mesure de la masse musculaire squelettique appendiculaire (MMSA) ajustée en fonction de la taille (indice de MMSA) à l’aide d’absorptiométrie à rayons X en double énergie. Environ 36 % des patients souffraient de sarcopénie. La force de préhension moyenne était plus importante chez les hommes qui ne souffraient pas de sarcopénie que chez ceux qui en étaient atteints (p = 0,035). Chez les hommes, l’indice de MMSA était positivement corrélé avec la force de préhension moyenne (r = 0,535, p = 0,018) et maximale (r = 0,457, p = 0,049). Aucune différence n’a été observée chez les femmes. La force de préhension a été associée à la sarcopénie chez les hommes atteints d’un cancer évolué et par conséquent, elle pourrait être utilisée à titre d’outil de dépistage nutritionnel portable et simple.

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Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 74Number 2July 2013
Pages: 69 - 74

History

Published online: 17 May 2013

Authors

Affiliations

Carla M.M. Prado PhD
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
Jessica R. Lieffers MSc, RD
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
Lindsay Bowthorpe RD
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
Vickie E. Baracos PhD
Department of Oncology, University of Alberta, Edmonton, AB
Marina Mourtzakis PhD
Department of Oncology, University of Alberta, Edmonton, AB
Linda J. McCargar PHD, RD
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB

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