Frailty is associated with myosteatosis in obese patients with colorectal cancer

Souza, Naiara Maria de; Gonzalez, Maria Cristina; Martucci, Renata Brum; Rodrigues, V.D.; Pinho, Nivaldo Barroso de; Avesani, Carla María

doi:10.1016/j.clnu.2019.02.026

Cited by 23 publications

(20 citation statements)

References 39 publications

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“…Published literature has shown that myosteatosis is positively associated with the increased severity of the patient's disease, longer hospital stays, more complications, earlier postoperative recurrence, and worse prognosis [ 19 , [21] , [22] , [23] , [24] , [25] ]. Recent studies have reported that myosteatosis was often associated with a weak physical state of the patients [ 20 , 21 ], and may contribute to an increased risk of developing severe symptoms [ 33 ] and viral pneumonia [ 24 ]. We speculate that the patients with myosteatosis in our cohort implicated relatively poor physical fitness, thus being more susceptible to severe COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

“…Myosteatosis indicating fat deposition inside the muscles is defined as abnormal distribution of inter and intra-myocellular adipose tissue, which is related to reduced muscle quality, physical fitness and muscle function [ [19] , [20] , [21] ]. Computed tomography (CT) is one of common methods for accessing myosteatosis with a radiological marker termed skeletal muscle radiation attenuation (SM-RA) [ [21] , [22] , [23] ].…”

Section: Introductionmentioning

confidence: 99%

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Myosteatosis predicting risk of transition to severe COVID-19 infection

Liu

Zhu

et al. 2022

Clinical Nutrition

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Background About 10–20% of patients with Coronavirus disease 2019 (COVID-19) infection progressed to severe illness within a week or so after initially diagnosed as mild infection. Identification of this subgroup of patients was crucial for early aggressive intervention to improve survival. The purpose of this study was to evaluate whether computer tomography (CT) - derived measurements of body composition such as myosteatosis indicating fat deposition inside the muscles could be used to predict the risk of transition to severe illness in patients with initial diagnosis of mild COVID-19 infection. Methods Patients with laboratory-confirmed COVID-19 infection presenting initially as having the mild common-subtype illness were retrospectively recruited between January 21, 2020 and February 19, 2020. CT-derived body composition measurements were obtained from the initial chest CT images at the level of the twelfth thoracic vertebra (T12) and were used to build models to predict the risk of transition. A myosteatosis nomogram was constructed using multivariate logistic regression incorporating both clinical variables and myosteatosis measurements. The performance of the prediction models was assessed by receiver operating characteristic (ROC) curve including the area under the curve (AUC). The performance of the nomogram was evaluated by discrimination, calibration curve, and decision curve. Results A total of 234 patients were included in this study. Thirty-one of the enrolled patients transitioned to severe illness. Myosteatosis measurements including SM-RA (skeletal muscle radiation attenuation) and SMFI (skeletal muscle fat index) score fitted with SMFI, age and gender, were significantly associated with risk of transition for both the training and validation cohorts (P < 0.01). The nomogram combining the SM-RA, SMFI score and clinical model improved prediction for the transition risk with an AUC of 0.85 [95% CI, 0.75 to 0.95] for the training cohort and 0.84 [95% CI, 0.71 to 0.97] for the validation cohort, as compared to the nomogram of the clinical model with AUC of 0.75 and 0.74 for the training and validation cohorts respectively. Favorable clinical utility was observed using decision curve analysis. Conclusion We found CT-derived measurements of thoracic myosteatosis to be associated with higher risk of transition to severe illness in patients affected by COVID-19 who presented initially as having the mild common-subtype infection. Our study showed the relevance of skeletal muscle examination in the overall assessment of disease progression and prognosis of patients with COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Myosteatosis predicting risk of transition to severe COVID-19 infection

Liu

Zhu

et al. 2022

Clinical Nutrition

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“…It is also primordial to evaluate muscle fat infiltration beyond assessing muscle mass, as myosteatosis is related to shorter survival in patients with cancer cachexia [4,73]. Thus, we evaluated skeletal muscle fat infiltration as an indicator of muscle quality, by measuring muscle TAG and the gene expression of proteins involved with fatty acid uptake and storing.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, skeletal muscle TAG was positively associated with the lumbar AT index measured by CT analysis, showing that increased adiposity was associated with muscle lipid content. Myosteatosis has been observed in patients with colorectal cancer and is positively associated with BMI, total adiposity and AT depots evaluated by CT analysis [73].…”

Section: Discussionmentioning

confidence: 99%

Myokines in treatment-naïve patients with cancer-associated cachexia

et al. 2021

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Cancer-associated cachexia is a complex metabolic syndrome characterized by weight loss and systemic inflammation. Muscle loss and fatty infiltration into muscle are associated with poor prognosis in cancer patients. Skeletal muscle secretes myokines, factors with autocrine, paracrine and/or endocrine action, which may be modified by or play a role in cachexia. This study examined myokine content in the plasma, skeletal muscle and tumor homogenates from treatment-naïve patients with gastric or colorectal stages I-IV cancer with cachexia (CC, N ¼ 62), or not (weight stable cancer, WSC, N ¼ 32). Myostatin, interleukin (IL) 15, follistatin-like protein 1 (FSTL-1), fatty acid binding protein 3 (FABP3), irisin and brain-derived neurotrophic factor (BDNF) protein content in samples was measured with Multiplex technology; body composition and muscle lipid infiltration were evaluated in computed tomography, and quantification of triacylglycerol (TAG) in the skeletal muscle. Cachectic patients presented lower muscle FSTL-1 expression (p ¼ 0.047), higher FABP3 plasma content (p ¼ 0.0301) and higher tumor tissue expression of FABP3 (p ¼ 0.0182), IL-15 (p ¼ 0.007) and irisin (p ¼ 0.0110), compared to WSC. Neither muscle TAG content, nor muscle attenuation were different between weight stable and cachectic patients. Lumbar adipose tissue (AT) index, visceral AT index and subcutaneous AT index were lower in CC (p ¼ 0.0149, p ¼ 0.0455 and p ¼ 0.0087, respectively), who also presented lower muscularity in the cohort (69.2% of patients; p ¼ 0.0301), compared to WSC. The results indicate the myokine profile in skeletal muscle, plasma and tumor is impacted by cachexia. These findings show that myokines eventually affecting muscle wasting may not solely derive from the muscle itself (as the tumor also may

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“…These findings may be influenced by reduced muscle mass and increased body fat, which occur throughout the aging process and with excess weight gain, in addition to changes in body composition in patients with cancer [42,43,44]. Reductions in muscle strength, mass, and function are usually attributable to a decrease in muscle size; however, evidence has shown a new scenario, known as myosteatosis, characterized by fat infiltration into the muscle [43,45,46].…”

Section: Discussionmentioning

confidence: 99%

Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients

et al. 2019

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Background and aim Malnutrition is common in patients with cancer, and its early diagnosis can reduce or prevent further complications and improve the clinical and nutritional prognosis. Adductor Pollicis Muscle Thickness (APMT) and Handgrip Strength have been explored in this population to identify a reduction in strength and muscle mass prior to the use of conventional methods. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA). Methods A cross-sectional study was conducted with 80 patients diagnosed with cancer who were candidates for surgery. Nutritional status was obtained from the PG-SGA. Conventional anthropometric measurements were taken, as well as APMT and Handgrip Strength. Pearson’s correlation analysis and multivariate linear regression were applied to detect the influence of variables on APMT and HGS. A significance level of 5.0% was considered. Results A high prevalence of malnutrition and the need for dietotherapic intervention was found, identified by the PG-SGA. Correlations between APMT and Handgrip Strength with anthropometric variables and with the PG-SGA score were observed. After regression adjustments, the variables that interacted with APMT were TSF and AC, and the PG-SGA score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength. Conclusion Correlations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention.

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Frailty is associated with myosteatosis in obese patients with colorectal cancer

Cited by 23 publications

References 39 publications

Myosteatosis predicting risk of transition to severe COVID-19 infection

Myosteatosis predicting risk of transition to severe COVID-19 infection

Myokines in treatment-naïve patients with cancer-associated cachexia

Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients

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