Muscle strength is a stronger prognostic factor than muscle mass in patients with gastrointestinal and hepatobiliary pancreatic cancers
Muscle strength is a stronger prognostic factor than muscle mass in patients with gastrointestinal and hepatobiliary pancreatic cancers
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对于胃肠道癌和肝胆胰腺癌患者，肌肉力量是比肌肉质量更强的预后因素
DOI：
10.1016/j.nut.2022.111826
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发表时间：
2022
期刊：
影响因子：
4.4
通讯作者：
Hamada Yasuhiro
中科院分区：
文献类型：
--
作者：
Nasu Nanami;Yasui-Yamada Sonoko;Kagiya Natsumi;Takimoto Mami;Kurokawa Yumiko;Tani-Suzuki Yoshiko;Kashihara Hideya;Saito Yu;Nishi Masaaki;Shimada Mitsuo;Hamada Yasuhiro
目的肌少症已被报道为胃肠道（GI）和肝胆胰（HBP）癌患者的预后危险因素。本研究旨在探讨肌肉质量或力量的损失是否是一个更强的预后因素，并探讨基于GI和HBP癌症患者生存结局的骨骼肌质量指数（SMI）和握力（HGS）的临界值。方法回顾性分析480例老年原发性胃肠道和高血压癌患者的首次手术资料。患者分为四组：适当的SMI和HGS组，单独低SMI组，单独低HGS组，低SMI和HGS组。低SMI来自生物电阻抗分析，低HGS是根据亚洲肌肉减少症工作组2019年的标准定义的。结果多因素分析显示，低SMI仅是男性死亡的重要危险因素，而低HGS在两性中均有显著性意义。从四组的多变量分析来看，单独低HGS和低SMI和HGS在两性中的风险比均明显高于适当的SMI和HGS。根据男性3年生存结果，SMI为7.21 kg/m2， HGS为28 kg作为临界值。结论低肌力是较低肌量更强的预后因素。因此，测量所有患者的肌肉力量是必要的。
ObjectivesSarcopenia has been reported as a prognostic risk factor in patients with gastrointestinal (GI) and hepatobiliary pancreatic (HBP) cancers. This study aimed to investigate whether the loss of muscle mass or strength is a stronger prognostic factor, and explore the cutoff values of skeletal muscle mass index (SMI) and handgrip strength (HGS) based on the survival outcome in patients with GI and HBP cancers.MethodsA total of 480 elderly patients with primary GI and HBP cancers who underwent their first resection surgery were analyzed retrospectively. Patients were divided into four groups: Appropriate SMI and HGS, low SMI alone, low HGS alone, and low SMI and HGS. Low SMI was derived from a bioelectrical impedance analysis, and low HGS was defined according to the Asian Working Group for Sarcopenia 2019 criteria.ResultsThe multivariate analysis showed that low SMI was a significant risk factor for mortality in men only, but low HGS was significant in both sexes. From the multivariate analysis of the four groups, low HGS alone and low SMI and HGS showed a significantly higher hazard ratio than appropriate SMI and HGS in both sexes. An SMI of 7.21 kg/m2and HGS of 28 kg were obtained as cutoff values based on the 3-y survival outcomes in men.ConclusionsLow muscle strength was a stronger prognostic factor than low muscle mass. Therefore, measuring muscle strength in all patients is essential.