Risk of Sarcopenia Identified by Sarc-Calf, Nutritional Status and Hand Grip Strength in Patients with Hematological Cancer.

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.

Agreement between maximum and mean handgrip strength measurements in cancer patients.

BACKGROUND AND AIM: Handgrip strength (HGS) can be used to identify probable sarcopenia, by measuring maximum strength and/or through the average of three measurements. This study analyzed the agreement between maximum and mean HGS measurements in identifying probable sarcopenia in cancer patients. METHODS: Adult individuals of both sexes diagnosed with malignant neoplasm were evaluated. HGS (kg/f) was measured in both hands and nutritional status defined by the Patient-Generated Subjective Global Assessment (PG-SGA). Bland-Altman, Intraclass Correlation Coefficient (ICC), and Cronbach's Alpha tests were applied to assess the agreement between measurements. RESULTS: One hundred forty-one patients aged 60.0 ± 14.2 years were evaluated. There was a predominance of elderly (57.4%), male (53.2%), and non-white (58.2%) individuals, with tumors located in the lower gastrointestinal tract (GIT) (36.9%) and with suspected or some degree of malnutrition (61.0%). For men, the Bland-Altman test showed a mean error of 1.37 (95% CI-1.03 to 3.80) for dominant HGS (DHGS) and 1.50 (95% CI-1.60 to 4.60) for non-dominant HGS (NDHGS), while for women the values were 1.34 (95% CI-0.27 to 2.95) and 1.14 (95% CI-1.10 to 3.39), respectively. The ICC showed excellent reproducibility (> 0.90) and the Cronbach's Alpha was satisfactory (0.99). CONCLUSION: Despite the satisfactory agreement observed between maximum and mean HGS values, in this study, individuals of both sexes with probable sarcopenia were better identified through mean values.

Presence of dynapenia and association with anthropometric variables in cancer patients.

BACKGROUND: Dynapenia is defined as an age-related loss of muscle strength. There is little information on dynapenia in cancer patients and on how it relates to anthropometric variables. The aim of this study was to analyze the presence of dynapenia and its association with anthropometric variables in hospitalized cancer patients. METHODS: Participants comprised adult and elderly cancer patients evaluated within the first 48 h of hospital admission to a tertiary public hospital, a referral center for gastrointestinal tract surgery. Anthropometric variables were measured according to standardized protocols. Dynapenia was identified based on handgrip strength (HGS), according to the cutoff points defined by the European Working Group on Sarcopenia in Older People (EWGSOP2), with values for women < 16 kg and for men < 27 kg. Statistical analysis was performed using SPSS software, version 22.0, with a significance level of 5%. RESULTS: This study included 158 patients aged in average 59.5 ± 14.0 years; of these, 53.6% were elderly, 58.9% non-white and 59.5% had some degree of malnutrition. The most prevalent type of cancer was that of the lower gastrointestinal tract (33.5%). The presence of dynapenia was observed in 23.4% of the patients and cachexia in 36.1%. There was an association between dynapenia with age (p < 0.001), life stage (p = 0.002) and race/color (p = 0.027), and also with body mass index (BMI) (p = 0.001) and adductor pollicis muscle thickness (APMT) of both hands (p < 0.05). After logistic regression analysis, adjusted for the sociodemographic variables, the APMT of the dominant hand and the low weight determined by body mass index remained associated with the occurrence of dynapenia (p < 0.05). CONCLUSIONS: In this study we confirmed that dynapenia was present in cancer patients, being associated with APMT of the dominant hand and low weight. HSG was proven to be a reliable and complementary measure to be added to the process of assessing nutritional status, contributing to the nutritional diagnosis of these patients and to the detection of early muscle depletion.