BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatme...BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatment.However,previous research reported widely differing sarcopenia prevalence due to different criteria.AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.METHODS An observational study was conducted from July 2014 to January 2017,which included 648 consecutive gastric cancer patients who underwent radical gastrectomy.The sarcopenia elements(skeletal muscle index,handgrip strength,and gait speed)were measured within 1 mo or 7 d before surgery.The patients were followed at fixed intervals to gain the outcomes.Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately.The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index(C-index)and area under the time-dependent receiver operating characteristic curve(AUC).The Akaike information criterion(AIC)was applied to compare model fits.RESULTS The prevalence of sarcopenia was 20.5%and 11.3%according to AWGS2019 and EWGSOP2,respectively.Sarcopenia was an independent risk factor for the longterm OS no matter based on AWGS2019 or EWGSOP2,but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio(HR)[2.150(1.547-2.988)]than EWGSOP2-sarcopenia[HR 1.599(1.092-2.339)].Meanwhile,the model with AWGS2019-sarcopenia[C-index 0.773(0.742-0.804);AIC 2193.7;time-dependent AUC 0.812(0.756-0.867)for 1-year OS,0.815(0.778-0.852)for 3-year OS,and 0.809(0.759-0.859)for 5-year OS]had better predictive power and model fits than the model with EWGSOP2-sarcopenia[C-index 0.762(0.729-0.795);AIC 2215.2;timedependent AUC 0.797(0.741-0.854)for 1-year OS,0.804(0.767-0.842)for 3-year OS,and 0.799(0.748-0.850)for 5-year OS].CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy.The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia.AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.展开更多
Background and Objectives:The Asian Working Group for Sarcopenia(AWGS)recommended various measures for identifying patients with possible sarcopenia in its 2019 consensus.The present survey aimed to assess older adult...Background and Objectives:The Asian Working Group for Sarcopenia(AWGS)recommended various measures for identifying patients with possible sarcopenia in its 2019 consensus.The present survey aimed to assess older adults in a senior home to determine the prevalence and associated factors for possible sarcopenia and to compare the differences between various assessment pathways based on AWGS 2019 criteria.Methods and Study Design:This cross-sectional study examined 583 participants of a senior home.Patients with possible sarcopenia were determined through the following four pathways:[Ⅰ]calf circumference(CC)+handgrip strength(HGS);[Ⅱ]SARC-F+HGS;(Ⅲ)SARC-CalF+HGS;and(Ⅳ)CC,SARC-F,and/or SARC-CalF+HGS.Results:The four assessment pathways revealed a high prevalence of possible sarcopenia in the older adults in the senior home([Ⅰ]=50.6%;[Ⅱ]=46.8%;[Ⅲ]=48.2%;[Ⅳ]=65.9%).There is significant difference in prevalence between pathway IV and the other pathways(p<0.001).A multivariate analysis revealed that advanced age,risk of malnutrition,malnutrition,high level of care,an exercise frequency of<3 times per week,and osteoporosis were correlated with a higher risk of possible sarcopenia.By contrast,oral nutritional supplements(ONS)reduced the risk of possible sarcopenia.Conclusions:This survey reported a high prevalence of possible sarcopenia in the older adults of the senior home and determined the associated influencing factors.Furthermore,our findings suggested that pathwayⅣis the most suitable pathway for the examined older adults which enabled the detection and early intervention of more possible sarcopenia.展开更多
基金Supported by Zhejiang Provincial Health Department Medical Support Discipline-Nutrition,No.11-ZC24Wenzhou Municipal Science and Bureau,No.Y2020732.
文摘BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatment.However,previous research reported widely differing sarcopenia prevalence due to different criteria.AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.METHODS An observational study was conducted from July 2014 to January 2017,which included 648 consecutive gastric cancer patients who underwent radical gastrectomy.The sarcopenia elements(skeletal muscle index,handgrip strength,and gait speed)were measured within 1 mo or 7 d before surgery.The patients were followed at fixed intervals to gain the outcomes.Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately.The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index(C-index)and area under the time-dependent receiver operating characteristic curve(AUC).The Akaike information criterion(AIC)was applied to compare model fits.RESULTS The prevalence of sarcopenia was 20.5%and 11.3%according to AWGS2019 and EWGSOP2,respectively.Sarcopenia was an independent risk factor for the longterm OS no matter based on AWGS2019 or EWGSOP2,but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio(HR)[2.150(1.547-2.988)]than EWGSOP2-sarcopenia[HR 1.599(1.092-2.339)].Meanwhile,the model with AWGS2019-sarcopenia[C-index 0.773(0.742-0.804);AIC 2193.7;time-dependent AUC 0.812(0.756-0.867)for 1-year OS,0.815(0.778-0.852)for 3-year OS,and 0.809(0.759-0.859)for 5-year OS]had better predictive power and model fits than the model with EWGSOP2-sarcopenia[C-index 0.762(0.729-0.795);AIC 2215.2;timedependent AUC 0.797(0.741-0.854)for 1-year OS,0.804(0.767-0.842)for 3-year OS,and 0.799(0.748-0.850)for 5-year OS].CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy.The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia.AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
基金supported by the National Nutrition Science Research Grant(grant number:CNS-NNSRG2019-253)the Shanghai Municipal Health System Important and Weak Discipline(Clinical Nutrition)Project(grant number:2019ZB0102).
文摘Background and Objectives:The Asian Working Group for Sarcopenia(AWGS)recommended various measures for identifying patients with possible sarcopenia in its 2019 consensus.The present survey aimed to assess older adults in a senior home to determine the prevalence and associated factors for possible sarcopenia and to compare the differences between various assessment pathways based on AWGS 2019 criteria.Methods and Study Design:This cross-sectional study examined 583 participants of a senior home.Patients with possible sarcopenia were determined through the following four pathways:[Ⅰ]calf circumference(CC)+handgrip strength(HGS);[Ⅱ]SARC-F+HGS;(Ⅲ)SARC-CalF+HGS;and(Ⅳ)CC,SARC-F,and/or SARC-CalF+HGS.Results:The four assessment pathways revealed a high prevalence of possible sarcopenia in the older adults in the senior home([Ⅰ]=50.6%;[Ⅱ]=46.8%;[Ⅲ]=48.2%;[Ⅳ]=65.9%).There is significant difference in prevalence between pathway IV and the other pathways(p<0.001).A multivariate analysis revealed that advanced age,risk of malnutrition,malnutrition,high level of care,an exercise frequency of<3 times per week,and osteoporosis were correlated with a higher risk of possible sarcopenia.By contrast,oral nutritional supplements(ONS)reduced the risk of possible sarcopenia.Conclusions:This survey reported a high prevalence of possible sarcopenia in the older adults of the senior home and determined the associated influencing factors.Furthermore,our findings suggested that pathwayⅣis the most suitable pathway for the examined older adults which enabled the detection and early intervention of more possible sarcopenia.
