Wallengren Ola, Iresjö Britt-Marie, Lundholm Kent, Bosaeus Ingvar
Department of Endocrinology, Diabetology and Metabolism, Sahlgrenska University Hospital, Dietistmotagningen, Per Dubbsgatan 14, 413 45, Gothenburg, Sweden,
Support Care Cancer. 2015 Jan;23(1):79-86. doi: 10.1007/s00520-014-2332-y. Epub 2014 Jul 1.
Muscle mass depletion is associated with adverse outcomes in cancer patients. There is limited information on the impact of age, sex, tumor type, and inflammation on muscle loss in the end of life of cancer patients.
Muscle depletion and loss of muscle in the last 2 years of life was estimated in 471 cancer patients from 779 dual-energy X-ray absorptiometry scans. A linear mixed model was used to estimate the impact of age, sex, tumor type, and inflammation.
Patients above median age (>71 years) had less muscle mass (-1.1 ± 0.3 kg, P < 0.001). Prevalence of muscle depletion was higher in men than women (59 vs. 28%, P < 0.001). Men lost muscle mass over time (mean, 1.4 ± 0.3 kg/year, P < 0.001) contrary to women (0.3 ± 0.4 kg/year, P = 0.5). Patients with pancreatic cancer had less muscle mass than patients with biliary tract and colorectal cancers (P < 0.02). There were no differences in muscle loss over time in patients grouped by median age or tumor type. The prevalence of elevated C-reactive protein was 61 to 70% during the study. Patients with C-reactive protein >10 mg/L had less muscle mass (0.6 ± 0.2 kg, P < 0.001) and lost muscle mass at an accelerated pace during the disease trajectory (0.7 ± 0.3 kg/year, P = 0.03).
Muscle loss in advanced cancer is related to age, sex, tumor type, and inflammation. The mechanism(s) behind the apparent sexual dimorphism warrants further study.
肌肉量减少与癌症患者的不良预后相关。关于年龄、性别、肿瘤类型和炎症对癌症患者临终时肌肉丢失的影响，相关信息有限。
通过779次双能X线吸收测定扫描，对471例癌症患者生命最后2年的肌肉消耗和肌肉丢失情况进行了评估。采用线性混合模型来评估年龄、性别、肿瘤类型和炎症的影响。
年龄中位数以上（>71岁）的患者肌肉量较少（-1.1±0.3千克，P<0.001）。男性肌肉消耗的患病率高于女性（59%对28%，P<0.001）。男性随时间推移肌肉量减少（平均每年1.4±0.3千克，P<0.001），而女性则相反（每年0.3±0.4千克，P=0.5）。胰腺癌患者的肌肉量低于胆管癌和结直肠癌患者（P<0.02）。按年龄中位数或肿瘤类型分组的患者，随时间推移肌肉丢失情况无差异。在研究期间，C反应蛋白升高的患病率为61%至70%。C反应蛋白>10毫克/升的患者肌肉量较少（0.6±0.2千克，P<0.001），且在疾病发展过程中肌肉量加速减少（每年0.7±0.3千克，P=0.03）。
晚期癌症患者的肌肉丢失与年龄、性别、肿瘤类型和炎症有关。明显的性别差异背后的机制值得进一步研究。
