SARC-F has low correlation and reliability with skeletal muscle mass index in older gastrointestinal cancer patients.

BACKGROUND & AIMS: The evaluation of function and muscle mass in older cancer patients is essential to reduce comorbidities. We hypothesized that Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC-F) questionnaire is useful to assessment the muscle function, but not muscle mass. Thus, the purpose of this study was to evaluate the correlation and reliability between the SARC-F and skeletal muscle mass index (SMI) in older gastrointestinal cancer patients. METHODS: A cross-sectional observational study enrolled 108 (63.55 ± 8.9 y) gastrointestinal cancer patients. The patients were evaluated using the SARC-F questionnaire and the muscle mass index (SMI). SMI was calculated using Lee's equation: the appendicular muscle mass (ASM) was divided by height. Pearson's correlation was used to examine the correlation between SARC-F and SMI. The Bland-Altman plot and Cohen's kappa coefficient were used to determine the concordance and reliability between them. Statistical difference was set at p < 0.05. RESULTS: The Bland-Altman plot showed that the difference between methods were within agreement (±1.96; p = 0.001). However, SARC-F has low concordance (κ = 0.20; standard error = 0.14) and correlation (r = -0.303; p = 0.0014) with SMI. CONCLUSION: In older cancer outpatients, we found that SARC-F has low correlation and reliability with SMI.

A high-protein diet, not isolated BCAA, is associated with skeletal muscle mass index in patients with gastrointestinal cancer.

OBJECTIVES: Patients with cancer are susceptible to experiencing the loss of skeletal muscle mass. Thus, the purpose of this study was to evaluate whether a high-protein diet (HPD) or isolated branched-chain amino acid (BCAA) intake is associated with an increased skeletal muscle mass index (SMI) in patients with cancer of the gastrointestinal tract. METHODS: This cross-sectional, observational study included 106 patients with gastrointestinal tract tumors. Food consumption was estimated using 24-h food recall. Patients were divided into two groups: a low-protein diet (LPD) group (≤1.2 g · kg · d-1) and a high-protein diet (HPD) group (>1.2 g · kg · d-1). Appendicular muscle mass (ASM) was calculated using Lee's formula, and its values were divided by the square of the height of the patient to obtain SMI values. Differences were considered significant when the probability they occurred by chance was <5% (P < 0.05). RESULTS: Of 106 patients assessed, 69 (65%) consumed a diet consistent with specifications of the LPD group and 37 (35%) consumed a diet consistent with HPD intake. Logistic regression after adjusting for sex and caloric and carbohydrate consumption showed an association between SMI and HPD (odds ratio, 4.19; 95% confidence interval, 1.06-16.56; P < 0.001) but not with BCAA. Daily total protein intake, but not isolated BCAA or leucine, was able to predict an increase in SMI in 43% of patients considered (P = 0.006). Thus, HPD was associated with SMI, and total protein intake was a better predictor of SMI than BCAAs. CONCLUSION: HPD is a cost-effective way to enhance SMI, rather than focusing on the ingestion of isolated BCAAs.

Muscle function loss is associated with anxiety in patients with gastrointestinal cancer.

OBJECTIVE: To verify the prevalence of patients with muscle function loss (MFL) and whether it is associated with anxiety and depression scores in gastrointestinal (GI) cancer patients. METHODS: A cross-sectional study with seventy-one adult GI cancer patients was conducted. The MFL was evaluated by the SARC-F questionnaire, and participants were divided into MFL (cut-off ≥4 SARC-F) and normal muscle function (NMF) groups (cut-off <4 SARC-F). Anxiety and depression were analyzed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: From 71 patients, 25.4% (n = 18) were classified as MFL and 74.6% (n = 53) as NMF. Body weight was lower in the MFL group when compared to the NMF group (MFL: 57.6 ± 11.3 vs. NMF: 64.8 ± 11.6 kg, p = 0.032). MFL showed higher anxiety (MFL: 7.5 (0-21) vs. NMF: 2 (0-17), p = 0.030) and depression scores (MFL: 6.5 (0-13) vs. NMF: 2 (0-17), p = 0.034) compared to NMF. A positive correlation between the SARC-F and the anxiety (r = 0.34, p = 0.004) and depression score (r = 0.32, p = 0.006) was found. When adjusted by sex and body weight, MFL saw an increase with the anxiety score (OR: 1.15 95%CI(1.01-1.31), p = 0.023), but not with the depression score. In addition, LMF was responsible for anxiety in 12% of the population. CONCLUSION: In our study, 25% of GI cancer patients presented LMF and an association with the anxiety score.