Evaluation of sarcopenia, sarcopenic obesity, and phase angle in geriatric gastrointestinal cancer patients: before and after chemotherapy
Evaluation of sarcopenia, sarcopenic obesity, and phase angle in geriatric gastrointestinal cancer patients: before and after chemotherapy
Background/aim: The purpose of this study was to determine sarcopenia, sarcopenic obesity and phase angle (PA) and the influence ofchemotherapy (CT) on anthropometric measurements and and the PA in in geriatric patients with gastrointestinal (GI) cancer.Material and methods: The anthropometric measurements, calf circumference (CC), upper midarm circumference (UMAC), and handgrip strength (HGS), have been measured to understand muscle function of 153 patients (mean age of 70.5 ± 5.6 years, 28.8% female,71.2% male). Sarcopenia and PA measurements have been evaluated by bioelectrical impedance analyses. The same evaluations werechecked again after 1 cycle of CT (min: 4, max: 6 weeks).Results: Patient population consisted of colorectal (51,6%), gastric (26.8%), pancreas (11.8%), liver (7.2%), and biliary tract cancer (2%).UMAC (28.5 ± 4.4 before, 28.1 ± 4.9, P = 0.034 after CT), and HGS measurements (27.5 ± 8.6 before, 26.8 ± 8.8 after CT, P = 0.007)have significantly decreased after CT. CC measurement < 31 cm at first visit was seen in 13.1% of patients, but the ratio raised to 20.3%after CT (χ², P = 0.003). Severe sarcopenia was determined in 33% of all patients, and 30.0% of them have been considered as sarcopenicobese.Conclusion: Sarcopenia and sarcopenic obesity were prevalent in this group patients. The CT caused a decrease in muscle functions,UMAC, and CC. Patients should be followed up carefully for sarcopenia, sarcopenic obesity, and nutritional aspect and it would beproper to intervene before sarcopenia has not occurred yet.
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- 1. Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi
D, Proia A, Tosato M, Bernabei R, Onder G. Sarcopenia and
mortality among older nursing home residents. J Am Med Dir
Assoc 2012; 13: 121-126.
- 2. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm
T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM.
European Working Group on Sarcopenia in Older People.
Sarcopenia: European consensus on definition and diagnosis:
Report of the European Working Group on Sarcopenia in
Older People. Age Ageing 2010; 39: 412-423.
- 3. Waters DL, Baumgartner RN. Sarcopenia and obesity. Clin
Geriatr Med 2011; 27: 401-421.
- 4. Batsis JA, Mackenzie TA, Barre LK, Lopez-Jimenez F, Bartels SJ.
Sarcopenia, sarcopenic obesity and mortality in older adults:
results from the National Health and Nutrition Examination
Survey III. Eur J Clin Nutr 2014; 68: 1001-1007.
- 5. Reijnierse EM, Trappenburg MC, Leter MJ, Blauw GJ, de van
der Schueren MA, Meskers CG, Maier AB. The association
between parameters of malnutrition and diagnostic measures
of sarcopenia in geriatric outpatients. PLoS One 2015; 10:
e0135933.
- 6. Beaudart C, Reginster JY, Slomian J, Buckinx F, Dardenne
N, Quabron A, Slangen C, Gillain S, Petermans J, Bruyère O.
Estimation of sarcopenia prevalence using various assessment
tools. Exp Gerontol 2015; 61: 31-37.
- 7. Barbosa-Silva MC, Barros AJ, Post CL, Waitzberg DL,
Heymsfield SB. Can bioelectrical impedance analysis identify
malnutrition in preoperative nutrition assessment? Nutrition
2003; 19: 422-426.
- 8. Gupta D, Lis CG, Dahlk SL, Vashi PG, Grutsch JF, Lammersfeld
CA. Bioelectrical impedance phase angle as a prognostic
indicator in advanced pancreatic cancer. Br J Nutr 2004; 92:
957-962.
- 9. Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL,
Grutsch JF, Lis CG. Bioelectrical impedance phase angle as a
prognostic indicator in breast cancer. BMC Cancer 2008; 8:
249.
- 10. Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, et
al. Bioelectrical impedance phase angle in clinical practice:
implications for prognosis in stage IIIB and IV non-small cell
lung cancer. BMC Cancer 2009; 9: 37.
- 11. Bicakli DH, Ozveren A, Uslu R, Dalak RM, Cehreli R, Uyar
M5 Karabulut B, Akcicek F. The effect of chemotherapy on
nutritional status and weakness in geriatric gastrointestinal
system cancer patients. Nutrition 2018; 47: 39-42.
- 12. Guigoz Y. The mini-nutritional assessment (MNA) review of
the literature - What does it tell us? J Nutr Health Aging 2006;
10: 466-487.
- 13. Janssen I, Heymsfield SB, Baumgartner RN, Ross R. Estimation
of skeletal muscle mass by bioelectrical impedance analysis. J
Appl Physiol (1985) 2000; 89: 465-471.
- 14. Yancik R, Ries LA. Aging and cancer in America. Demographic
and epidemiologic perspectives. Hematol Oncol Clin North
Am 2000; 14: 17-23.
- 15. van Bokhorst-de van der Schueren MA. Nutritional support
strategies for malnourished cancer patients. Eur J Oncol Nurs
2005; 9 (Suppl. 2): S74-83.
- 16. Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff
R. Skeletal muscle cutpoints associated with elevated physical
disability risk in older men and women. Am J Epidemiol 2004;
159: 413-421.
- 17. Landi F, Russo A, Liperoti R, Pahor M, Tosato M, Capoluongo
E, Bernabei R, Onder G. Midarm muscle circumference,
physical performance and mortality: results from the aging
and longevity study in the Sirente geographic area (SIRENTE
study). Clin Nutr 2010; 29: 441-447.
- 18. Rolland Y, Lauwers-Cances V, Cournot M, Nourhashémi
F, Reynish W, Rivière D, Vellas B, Grandjean H. Sarcopenia,
calf circumference, and physical function of elderly women: a
cross-sectional study. J Am Geriatr Soc 2003; 51:1120-1124.
- 19. Pagotto V, Silveira EA. Methods, diagnostic criteria, cutoff
points, and prevalence of sarcopenia among older people.
ScientificWorldJournal 2014; 2014: 231312.
- 20. Kavouras SA. Assessing hydration status. Curr Opin Clin Nutr
Metab Care. 2002; 5: 519-524.
- 21. Sun F, Norman IJ, While AE. Physical activity in older people:
a systematic review. BMC Public Health 2013; 13: 449.
- 22. McLaughlin L. Expert consensus on the nutritional therapy for
patients with malignancies. Chin Clin Oncol 2013; 2: 20.
- 23. Studley HO. Percentage of weight loss. A basic indicator of
surgical risk in patients with chronic peptic ulcer. JAMA 1936;
106: 458-460.
- 24. Hickson M. Malnutrition and ageing. Postgrad Med J 2006; 82:
2-8.
- 25. Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB,
Martin L, Baracos VE. 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: 629-635.
- 26. Kyle UG, Schneider SM, Pirlich M, Lochs H, Hebuterne X,
Pichard C. Does nutritional risk, as assessed by Nutritional
Risk Index, increase during hospital stay? A multinational
population-based study. Clin Nutr 2005; 24: 516-524.
- 27. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact
of disease related malnutrition. Clin Nutr 2008; 27: 5-15.
- 28. Gupta D, Lammersfeld CA, Burrows JL, Dahlk SL, Vashi PG,
Grutsch JF, Hoffman S, Lis CG. Bioelectrical impedance phase
angle in clinical practice: implications or prognosis in advanced
colorectal cancer. Am J Clin Nutr 2004; 80: 1634-1638.