Risk of Sarcopenia Identified by Sarc-Calf, Nutritional Status and Hand Grip Strength in Patients with Hematological Cancer
Abstract
Background: Hematological cancer patients are prone to the development of sarcopenia and impaired nutritional and functional status. SARC-CalF is a screening tool for the risk of sarcopenia that has shown good results in this population. This study aimed to identify the risk of sarcopenia by SARC-CalF and to verify its association with nutritional status and Hand Grip Strength (HGS) in patients with hematological cancer.
Materials and Methods: Adult patients, of both sexes, with hematological cancer, and in outpatient care participated in the study. We measured the Hand Grip Strength of the Dominant Hand (HGSD) and the Adductor Pollicis Muscle Thickness of the Dominant Hand (APMTD). Moreover, we applied the Patient-Generated Subjective Global Assessment (PG-SGA) and SARC-CalF. Data were analyzed with SPSS® software, 22.0, with a significance level of 5.0%.
Results: Fifty-one patients aged an average of 60.4 ± 15.1 years were evaluated. Of those, 58.8% were elderly, 51% female, and 80.4% declared themselves non-white. The predominant diagnosis was Mature B Lymphoid Cell Neoplasia (37.7%), and 60.8% of the patients had a diagnosis time of ≤ 3 years. PG-SGA revealed that 35.3% of the patients were malnourished; APMTD and HGSD revealed that 60.8% and 25.5% had reduced muscle strength, respectively. SARC-CalF exposed that 39.2% of the patients were at risk for sarcopenia. Significant associations were found between SARC-CalF and diagnosis time ≤ 3 years (p = 0.039), PG-SGA (p = 0.020), APMTD (p = 0.039) and HGSD (p = 0.002). After binary logistic regression adjusted for age and sex, the reduced HGSD remained associated with the risk of sarcopenia.
Conclusion: SARC-CalF identified a risk of sarcopenia in 39.2% of patients. The reduced HGSD was associated with the risk of sarcopenia.
2. Morishita S, Kaida K, Tanaka T, et al. Prevalence of sarcopenia and relevance of body composition, physiological function, fatigue, and health-related quality of life in patients before allogeneic hematopoietic stem cell transplantation. Support Care Cancer. 2012; 20(12):3161–8.
3. Krawczyk J, Kraj L, Korta T, et al. Nutritional Status of Hematological Patients before Hematopoietic Stem Cell Transplantation and in Early Posttransplantation Period. Nutr Cancer. 2017; 69(8):1205–10.
4. Camargo C de Q, Borges D da S, Oliveira PF de, et al. Individuals with Hematological Malignancies Before Undergoing Chemotherapy Present Oxidative Stress Parameters and Acute Phase Proteins Correlated with Nutritional Status. Nutr Cancer. 2015; 67(3):463–71.
5. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48(4):601.
6. Luna EB, Guzmán LIO, Hernández LO, et al. Estado nutricio en pacientes de primer ingreso a hospitalización del Servicio de Hematología del Instituto Nacional de Cancerología. Nut Hosp. 2013; 28(4):1259–65.
7. Gonzalez MC, Borges LR, Silveira DH, et al. Validation of a Portuguese version of patient-generated subjective global assessment. Rev Bras Nutr Clin. 2010; 25:102–8.
8. Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15(2):95-101.
9. Humphreys J, de la Maza P, Hirsch S, et al. Muscle Strength as a Predictor of Loss of Functional Status in Hospitalized Patients. Nutrition. 2002; 18(7-8):616-20.
10. Ibrahim K, May C, Patel HP, et al. A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol. Pilot Feasibility Stud. 2016; 2:27.
11. Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015; 386(9990): 266–73.
12. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017; 36(1):11-48.
13. Valente KP, Almeida BL, Lazzarini TR, et al. Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients. PLoS One. 2019;14(8): e0220334.
14. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013; 14(8):531–2.
15. Barbosa-Silva TG, Menezes AMB, Bielemann RM, et al. Enhancing SARC-F: improving sarcopenia screening in the clinical practice. J Am Med Dir Assoc. 2016; 17912):1136–41.
16. Urzi F, Šimunič B, Buzan E. Basis for sarcopenia screening with the SARC-CalF in nursing homes. J Am Med Dir Assoc. 2017; 18(11): 991.e5-991.e10.
17. OPAS. Organização Pan-Americana. XXXVI Reunión Del Comitê Asesor de Investigaciones en Salud – Encuestra Multicêntrica – Salud Beinestar y Envejecimeiento (SABE) en América Latina e el Caribe, https://www.sciepub.com/reference/230256; 2002 [accessed 06 November 2020].
18 .Fess EE, Morgan C. Grip strength. In: Chicago JS (ed). Clinical assessment recommendations, 2nd ed. Chicago: American Society of Hand Therapist, 1992, pp. 41–45.
19. Lameu EB, Gerude MF, Corrêa RC, et al. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin Fac Med Sao Paulo. 2004;59(2):57-62.
20. Bragagnolo R, Caporossi FS, Dock-Nascimento DB, et al. [Adductor pollicis muscle thickness: a fast and reliable method for nutritional assessment in surgical patients]. Rev Col Bras Cir. 2009; 36(5):371-6.
21. Tanaka S, Imataki O, Kitaoka A, et al. Clinical impact of sarcopenia and relevance of nutritional intake in patients before and after allogeneic hematopoietic stem cell transplantation. J Cancer Res Clin Oncol. 2017; 143(6):1083–92.
22. Lin RJ, Michaud L, Lobaugh SM, et al. The Geriatric Syndrome of Sarcopenia Impacts Allogeneic Hematopoietic Cell Transplantation Outcomes in Older Lymphoma Patients. Leuk Lymphoma. 2020; 61(8):1833–41.
23. Williams A, Baruah S, Patel J, et al. Prevalence and significance of sarcopenia in multiple myeloma patients undergoing autologous hematopoietic cell transplantation. Bone Marrow Transplant. 2021; 56(1):225-231.
24. Morishita S. Prevalence of sarcopenia in cancer patients: review and future directions. Int J Phys Med Rehabil. 2016; 4(3):1000342.
25. Souza VF, Ribeiro TSC, Marques RA, et al. SARC-Calf risk of sarcopenia and associated factors in cancer patients. Nutr Hosp. 2020;37(6):1173-1178.
26. Rodrigues BC, Sales AEC, Rodrigues BC, et al. Evaluation of nutritional risk in hospitalized oncohematologic patients. Rev Bras Cancerol. 2019;65(1):e-01266.
27. Hébuterne X, Lemarié E, Michallet M, et al. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014; 38(2):196–204.
28. Silva TC, Silva PO, Morais DS, et al. Functional capacity, lung function, and muscle strength in patients undergoing hematopoietic stem cell transplantation: A prospective cohort study. Hematol Oncol Stem Cell Ther. 2021;14(2):126-133.
29. Pulido AL, Zúñiga AES, Madrid TPT, et al. Prevalence of nutritional alterations in cancer patients in a third level hospital. Nutr clín diet hosp. 2018; 38(1):90-6.
30. José Alencar Gomes da Silva National Cancer Institute (INCA). National Consensus on Oncological Nutrition. 2a ed. Rio de Janeiro: INCA; 2016.
31. Rechinelli AB, Marques IL, Viana ECRM, et al. Presence of dynapenia and association with anthropometric variables in cancer patients. BMC Cancer. 2020; 20(1):1010.
32. Luz MCL, Pinho CPS, Bezerra GKA, et al. SARC-F and SARC-CalF in screening for sarcopenia in older adults with Parkinson’s disease. Exp Gerontol. 2021:144:111183.
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Issue | Vol 18 No 2 (2024) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijhoscr.v18i2.15370 | |
Keywords | ||
Nutritional statu Muscle strength Nutritional risk Sarcopenia |
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