Posgraduate Program in Physical Education, Health Sciences Center, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil; Onofre Lopes University Hospital, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Postgraduate Program in Health and Behaviour of the Universidade Católica de Pelotas, Pelotas, RS, Brazil.
Exp Gerontol. 2019 Oct 1;125:110688. doi: 10.1016/j.exger.2019.110688. Epub 2019 Aug 9.
Worsening nutritional status in older adult cancer patients can lead to sarcopenia, a condition that occurs with low quantity or quality of muscle mass associated with low physical function. However, most of the studies with cancer patients have only analyzed the quantity of muscle mass for diagnostic of sarcopenia, without exploring muscle characteristics and physical function. The purpose of the present study is to explore the associations between muscle mass characteristics and physical function in older adult patients with cancer.
Gastric older cancer patients were enrolled in a cross-sectional study. Computed tomography images of the abdominal region evaluated skeletal muscle mass using the Slice-O-Matic version 5.0 Software program (Tomovision, Montreal, Canada) to determine the parameters of skeletal muscle index (SMI, muscle quantity) and skeletal muscle radiodensity (SMD). The physical function was evaluated through handgrip strength and gait speed test. Four musculature phenotypes were identified: normal SMI and SMD, only low SMI, only low SMD, and low SMI and SMD. Linear regression analyses adjusted by age and tumor stage verified the associations between SMI, SMD and physical function. A One-Way Covariance Analysis with Bonferroni post hoc test was used to compare the physical function variables among the four different phenotypes.
In total, 167 patients were evaluated (58.1% males; mean age 69.17 ± 7.97 years). The results showed that muscle mass characteristics explains, at least partially, the variability in handgrip strength and gait speed in a direct relationship. The phenotypes with low muscular SMI and/or SMD presented worse performances in handgrip strength and gait speed tests. When stratified for sexes, the significant difference occurs only in males.
Low SMD has negatively impacted physical function in older adults with gastrointestinal cancer, especially in males.
老年癌症患者营养状况恶化可导致肌肉减少症，这种情况发生于肌肉质量减少或质量下降，同时伴有身体功能降低。然而，大多数针对癌症患者的研究仅分析了肌肉质量的数量来诊断肌肉减少症，而没有探讨肌肉特征和身体功能。本研究的目的是探讨老年癌症患者肌肉质量特征与身体功能之间的关系。
纳入了患有胃癌的老年癌症患者进行横断面研究。使用 Slice-O-Matic 版本 5.0 软件程序（Tomovision，蒙特利尔，加拿大）对腹部区域的计算机断层扫描图像进行评估，以确定骨骼肌指数（SMI，肌肉量）和骨骼肌密度（SMD）的参数。通过握力和步态速度测试评估身体功能。确定了四种肌肉表型：正常的 SMI 和 SMD、仅低 SMI、仅低 SMD 和低 SMI 和 SMD。通过年龄和肿瘤分期进行调整的线性回归分析验证了 SMI、SMD 与身体功能之间的关系。使用单向方差分析（One-Way Covariance Analysis）和 Bonferroni 事后检验比较了四种不同表型之间的身体功能变量。
共评估了 167 名患者（58.1%为男性；平均年龄 69.17±7.97 岁）。结果表明，肌肉质量特征至少部分解释了握力和步态速度的变异性，呈直接关系。肌肉 SMI 和/或 SMD 低的表型在手握力和步态速度测试中的表现较差。按性别分层时，仅在男性中存在显著差异。
低 SMD 对胃肠道癌症老年患者的身体功能有负面影响，特别是对男性。
