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1.
Zhonghua Gan Zang Bing Za Zhi ; 29(3): 193-195, 2021 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-33902182

RESUMO

Liver cirrhosis can lead to a variety of complications. Ascites, hepatic encephalopathy, esophageal variceal bleeding, and hepatorenal syndrome have been well recognized. However, there are still some complications that have a high incidence, but are overlooked by clinicians. These complications will also significantly affect the patient's quality of life and long-term prognosis. In this paper, the overlooked complications of liver cirrhosis, such as portal vein thrombosis, cirrhotic sarcopenia, and hepatic osteopathy and so on, are discussed, and the future research direction and work focus are prospected, in order to attract the attention of clinicians and researchers.


Assuntos
Varizes Esofágicas e Gástricas , Sarcopenia , Varizes Esofágicas e Gástricas/patologia , Hemorragia Gastrointestinal/patologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/patologia , Veia Porta/patologia , Qualidade de Vida , Sarcopenia/etiologia , Sarcopenia/patologia
2.
Zhonghua Gan Zang Bing Za Zhi ; 29(3): 199-203, 2021 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-33902184

RESUMO

Sarcopenia is a common complication in patients with liver cirrhosis, which has an adverse effect on the clinical outcome and prognosis. Attention must be paid to early detection and active diagnosis and treatment. Clinically, the diagnosis process of finding suspicious cases can be traced through screening-assessment-diagnosis-severity evaluation. On the ground of treating liver cirrhosis and its complications, reasonable nutritional intervention and exercise are currently important measures for the treatment of liver cirrhosis with sarcopenia, and the role of hormone supplementation and drug therapy for skeletal muscle metabolism needs to be further investigated.


Assuntos
Sarcopenia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/patologia , Músculo Esquelético/patologia , Prognóstico , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Sarcopenia/terapia
3.
Int J Mol Sci ; 22(4)2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33671926

RESUMO

The picture of chronic liver diseases (CLDs) has changed considerably in recent years. One of them is the increase of non-alcoholic fatty liver disease. More and more CLD patients, even those with liver cirrhosis (LC), tend to be presenting with obesity these days. The annual rate of muscle loss increases with worsening liver reserve, and thus LC patients are more likely to complicate with sarcopenia. LC is also characterized by protein-energy malnutrition (PEM). Since the PEM in LC can be invariable, the patients probably present with sarcopenic obesity (Sa-O), which involves both sarcopenia and obesity. Currently, there is no mention of Sa-O in the guidelines; however, the rapidly increasing prevalence and poorer clinical consequences of Sa-O are recognized as an important public health problem, and the diagnostic value of Sa-O is expected to increase in the future. Sa-O involves a complex interplay of physiological mechanisms, including increased inflammatory cytokines, oxidative stress, insulin resistance, hormonal disorders, and decline of physical activity. The pathogenesis of Sa-O in LC is diverse, with a lot of perturbations in the muscle-liver-adipose tissue axis. Here, we overview the current knowledge of Sa-O, especially focusing on LC.


Assuntos
Cirrose Hepática/complicações , Cirrose Hepática/metabolismo , Obesidade/etiologia , Obesidade/metabolismo , Sarcopenia/etiologia , Sarcopenia/metabolismo , Tecido Adiposo/metabolismo , Citocinas/metabolismo , Disbiose/metabolismo , Terapia por Exercício/métodos , Jejum , Humanos , Resistência à Insulina , Cirrose Hepática/dietoterapia , Cirrose Hepática/tratamento farmacológico , Obesidade/dietoterapia , Obesidade/tratamento farmacológico , Desnutrição Proteico-Calórica/metabolismo , Sarcopenia/dietoterapia , Sarcopenia/tratamento farmacológico
4.
Nutrients ; 13(3)2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33652812

RESUMO

The recent publication of the revised Consensus on definition and diagnosis of sarcopenia (EWGSOP2) and the Global Leadership Initiative on Malnutrition (GLIM) criteria changed the approach to research on sarcopenia and malnutrition. Whilst sarcopenia is a nutrition-related disease, malnutrition and cachexia are nutritional disorders sharing the common feature of low fat-free mass. However, they have differential characteristics and etiologies, as well as specific therapeutic approaches. Applying the current definitions in clinical practice is still a challenge for health professionals and the potential for misdiagnosis is high. This is of special concern in the subgroup of older people with cancer, in which sarcopenia, malnutrition, and cancer cachexia are highly prevalent and can overlap or occur separately. The purpose of this review is to provide an updated overview of the latest research and consensus definitions of sarcopenia, malnutrition, and cachexia and to discuss their implications for clinical practice in older patients with cancer. The overall aim is to improve the quality of nutritional care in light of the latest findings.


Assuntos
Caquexia/diagnóstico , Desnutrição/diagnóstico , Neoplasias/complicações , Sarcopenia/diagnóstico , Terminologia como Assunto , Idoso , Idoso de 80 Anos ou mais , Caquexia/etiologia , Consenso , Fenômenos Fisiológicos da Nutrição do Idoso , Feminino , Humanos , Masculino , Desnutrição/etiologia , Avaliação Nutricional , Estado Nutricional , Sarcopenia/etiologia
6.
Nutrients ; 13(2)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33498571

RESUMO

Sarcopenia is a disorder characterized by a loss of muscle mass which leads to the reduction of muscle strength and a decrease in the quality and quantity of muscle. It was previously thought that sarcopenia was specific to ageing. However, sarcopenia may affect patients suffering from chronic diseases throughout their entire lives. A decreased mass of muscle and bone is common among patients with inflammatory bowel disease (IBD). Since sarcopenia and osteoporosis are closely linked, they should be diagnosed as mutual consequences of IBD. Additionally, multidirectional treatment of sarcopenia and osteoporosis including nutrition, physical activity, and pharmacotherapy should include both disorders, referred to as osteosarcopenia.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Osteoporose , Sarcopenia , Calcifediol/sangue , Dieta , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Exercício Físico , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/fisiopatologia , Masculino , Desnutrição/fisiopatologia , Terapia Nutricional , Osteoporose/tratamento farmacológico , Osteoporose/etiologia , Osteoporose/terapia , Sarcopenia/tratamento farmacológico , Sarcopenia/etiologia , Sarcopenia/terapia , Deficiência de Vitamina D/etiologia
7.
World J Surg Oncol ; 19(1): 8, 2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33430881

RESUMO

BACKGROUND: The long-term physiological consequences of SARS-CoV-2 (severe acute respiratory syndrome coronavirus) infection are not known. The ability of COVID-19 to cause chronic illness, sarcopenia, and physical deconditioning may be underestimated and go beyond the anticipated respiratory sequelae. Myalgia, lethargy, and anorexia are common symptoms even in mild to moderate cases and have the potential to exacerbate frailty. How this impacts on risk-stratification for patients requiring surgery for time-critical conditions, such as malignancy, requires further urgent investigation. MAIN BODY: The deleterious effect of sarcopenia and poor physical capacity are well recognised in cancer surgery. This review commentary highlights current evidence which suggests skeletal muscle as an under recognised cause of COVID-19-related functional deconditioning. The mechanisms behind this are via direct (viral induced myositis, nutritional decline, cytokine-mediated myopathy) and indirect mechanisms (social isolation, inactivity, and psychological consequences). CONCLUSION: Further mechanistic research is required to explore the processes behind the deconditioning effects of SARS-CoV-2 infection and how this impacts on treatment of malignant disease.


Assuntos
/complicações , Neoplasias/cirurgia , Desempenho Físico Funcional , Sarcopenia/etiologia , /fisiopatologia , Humanos , Mialgia/etiologia , Procedimentos Cirúrgicos Operatórios/efeitos adversos
8.
J Nutr Health Aging ; 25(1): 64-70, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33367464

RESUMO

BACKGROUND: In older patients, sarcopenia is a prevalent disease associated with negative outcomes. Sarcopenia has been investigated in patients undergoing transcatheter aortic valve implantation (TAVI), but the criteria for diagnosis of the disease are heterogeneous. This systematic review of the current literature aims to evaluate the prevalence of sarcopenia in patients undergoing TAVI and to analyse the impact of sarcopenia on clinical outcomes. METHODS: A comprehensive search of the literature has been performed in electronic databases from the date of initiation until March 2020. Using a pre-defined search strategy, we identified studies assessing skeletal muscle mass, muscle quality and muscle function as measures for sarcopenia in patients undergoing TAVI. We evaluated how sarcopenia affects the outcomes mortality at ≥1 year, prolonged length of hospital stay, and functional decline. RESULTS: We identified 18 observational studies, enrolling a total number of 9'513 patients. For assessment of skeletal muscle mass, all included studies used data from computed tomography. Cut-off points for definition of low muscle mass were heterogeneous, and prevalence of sarcopenia varied between 21.0% and 70.2%. In uni- or multivariate regression analysis of different studies, low muscle mass was found to be a significant predictor of mortality, prolonged length of hospital stay, and functional decline. No interventional study was identified measuring the effect of nutritional or physiotherapy interventions on sarcopenia in TAVI patients. CONCLUSIONS: Sarcopenia is highly prevalent among patients undergoing TAVI, and negatively affects important outcomes. Early diagnosis of this condition might allow a timely start of nutritional and physiotherapy interventions to prevent negative outcomes in TAVI patients.


Assuntos
Sarcopenia/etiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Fatores de Risco , Sarcopenia/patologia , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
9.
Am J Clin Oncol ; 44(2): 74-81, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33350681

RESUMO

BACKGROUND: Sarcopenia and inflammation are independently associated with worse survival in cancer patients. This study aims to determine the impact of sarcopenia, body mass index (BMI), and inflammatory biomarkers on survival in advanced hepatocellular carcinoma (HCC) patients treated with anti-PD-1 antibody-based immunotherapy. METHODS: A retrospective review of advanced HCC patients treated with immunotherapy at Winship Cancer Institute between 2015 and 2019 was performed. Baseline computed tomography and magnetic resonance images were collected at mid-L3 level, assessed for skeletal muscle density using SliceOmatic (TomoVision, version 5.0) and converted to skeletal muscle index (SMI) by dividing it by height (m2). Sex-specific sarcopenia was defined by the median value of SMI. The optimal cut for continuous inflammation biomarker was determined by bias-adjusted log-rank test. Overall survival (OS) was set as primary outcome and Cox proportional hazard model was used for association with survival. RESULTS: A total of 57 patients were included; 77.2% male, 52.6% Caucasian, 58.5% Eastern Cooperative Oncology Group performance status 0-1, 80.7% Child Pugh A. Treatment was second line and beyond in 71.9% of patients. The median follow-up time was 6 months. Sarcopenia cut-off for males and females was SMI of 43 and 39, respectively. 49.1% of patients had sarcopenia. Median OS was 5 versus 14.3 months in sarcopenic versus nonsarcopenic patients (Log-rank P=0.054). Median OS was 5 and 17.5 months in patients with BMI <25 and BMI ≥25, respectively (Log-rank P=0.034). Median OS was 3.6 and 14.3 months for patients with neutrophil-to-lymphocyte ratio (NLR) ≥5.15 versus NLR <5.15 (Log-rank P<0.001). In multivariable Cox regression model, higher baseline NLR was associated with worse OS (hazard ratio [HR]: 4.17, 95% confidence interval [CI]: 1.52-11.39, P=0.005). Sex-specific sarcopenia showed a trend of worse OS (HR: 1.71, 95% CI: 0.73-4.00, P=0.215) but was not statistically significant. BMI<25 was associated with worse OS (HR: 2.28, 95% CI: 0.92-5.65, P=0.076). In the association with progression free survival, neither baseline BMI nor sex-specific sarcopenia showed statistical significance. CONCLUSION: After controlling for baseline Child Pugh score and NLR, sex-specific sarcopenia does not predict OS. Baseline BMI and NLR together may predict OS in advanced HCC patients treated with anti-PD-1 antibody.


Assuntos
Biomarcadores/sangue , Carcinoma Hepatocelular/terapia , Imunoterapia/métodos , Neoplasias Hepáticas/terapia , Sarcopenia/etiologia , Idoso , Antígeno B7-H1/antagonistas & inibidores , Antígeno B7-H1/imunologia , Índice de Massa Corporal , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Inflamação/etiologia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Estudos Retrospectivos , Sarcopenia/mortalidade
14.
Medicine (Baltimore) ; 99(42): e22769, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080746

RESUMO

BACKGROUND: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) in early rehabilitation of patients with postoperative complications after cardiovascular surgery. METHODS: 37 patients (25 men and 12 women) aged 45 to 70 years with postoperative complications after cardiovascular surgery were included in the study. Eighteen patients underwent NMES daily since postoperative day 3 until discharge in addition to standard rehabilitation program (NMES group), and 19 patients underwent standard rehabilitation program only (non-NMES group). The primary outcome was the knee extensors strength at discharge in NMES group and in control. Secondary outcomes were the handgrip strength, knee flexor strength, and cross-sectional area (CSA) of the quadriceps femoris in groups at discharge. RESULTS: Baseline characteristics were not different between the groups. Knee extensors strength at discharge was significantly higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45 [22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1] and 22.5 [20.1; 25.9] kg, respectively; P < .001). Handgrip strength, knee flexor strength, quadriceps CSA, and 6 minute walk distance at discharge in the groups had no significant difference. CONCLUSIONS: This pilot study shows a beneficial effect of NMES on muscle strength in patients with complications after cardiovascular surgery. The use of NMES showed no effect on strength of non-stimulated muscle, quadriceps CSA, and distance of 6-minute walk test at discharge.Further blind randomized controlled trials should be performed with emphasis on the effectiveness of NEMS in increasing muscle strength and structure in these patients.


Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Terapia por Estimulação Elétrica , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Sarcopenia/prevenção & controle , Idoso , Reabilitação Cardíaca , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Projetos Piloto , Sarcopenia/etiologia , Teste de Caminhada
15.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(7): 486-492, ago.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194705

RESUMO

Se revisan los aspectos básicos del metabolismo de la creatina/creatinina y la íntima relación entre la creatinina y la masa muscular, lo que la convierte en un marcador bioquímico de ésta. Se hace énfasis en la utilidad pronóstica actual, tanto de la baja excreción urinaria de creatinina como de los niveles bajos de creatinina sérica, en diferentes contextos clínicos en los que la sarcopenia probablemente desempeña un papel importante en la morbilidad y mortalidad


A review is made of the basic aspects of creatine/creatinine metabolism and the close relationship between creatinine and muscle mass, which makes the former a biochemical marker of the latter. Emphasis is placed on the current prognostic value of both the low urinary excretion of creatinine and low serum creatinine levels in different clinical settings in which sarcopenia probably plays a significant role in morbidity and mortality


Assuntos
Humanos , Sarcopenia/diagnóstico , Doenças Musculares/diagnóstico , Avaliação Nutricional , Creatinina/sangue , Creatinina/urina , Creatinina/metabolismo , Atividade Motora , Músculo Esquelético , Biomarcadores/sangue , Biomarcadores/urina , Sarcopenia/etiologia
16.
Rev. cuba. salud pública ; 46(3): e1105, jul.-set. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144554

RESUMO

Introducción: El progresivo envejecimiento poblacional se estima a nivel mundial como un indicador de mejora de la salud. No obstante, al vivir más años se le asocian problemas sanitarios que se van posicionando en el tiempo, y uno de ellos es la sarcopenia, la que se considera una condición común en los adultos mayores y se asocia a la inactividad física, baja resistencia, baja velocidad de marcha y disminución de la movilidad. Estos factores contribuyen a un aumento del riesgo de caída y a una disminución de la funcionalidad y de la calidad de vida. Objetivo: Mostrar evidencia actualizada respecto a los resultados del entrenamiento de fuerza con restricción parcial del flujo sanguíneo en población adulto mayor con sarcopenia, como estrategia costo-efectiva para la dependencia asociada al envejecimiento. Métodos: Se realizó una búsqueda en bases de datos científicas EBSCOhost, ScienceDirect, Web of Science y en el buscador PubMed. Se utilizaron los siguientes términos de búsqueda: entrenamiento con restricción parcial del flujo sanguíneo, sarcopenia, adulto mayor. Los artículos analizados incluyeron revisiones y artículos de investigación, principalmente ensayos clínicos controlados y revisiones sistemáticas con metanálisis. Conclusiones: El entrenamiento con restricción parcial del flujo sanguíneo en el adulto mayor surge como una herramienta útil para intervenir en la sarcopenia asociada al envejecimiento, constituyendo una alternativa para inducir la ganancia de fuerza muscular, con la disminución de los riesgos del entrenamiento de alta intensidad. Además, es una técnica económica y fácil de implementar en centros de salud de asistencia masiva(AU)


Introduction: Progressive population aging is estimated globally as an indicator of health improvement. However, when living is extended, health issues appear; one of them is sarcopenia, which is consider a common condition in older adults and it is associated to physical inactivy, low resistance, low walk speed and a decrease in mobility. These factors contribute to an increase of falls risk and to a decrease of functionality and life quality. Objective: To show updated evidence on the results of the strength training with partial restriction of blood flow in older adults populations with sarcopenia, as a cost-effective strategy for dependence associated to aging. Methods: Search was done in scientific databases as EBSCOhost, ScienceDirect, Web of Science and PubMed searcher. Following terms were used: training with partial restriction of blood flow, sarcopenia, older adult. The analyzed articles included reviews and research articles, mainly controlled clinical trials and systematic reviews with meta-analysis. Conclusions: Training with partial restriction of the blood flow in older adults emerges as an useful tool to intervene in sarcopenia associated to aging, being an alternative to induce muscle force´s gain, and decreasing the risks of high intensity training. In addition, it is an economic and easy to implement technique in health centers with massive audiences(AU)


Assuntos
Humanos , Masculino , Feminino , Envelhecimento/fisiologia , Sarcopenia/etiologia , Idoso/fisiologia
17.
J Stroke Cerebrovasc Dis ; 29(9): 105017, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807432

RESUMO

OBJECTIVE: Intervention for treating sarcopenia is of great concern in clinical settings. The aim of this study was to investigate the relationship between changes in skeletal muscle mass and functional outcomes in patients with sarcopenia after stroke. METHODS: A retrospective cohort study of stroke patients with sarcopenia consecutively admitted to a single center's convalescent rehabilitation wards was conducted from 2015 to 2018. Sarcopenia was defined as a loss of skeletal muscle mass index (SMI) with bioelectrical impedance and decreased muscle strength as measured by handgrip strength; cut-off values were adopted from the 2019 Asian Working Group for Sarcopenia. Changes in SMI during hospitalization were measured. Outcomes included the motor domain of Functional Independence Measure at discharge and its gain. Multivariate analysis determined whether the changes in SMI were associated with these outcomes. RESULTS: During the study period, 272 stroke patients were enrolled. Of those, 120 patients (44%) (mean age 79 years, 70 females) were diagnosed with sarcopenia. The mean (SD) for changes in SMI was 0.2 (0.5) kg/m2. Multiple linear regression analysis showed that changes in SMI were significantly associated with Functional Independence Measure - motor at discharge (ß=0.175, P=0.003) and Functional Independence Measure - motor gain (ß=0.247, P=0.003). CONCLUSIONS: Muscle mass gain may be positively associated with functional recovery in patients with sarcopenia after stroke. Exercise and nutritional therapy to increase skeletal muscle mass, in addition to conventional stroke rehabilitation, is needed for these patients.


Assuntos
Composição Corporal , Músculo Esquelético/fisiopatologia , Sarcopenia/fisiopatologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Impedância Elétrica , Feminino , Força da Mão , Humanos , Masculino , Tamanho do Órgão , Recuperação de Função Fisiológica , Estudos Retrospectivos , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
18.
J Pediatr ; 223: 93-99.e2, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32711755

RESUMO

OBJECTIVE: To investigate the association between muscle mass and liver disease severity in pediatric patients with non-alcoholic fatty liver disease (NAFLD). STUDY DESIGN: This was a retrospective study of patients aged <20 years followed from 2009 to 2018. Muscle mass was estimated in all patients by measuring magnetic resonance imaging-based total psoas muscle surface area (tPMSA) and correcting for height (tPMSA index = tPMSA/height2). Two cohorts were studied, one with histological confirmation of NAFLD (n = 100) and the other with magnetic resonance imaging (MRI) evidence of hepatic steatosis (n = 236). Histology was scored using Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) criteria. MRI-measured proton density fat fraction (PDFF) and liver stiffness were collected. Demographic, clinical, and socioeconomic status (using a validated Community Deprivation Index [CDI]) were assessed as covariates. Univariate regression analyses, followed by multivariable regression analyses, were used to determine the relationships between tPMSA index and NAS, MRI-PDFF, and liver stiffness, adjusting for clinical, demographic, and CDI variables. RESULTS: In the multivariable regression analyses, higher steatosis score was associated with a lower tPMSA index (OR, 0.73; 95% CI, 0.56-0.96) and younger age (OR, 0.84; 95% CI, 0.73-0.97). Liver PDFF was also significantly associated with the tPMSA index (P = .029), sex (P = .019), and CDI (P = .005). In contrast, liver stiffness was not associated with tPMSA in multivariable analyses. CONCLUSIONS: tPMSA index was independently associated with both imaging and histological features of hepatic steatosis severity in children. Future studies should directly explore the presence and directionality of causative links between muscle mass and steatosis, as well as whether interventions that enhance muscle mass can reduce disease severity in children with NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica/patologia , Músculos Psoas/patologia , Sarcopenia/diagnóstico , Adolescente , Adulto , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Músculos Psoas/diagnóstico por imagem , Estudos Retrospectivos , Sarcopenia/etiologia , Sarcopenia/patologia , Índice de Gravidade de Doença , Adulto Jovem
19.
Anticancer Res ; 40(8): 4271-4279, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32727754

RESUMO

BACKGROUND/AIM: Skeletal muscle mass (SMM) is often depleted in patients with gastric cancer undergoing gastrectomy. Using a novel method, we evaluated the effect of SMM depletion after gastrectomy on disease prognosis. PATIENTS AND METHODS: The maximum cross-sectional area of the psoas-muscle (MCA-PM) was measured before surgery and at 1 year after in 233 patients with gastric cancer who underwent radical gastrectomy to determine the ratio (MCA-PMR) as an indicator of SMM depletion. RESULTS: The MCA-PMR cutoff value was set at 90%, and patients were divided into the groups with <90% and ≥90%. MCA-PMR <90% was an independent prognostic factor for all patients. In 88 patients who received adjuvant chemotherapy including S-1, the 5-year cancer-specific survival rate was significantly better for those with MCA-PMR ≥90% than for those with MCA-PMR <90% (84.1% vs. 59.1%; p=0.010; hazard ratio=2.974; 95% confidence interval=1.241-7.124). CONCLUSION: SMM depletion after gastrectomy can be measured using the MCA-PMR. This novel measurement can be easily implemented in the clinical setting.


Assuntos
Gastrectomia/efeitos adversos , Músculo Esquelético/patologia , Sarcopenia/etiologia , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Sarcopenia/patologia , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Adulto Jovem
20.
J Cancer Res Clin Oncol ; 146(11): 2967-2978, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32507973

RESUMO

PURPOSE: This study investigated the frequency and characteristics of sarcopenia among patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a specific focus on the chronic graft-versus-host disease (cGVHD) population and its association with malnutrition, vitamin D and clinical characteristics. METHODS: We assessed sarcopenia, vitamin D levels, and nutritional status in 73 patients who underwent allo-HSCT, of which 45 were diagnosed with cGVHD. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. RESULTS: Sarcopenia was diagnosed in 19.2% of patients after allo-HSCT with statistically no significant difference between cGVHD and non-cGVHD patients. The risk factor for sarcopenia was the male gender. Sarcopenia in allo-HSCT patients correlated strongly with malnutrition and with current corticosteroid treatment (p < 0.005). Among cGVHD patients sarcopenia additionally correlated strongly with the number of prior systemic immunosuppressive therapy lines (p < 0.005) and moderately with the intensity of immunosuppression, cGVHD severity global rating assessed by both the health care provider and the patient and joint and fascia cGVHD involvement (p < 0.05). Vitamin D deficiency was found in more than 54.8% of patients, but the correlation to sarcopenia was not found. CONCLUSION: Sarcopenia was found to be common in long term survivors of allo-HSCT independently of the cGVHD diagnosis. Prospective longitudinal studies are needed for a better understanding of factors affecting the development of sarcopenia after allo-HSCT.


Assuntos
Doença Enxerto-Hospedeiro/epidemiologia , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Sarcopenia/epidemiologia , Adulto , Idoso , Aloenxertos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Sarcopenia/etiologia , Vitamina D/sangue , Adulto Jovem
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