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Am J Clin Nutr. 2019 Mar 1;109(3):615-625. doi: 10.1093/ajcn/nqy328.

The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer.

Author information

1
Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science.
2
Division of Research, Kaiser Permanente Northern California, Oakland, CA.
3
Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
4
Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Sarcopenia and low skeletal muscle radiodensity (SMD) have been associated with adverse outcomes in patients with colorectal cancer (CRC); however, factors contributing to these 2 muscle abnormalities are unclear.

OBJECTIVES:

The aim of this study was to investigate the association of medical and demographic characteristics with muscle abnormalities among patients with nonmetastatic CRC.

METHODS:

Patients with stage I-III invasive CRC (2006-11) who had diagnostic computed tomography (CT) available from Kaiser Permanente Northern California electronic medical records were included. CT-assessed sarcopenia and low SMD were defined according to optimal stratification. Logistic regressions including age, stage, site, total adipose tissue (TAT), race/ethnicity, neutrophil-lymphocyte ratio, smoking history, alcohol use, and Charlson Comorbidity Score were performed to identify characteristics associated with muscle abnormalities.

RESULTS:

The study included 3262 patients (49.9% females) with a mean ± SD age of 62.6 ± 11.4 y. Sarcopenia and low SMD were highly prevalent (42.4% and 29.6%, respectively). Age and sex interactions were noted for muscle mass, but not SMD. Age was associated with higher odds of muscle abnormalities in a dose-response manner. Compared with those aged ≤50 y, patients aged 70-80 y had considerably higher odds (OR: 6.19; 95% CI: 4.72, 8.11) of sarcopenia, and low SMD (OR: 17.81; 95% CI: 11.73, 27.03). High TAT was related to a higher odds of low SMD (OR: 9.62; 95% CI: 7.37, 12.56), but lower odds of sarcopenia (OR: 0.59; 95% CI: 0.48, 0.71). Compared with Caucasians, African Americans had lower odds of sarcopenia and low SMD. Patients with a higher neutrophil-lymphocyte ratio had higher odds of having both muscle abnormalities. Patients who were smokers or had any comorbidity had higher odds of low SMD, but not sarcopenia.

CONCLUSIONS:

Muscle abnormalities were common in patients with nonmetastatic CRC, with great variability in muscle mass and SMD across age, TAT, and race/ethnicity. Factors associated with muscle abnormalities may be used to facilitate risk stratification and the guidance of targeted strategies to counteract these abnormalities.

KEYWORDS:

adiposity; computed tomography (CT); inflammation; muscle radiodensity; nonmetastatic colorectal cancer; race/ethnicity; sarcopenia

PMID:
30850836
PMCID:
PMC6408202
[Available on 2020-03-01]
DOI:
10.1093/ajcn/nqy328

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