Systematic review of sarcopenia in chronic pancreatitis: prevalence, impact on surgical outcomes, and survival

Bundred, James; Thakkar, Rohan; Pandanaboyana, Sanjay

doi:10.1080/17474124.2022.2091544

Cited by 12 publications

(11 citation statements)

References 41 publications

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“…Sarcopenia has been associated with lower survival and increased hospitalisation in CP patients [33]. Even though no evidence has so far been presented that sarcopenia is related to a higher complication rate in CP patients, a connection to failure to overcome complications related to surgery has been reported [34][35][36]. Sarcopenia in CP could be due to malnutrition and assessment and prevention of this needs to a focal point in treatment of CP [37].…”

Section: Discussionmentioning

confidence: 99%

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Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

et al. 2023

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Purpose Chronic pancreatitis (CP) leads to diabetes and pancreatic exocrine insufficiency (PEI). PEI may lead to maldigestion and malnutrition, which may cause fat-soluble vitamin deficiency, sarcopenia and abnormal bone density. We aim to study the prevalence of osteoporosis, sarcopenia and vitamin deficiency among CP patients. Methods Long-term (4–5 years) follow-up was implemented on CP patients. We recorded CP duration, BMI, smoking, alcohol consumption and medication. We determined the serum values for A, D and E vitamins, albumin, creatinine, haemoglobin, calcium and magnesium. Bone density measurement was taken from the proximal femur and lumbar spine. CT/MRI scans were used to measure for psoas muscle area. Results A total of 33 patients (median age 62 [39–81] years, 61% male) were included. None of these patients had earlier diagnosis of osteopathy, and none of them had known vitamin deficiency or were sarcopenic. Nineteen patients (57%) had pancreatic exocrine insufficiency and of these seven patients (37%) had no pancreatic enzyme replacement therapy (PERT) and one (5%) had inadequate enzyme therapy. During the study, osteoporosis was diagnosed in 20% and possible sarcopenia in 48% of patients. PEI and inadequate PERT was associated with low E vitamin levels (75% vs. 0%, p = 0.012), higher risk of osteoporosis (43% vs. 5.6%, p = 0.013) and sarcopenia (80% vs. 36%, p = 0.044). Conclusion This study demonstrates that chronic pancreatitis is associated with osteoporosis, sarcopenia and vitamin deficiency. If untreated, pancreatic exocrine insufficiency is associated with increased risk of these outcomes. This highlights the importance of identifying and treating PEI in CP patients.

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Section: Discussionmentioning

confidence: 99%

“…Whether this represents overall sarcopenia remains beyond the scope of this study. We used imaging CT/MRI imaging to asses possible sarcopenia which still remains the primary modality for assessment of sarcopenia due to availability and ease of use [49] and it is still considered a practical method of assessing sarcopenia [50].…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

et al. 2023

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“…The definitions published all demonstrate a consensus requiring low skeletal muscle mass and loss of muscle strength/function in the diagnosis. Utilisation of CT has been described in the literature for evaluating sarcopenia, however use of modalities such as whole-body dual-energy X-ray absorptiometry, bioelectrical impedance and functional tests such as grip dynamometry have also been described[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…There has been little in the way of studies exploring the prevalence of sarcopenia in these patients so far. However, this topic is the subject of increasing research interest in the last few years, with recent reviews estimating the prevalence of sarcopenia amongst chronic pancreatitis patients to be between 17-62%[ 3 , 6 ]. In this patient group, sarcopenia was significantly associated with reduced quality of life, reduced survival, increased hospitalisation and worse surgical outcomes in patients undergoing total pancreatectomy with islet autotransplantation[ 4 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…This has prompted various publications from independent groups such as; the European Working Group on Sarcopenia in Older People (EWGSOP), diagnosis. Utilisation of CT has been described in the literature for evaluating sarcopenia, however use of modalities such as whole-body dual-energy X-ray absorptiometry, bioelectrical impedance and functional tests such as grip dynamometry have also been described 3 .…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenia: An Assessment into the Prevalence and Disease Burden in Chronic Pancreatitis Patients

Oyebola¹,

Mavilakandy²,

Stephenson³

et al. 2023

JFSF

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Objectives: To evaluate the prevalence of sarcopenia in patients referred to a Multidisciplinary Chronic Pancreatitis (CP) Clinic at the University Hospitals of Leicester. Methods: All patients who had undergone CT scans were identified. Controls were identified from CT colonograms with no features of malignancy or pancreatic pathology. The psoas muscle index (PMI) was calculated using the formula: total psoas muscle cross-sectional area at the third lumbar vertebral level (cm 2 )/ the patient’s height squared (m 2 ). PMI cut-offs were <6.31cm 2 /m 2 and <3.91cm 2 /m 2 for males and females, respectively. Results: 58 CP CT scans were available for analysis along with 62 control scans. 71.9% of CP patients had a PMI below the cut-off for their gender, compared to 45.2% of the controls. The mean PMI (±SD) for male CP patients and male controls were 5.54cm 2 /m 2 (±1.60) and 6.73 cm 2 /m 2 (±1.54), ( P =0.0023). The mean PMI (±SD) for female CP patients and female controls were 3.82 cm 2 /m 2 (+/-1.46) and 4.98 cm 2 /m 2 (+/-1.43), ( P =0.0021). Conclusions: CP patients had a mean PMI below the cut-off value, suggesting that CP patients are largely sarcopenic. As malnutrition is a significant feature of CP, optimisation of nutrition may help to ameliorate sarcopenia in CP patients.

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Skeletal muscle mass and function are affected by pancreatic atrophy, pancreatic exocrine insufficiency and poor nutritional status in patients with chronic pancreatitis

Matsumoto,

Kikuta,

Takikawa

et al. 2024

Pancreatology

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Systematic review of sarcopenia in chronic pancreatitis: prevalence, impact on surgical outcomes, and survival

Cited by 12 publications

References 41 publications

Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

Sarcopenia: An Assessment into the Prevalence and Disease Burden in Chronic Pancreatitis Patients

Skeletal muscle mass and function are affected by pancreatic atrophy, pancreatic exocrine insufficiency and poor nutritional status in patients with chronic pancreatitis

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