Kyomen Momoko, Tatsumi Ayako, Tsutsumi Rie, Izumi-Mishima Yuna, Hyodo Mizusa, Tanaka Eiji, Iguchi Kohta, Taura Kojiro, Terajima Hiroaki, Honjo Sachiko, Hamasaki Akihiro, Nomura Kazuhiro, Sakaue Hiroshi
Department of Nutrition and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan.
Department of Nutrition, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, Osaka 530-8480, Japan.
Int J Mol Sci. 2025 Feb 26;26(5):2026. doi: 10.3390/ijms26052026.
Perioperative malnutrition is common in patients with gastroenterological cancer and contributes to postoperative skeletal muscle atrophy, which adversely affects their prognosis. Early assessment of skeletal muscle atrophy is crucial for improving postoperative outcomes. This study aimed to evaluate the efficacy of urinary titin as a biomarker for skeletal muscle atrophy. A prospective observational study was conducted, and a total of 34 gastroenterological cancer patients were included. Urinary titin levels were measured using ELISA at admission, postoperative days (POD) 1, 7, and 14, and at 6 months after surgery. Surgical procedure, operative time, cancer stage, postoperative complications, hospital stay, and preoperative and postoperative body composition were evaluated, along with nutritional status and grip strength from admission to 6 months after surgery. Changes in urinary titin levels were measured at the same time points as described above. Preoperatively, the mean urinary titin level was 5.03 pmol/mg Cr, slightly higher than in healthy subjects. Urinary titin peaked at 33.71 (24.30-66.58) pmol/mg/dL Cr on POD1 and was associated with serum free branched-chain amino acid concentrations. Urinary titin on POD1 was significantly correlated with a decrease in skeletal muscle mass (rs -0.361, = 0.036) and body cell mass (rs -0.361, = 0.038) at 6 months postoperatively. The grip strength at 6 months postoperatively tended to decrease (rs -0.342, = 0.052). BMI and serum LDH at admission were associated with urinary titin on POD1 but were not correlated with skeletal muscle loss at 6 months, suggesting that urinary titin on POD1 is an independent biomarker of skeletal muscle atrophy. These data indicate that urinary titin on POD1 can predict long-term skeletal muscle atrophy.
围手术期营养不良在胃肠癌患者中很常见，会导致术后骨骼肌萎缩，对患者预后产生不利影响。早期评估骨骼肌萎缩对于改善术后结局至关重要。本研究旨在评估尿肌联蛋白作为骨骼肌萎缩生物标志物的有效性。进行了一项前瞻性观察研究，共纳入34例胃肠癌患者。在入院时、术后第1天、第7天和第14天以及术后6个月，使用酶联免疫吸附测定法（ELISA）测量尿肌联蛋白水平。评估手术方式、手术时间、癌症分期、术后并发症、住院时间以及术前和术后身体成分，同时评估从入院到术后6个月的营养状况和握力。在上述相同时间点测量尿肌联蛋白水平的变化。术前，尿肌联蛋白平均水平为5.03 pmol/mg Cr，略高于健康受试者。尿肌联蛋白在术后第1天达到峰值，为33.71（24.30 - 66.58）pmol/mg/dL Cr，且与血清游离支链氨基酸浓度相关。术后第1天的尿肌联蛋白与术后6个月骨骼肌质量的减少（rs -0.361，P = 0.036）和体细胞质量的减少（rs -0.361，P = 0.038）显著相关。术后6个月的握力有下降趋势（rs -0.342，P = 0.052）。入院时的体重指数（BMI）和血清乳酸脱氢酶（LDH）与术后第1天的尿肌联蛋白相关，但与术后6个月的骨骼肌丢失无关，这表明术后第1天的尿肌联蛋白是骨骼肌萎缩的独立生物标志物。这些数据表明术后第1天的尿肌联蛋白可以预测长期骨骼肌萎缩。
