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Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition

BACKGROUND: Sarcopenia, frailty, and malnutrition are associated with undesirable clinical outcomes in cancer patients. Sarcopenia-related measurements may be promising fast biomarkers for frailty. Our objectives were to assess the prevalence of nutritional risk, malnutrition, frailty, and sarcopeni...

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Autores principales: Wang, Fang, Zhen, Hong-nan, Wang, Han-ping, Yu, Kang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149728/
https://www.ncbi.nlm.nih.gov/pubmed/37139454
http://dx.doi.org/10.3389/fnut.2023.1143213
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author Wang, Fang
Zhen, Hong-nan
Wang, Han-ping
Yu, Kang
author_facet Wang, Fang
Zhen, Hong-nan
Wang, Han-ping
Yu, Kang
author_sort Wang, Fang
collection PubMed
description BACKGROUND: Sarcopenia, frailty, and malnutrition are associated with undesirable clinical outcomes in cancer patients. Sarcopenia-related measurements may be promising fast biomarkers for frailty. Our objectives were to assess the prevalence of nutritional risk, malnutrition, frailty, and sarcopenia in lung cancer inpatients, and describe the relationship of them. METHODS: Stage III and IV lung cancer inpatients were recruited before chemotherapy. The skeletal muscle index (SMI) was assessed by multi-frequency bioelectric impedance analysis (m-BIA). Sarcopenia, frailty, nutritional risk, and malnutrition were diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), Fried Frailty Phenotype (FFP), nutritional risk screening-2002 (NRS-2002), and Global Leadership Initiative on Malnutrition criteria (GLIM), and correlation analysis was performed between them with Pearson’s r correlation coefficients. A univariate and multivariate logistic regression analysis was conducted for all patients, gender and age-stratified subgroups to obtain odds ratios (ORs) and 95% confidence intervals (95%CIs). RESULTS: The cohort included 97 men (77%) and 29 women (23%), with mean age of 64.8 ± 8.7 years. Among the 126 patients, 32 (25.4%) and 41 (32.5%) had sarcopenia and frailty, and the prevalence of nutritional risk and malnutrition was 31.0% (n = 39) and 25.4% (n = 32). Adjusted for age and gender, SMI was correlated with FFP (r = −0.204, p = 0.027), and did not remain significantly when stratified by gender. Stratification according to age revealed in ≥65-years-old population, SMI and FFP were significantly correlated (r = −0.297, p = 0.016), which is not seen in <65-years-old group (r = 0.048, p = 0.748). The multivariate regression analysis showed FFP, BMI, and ECOG were the independent variables associated with sarcopenia (OR 1.536, 95%CI 1.062–2.452, p = 0.042; OR 0.625, 95%CI 0.479–0.815, p = 0.001; OR 7.286, 95%CI 1.779–29.838, p = 0.004). CONCLUSION: Comprehensively assessed sarcopenia is independently associated with frailty based on FFP questionnaire, BMI, and ECOG. Therefore, sarcopenia assessment including m-BIA based SMI, and muscle strength and function could be used to indicate frailty to help select the targeting patients for care. Moreover, in addition to muscle mass, muscle quality should not be ignored in clinical practice.
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spelling pubmed-101497282023-05-02 Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition Wang, Fang Zhen, Hong-nan Wang, Han-ping Yu, Kang Front Nutr Nutrition BACKGROUND: Sarcopenia, frailty, and malnutrition are associated with undesirable clinical outcomes in cancer patients. Sarcopenia-related measurements may be promising fast biomarkers for frailty. Our objectives were to assess the prevalence of nutritional risk, malnutrition, frailty, and sarcopenia in lung cancer inpatients, and describe the relationship of them. METHODS: Stage III and IV lung cancer inpatients were recruited before chemotherapy. The skeletal muscle index (SMI) was assessed by multi-frequency bioelectric impedance analysis (m-BIA). Sarcopenia, frailty, nutritional risk, and malnutrition were diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019), Fried Frailty Phenotype (FFP), nutritional risk screening-2002 (NRS-2002), and Global Leadership Initiative on Malnutrition criteria (GLIM), and correlation analysis was performed between them with Pearson’s r correlation coefficients. A univariate and multivariate logistic regression analysis was conducted for all patients, gender and age-stratified subgroups to obtain odds ratios (ORs) and 95% confidence intervals (95%CIs). RESULTS: The cohort included 97 men (77%) and 29 women (23%), with mean age of 64.8 ± 8.7 years. Among the 126 patients, 32 (25.4%) and 41 (32.5%) had sarcopenia and frailty, and the prevalence of nutritional risk and malnutrition was 31.0% (n = 39) and 25.4% (n = 32). Adjusted for age and gender, SMI was correlated with FFP (r = −0.204, p = 0.027), and did not remain significantly when stratified by gender. Stratification according to age revealed in ≥65-years-old population, SMI and FFP were significantly correlated (r = −0.297, p = 0.016), which is not seen in <65-years-old group (r = 0.048, p = 0.748). The multivariate regression analysis showed FFP, BMI, and ECOG were the independent variables associated with sarcopenia (OR 1.536, 95%CI 1.062–2.452, p = 0.042; OR 0.625, 95%CI 0.479–0.815, p = 0.001; OR 7.286, 95%CI 1.779–29.838, p = 0.004). CONCLUSION: Comprehensively assessed sarcopenia is independently associated with frailty based on FFP questionnaire, BMI, and ECOG. Therefore, sarcopenia assessment including m-BIA based SMI, and muscle strength and function could be used to indicate frailty to help select the targeting patients for care. Moreover, in addition to muscle mass, muscle quality should not be ignored in clinical practice. Frontiers Media S.A. 2023-04-17 /pmc/articles/PMC10149728/ /pubmed/37139454 http://dx.doi.org/10.3389/fnut.2023.1143213 Text en Copyright © 2023 Wang, Zhen, Wang and Yu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Wang, Fang
Zhen, Hong-nan
Wang, Han-ping
Yu, Kang
Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title_full Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title_fullStr Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title_full_unstemmed Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title_short Measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
title_sort measurement of sarcopenia in lung cancer inpatients and its association with frailty, nutritional risk, and malnutrition
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149728/
https://www.ncbi.nlm.nih.gov/pubmed/37139454
http://dx.doi.org/10.3389/fnut.2023.1143213
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