Sarcopenia and cachexia in the era of obesity: clinical and nutritional impact

Prado, Carla M.; Cushen, S.; Orsso, Camila E.; Ryan, Aoife M.

doi:10.1017/s0029665115004279

Cited by 239 publications

(201 citation statements)

References 77 publications

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“…For example, protein and energy needs are often determined based on body weight, yet, considering lean mass drives protein requirements, people with the same body weight can receive varying amounts of protein per unit of lean mass (LST), a concept previously explored [40, 41]. In the selected example on Figure 1(b), if protein requirements were assessed as 1 g/kg actual body weight (116 kg), the estimated amount of dietary protein would be equivalent to 1.6 to 2.2 g/kg LST.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

Johnson-Stoklossa

Sharma

Forhan

et al. 2017

Journal of Nutrition and Metabolism

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Background/Objective. Sarcopenic obesity (SO) is a hidden condition of reduced lean soft tissue (LST) in context of excess adiposity. SO is most commonly reported in older adults and both its risk and prevalence increase with age. A variety of body composition indices and cut points have been used to define this condition, leading to conflicting prevalence and risk prediction. Here, we investigate variability in the prevalence of SO in an adult sample of individuals with class II/III obesity (BMI ≥ 35 kg/m2) using different diagnostic criteria. Methods. SO definitions were identified from a literature review of studies using dual-energy X-ray absorptiometry (DXA) to assess LST. Demographics, anthropometrics, and body composition (by DXA) were measured in n = 120, 86% female (46.9 ± 11.1 years). Results. LST was extremely variable in individuals, even with similar body sizes, and observed across the age spectrum. The prevalence of SO ranged from 0 to 84.5% in females and 0 to 100% in males, depending upon the definition applied, with higher prevalence among definitions accounting for measures of body size or fat mass. Conclusion. SO is present, yet variable, in adults with class II/III obesity. Accounting for body mass or fat mass may identify a higher number of individuals with SO, although risk prediction remains to be studied.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

Johnson-Stoklossa

Sharma

Forhan

et al. 2017

Journal of Nutrition and Metabolism

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“…Body composition characteristics, such as skeletal muscle and visceral fat, are considered to be prognostic factors for various diseases, including cancer [10]. In particular, sarcopenia has been reported to be an independent predictor of survival in patients with lung, gastrointestinal, pancreatic, and colorectal cancer as well as HCC [11-15].…”

Section: Introductionmentioning

confidence: 99%

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

et al. 2018

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Background: Sorafenib is a standard therapy for patients with advanced hepatocellular carcinoma (HCC). However, no predictive biomarkers of sorafenib efficacy have been discovered. Herein, we investigated the impact of body composition, such as skeletal muscle and visceral fat, on the prognosis of advanced HCC patients treated with sorafenib. Methods: We enrolled 100 patients with advanced HCC treated with sorafenib. Prior to receiving sorafenib therapy, skeletal muscle index (SMI) and visceral fat area (VFA) were measured using computed tomography at the third lumbar vertebra and umbilical level, respectively. Muscle depletion was defined as an SMI value < 42 cm²/m² in men and < 38 cm²/m² in women. High VFA (H-VFA) was defined as a value ≥100 cm². In addition to SMI and VFA, we also analyzed various clinical parameters as potential prognostic factors. Results: Multivariate analysis showed that having a tumor number < 7 (hazard ratio [HR] = 0.409, p < 0.001), absence of extrahepatic spread (EHS) (HR = 0.562, p < 0.001), absence of muscle depletion (HR = 0.498, p = 0.006), and H-VFA (HR = 0.556, p = 0.031) were significant factors for long-term survival. Therefore, we evaluated the prognosis of those with no muscle depletion with H-VFA. The no muscle depletion with H-VFA group showed significantly longer survival than the other group (median survival time 15.6 vs. 11.0 months, p = 0.003). Multivariate analysis showed that having a tumor number < 7 (HR = 0.454, p = 0.001), absence of EHS (HR = 0.511, p = 0.008), and no muscle depletion with H-VFA (HR = 0.454, p = 0.002) were significant predictors of survival. Conclusions: We identified no muscle depletion with H-VFA as a novel biomarker for advanced HCC patients treated with sorafenib.

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“…The association between sarcopenia and decreased survival has been studied most extensively in patients with various forms of cancer, who may be uniquely affected by cancer cachexia and toxicity from chemo-therapy [1, 11]. However, little is known about any association between sarcopenia and overall survival in patients with osteoporotic hip fractures, even though the mortality rates among elderly patients with hip fractures are higher than those for many forms of cancer (e.g., breast cancer) [12].…”

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confidence: 99%

CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

Boutin

Bamrungchart

Bateni

et al. 2017

American Journal of Roentgenology

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OBJECTIVE Our objective was to determine the association between muscle cross-sectional area and attenuation, as measured on routine CT scans, and mortality in older patients with hip fracture. MATERIALS AND METHODS A retrospective 10-year study of patients with hip fracture was conducted with the following inclusion criteria: age 65 years or older, first-time hip fracture treated with surgery, and CT of the chest, abdomen, or pelvis. This yielded 274 patients (70.4% women; mean [± SD] age, 81.3 ± 8.3 years). On each CT scan, two readers independently measured the size (cross-sectional area, indexed for patient height) and attenuation of the paravertebral muscle at T12 and the psoas muscle at L4. We then determined the association between overall mortality and the muscle size and muscle attenuation, while adjusting for demographic variables (age, sex, ethnicity, and body mass index), American Society of Anesthesiologists (ASA) classification, and Charlson comorbidity index (CCI). RESULTS The overall mortality rate increased from 28.3% at 1 year to 79.5% at 5 years. Mortality was associated with decreased thoracic muscle size (odds ratio [OR], 0.66; 95% CI, 0.49–0.87). This association persisted after adjusting for demographic variables (OR, 0.69; 95% CI, 0.50–0.95), the ASA classification (OR, 0.70; CI, 0.51–0.97), and the CCI (OR, 0.72; 95% CI, 0.52–1.00). Similarly, decreased survival was associated with decreased thoracic muscle attenuation after adjusting for all of these combinations of covariates (OR, 0.67–0.72; 95% CI, 0.49–0.99). Decreased lumbar muscle size and attenuation trended with decreased survival but did not reach statistical significance. CONCLUSION In older adults with hip fractures, CT findings of decreased thoracic paravertebral muscle size and attenuation are associated with decreased overall survival.

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Sarcopenia and cachexia in the era of obesity: clinical and nutritional impact

Cited by 239 publications

References 77 publications

Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

Prevalence of Sarcopenic Obesity in Adults with Class II/III Obesity Using Different Diagnostic Criteria

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

CT of Patients With Hip Fracture: Muscle Size and Attenuation Help Predict Mortality

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