Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
College of Public Health, Zhengzhou University, Zhengzhou, China.
Nutrition. 2023 Oct;114:112107. doi: 10.1016/j.nut.2023.112107. Epub 2023 May 27.
Although previous studies have implicated the negative outcomes of sarcopenia, evidence is limited to one or a few types of cancer. The aim of this study was to evaluate the distribution and influencing factors of sarcopenia, and explore the relationship between sarcopenia and cancer prognosis in a large oncological population.
This observational cohort study included patients diagnosed with malignant cancer between May 2011 and January 2019. Hematologic and anthropometric parameters were collected prospectively. Low skeletal muscle mass and radiodensity were diagnosed using clinical indicators, according to the two prediction models. The importance of potential risk factors for sarcopenia was estimated by subtracting the predicted degrees of freedom from the partial χ statistic. Hazard rates of death were calculated using the hazard function and Cox regression analyses.
We included 13 761 patients with cancer; the prevalence of sarcopenia was 33%. The median age was 58 y and 7135 patients (52%) were men. Patients with sarcopenia had a worse nutritional status and quality of life than those without sarcopenia. Age was the most important risk factor for sarcopenia compared with body mass index or TNM stage. Additionally, patients with sarcopenia had a significantly higher and earlier peak risk for mortality. After adjusting for baseline characteristics, sarcopenia was independently associated with mortality in the research population (hazard ratio, 1.429; P < 0.001) and most cancer types.
Age is the most important risk factor for sarcopenia even in patients with cancer. Sarcopenia is strongly associated with a poor quality of life and reduced overall survival.
尽管先前的研究表明肌肉减少症存在负面结果，但证据仅限于一种或几种类型的癌症。本研究旨在评估肌肉减少症的分布和影响因素，并在大型肿瘤患者群体中探索肌肉减少症与癌症预后之间的关系。
本观察性队列研究纳入了 2011 年 5 月至 2019 年 1 月期间被诊断患有恶性肿瘤的患者。前瞻性收集血液学和人体测量参数。使用临床指标根据两种预测模型诊断低骨骼肌质量和放射密度。通过从偏 χ 统计中减去预测自由度来估计潜在的肌肉减少症危险因素的重要性。使用风险函数和 Cox 回归分析计算死亡的危险率。
我们纳入了 13761 例癌症患者；肌肉减少症的患病率为 33%。中位年龄为 58 岁，7135 例患者（52%）为男性。与无肌肉减少症的患者相比，有肌肉减少症的患者的营养状况和生活质量更差。与 BMI 或 TNM 分期相比，年龄是肌肉减少症最重要的危险因素。此外，有肌肉减少症的患者的死亡率峰值更高且更早。在调整基线特征后，肌肉减少症与研究人群的死亡率（危险比，1.429；P<0.001）和大多数癌症类型独立相关。
即使在癌症患者中，年龄也是肌肉减少症最重要的危险因素。肌肉减少症与生活质量差和总生存期缩短密切相关。
