Clinic of Internal Medicine, Ministry of Health Serik State Hospital, 07500, Antalya, Turkey.
Department of Internal Medicine, University of Health Sciences, İstanbul Training and Research Hospital, 34098, Fatih, Istanbul, Turkey.
BMC Cancer. 2023 Sep 28;23(1):911. doi: 10.1186/s12885-023-11423-y.
Sarcopenic obesity arises from increased muscle catabolism triggered by inflammation and inactivity. Its significance lies in its role in contributing to morbidity and mortality in gastric cancer. This study aims to explore the potential correlation between sarcopenia, sarcopenic obesity, and gastric cancer, as well as their effect on survival.
This retrospective study included 162 patients aged ≥ 18 years who were diagnosed with stomach cancer. Patient age, gender, diagnostic laboratory results, and cancer characteristics were documented. Sarcopenia was assessed using the skeletal muscle index (SMI) (cm2/m2), calculated by measuring muscle mass area from a cross-sectional image at the L3 vertebra level of computed tomography (CT).
Among the 162 patients, 52.5% exhibited sarcopenia (with cut-off limits of 52.4 cm2/m2 for males and 38.5 cm2/m2 for females), and 4.9% showed sarcopenic obesity. Average skeletal muscle area (SMA) was 146.8 cm2; SMI was 50.6 cm2/m2 in men and 96.9 cm2 and 40.6 cm2/m2 in women, respectively. Sarcopenia significantly reduced mean survival (p = 0.033). There was no association between sarcopenic obesity and mortality (p > 0.05), but mortality was higher in sarcopenic obesity patients (p = 0.041). Patient weight acted as a protective factor against mortality, supporting the obesity paradox. Tumor characteristics, metabolic parameters, and concurrent comorbidities did not significantly impact sarcopenia or mortality.
Sarcopenia is more prevalent in the elderly population and is linked to increased mortality in gastric cancer patients. Paradoxically, higher body mass index (BMI) was associated with improved survival. Computed tomography offers a practical and reliable method for measuring muscle mass and distinguishing these distinctions.
This study was approved by Istanbul Training and Research Hospital Clinical Research Ethics Committee of the University of Health Sciences (29.05.2020/2383).
肌肉减少性肥胖是由炎症和不活动引起的肌肉分解代谢增加引起的。其意义在于它在导致胃癌发病率和死亡率方面的作用。本研究旨在探讨肌肉减少症、肌肉减少性肥胖与胃癌之间的潜在相关性及其对生存的影响。
本回顾性研究纳入了 162 名年龄≥18 岁的被诊断患有胃癌的患者。记录了患者的年龄、性别、诊断实验室结果和癌症特征。使用骨骼肌指数（SMI）（cm2/m2）评估肌肉减少症，通过 CT 测量第 3 腰椎水平的横断面图像上的肌肉质量面积来计算。
在 162 名患者中，52.5%存在肌肉减少症（男性的截止值为 52.4 cm2/m2，女性为 38.5 cm2/m2），4.9%存在肌肉减少性肥胖。平均骨骼肌面积（SMA）为 146.8 cm2；男性 SMI 为 50.6 cm2/m2，女性分别为 96.9 cm2 和 40.6 cm2/m2。肌肉减少症显著降低了平均生存时间（p=0.033）。肌肉减少性肥胖与死亡率之间无关联（p>0.05），但肌肉减少性肥胖患者的死亡率更高（p=0.041）。患者体重是死亡率的保护因素，支持肥胖悖论。肿瘤特征、代谢参数和并存的合并症与肌肉减少症或死亡率无显著关系。
肌肉减少症在老年人群中更为普遍，与胃癌患者的死亡率增加有关。具有讽刺意味的是，较高的体重指数（BMI）与生存改善相关。CT 提供了一种实用可靠的测量肌肉质量和区分这些差异的方法。
本研究得到伊斯坦布尔培训和研究医院大学健康科学临床研究伦理委员会的批准（2020 年 5 月 29 日/2383）。
