Objective To investigate the prognostic value of sarcopenia in patients with early non-small cell lung cancer (NSCLC) after surgery and chemotherapy. Methods This study included 592 patients with early non-small cell lung cancer who received lung cancer resection from January 2014 to December 2015, and they were divided into two groups: 473 patients received surgery alone (the surgery group), 119 patients received chemotherapy after surgery (the postoperative chemotherapy group), and the two groups were divided into sarcopenia group and non-sarcopenia group. General clinical data, laboratory data, and imaging data of these patients were compared. Results The median follow-up time of 592 patients was 69.1 months [95% confidential interval (CI) 64.9 - 78.2], and 110 patients were with sarcopenia (18.6%). Multivariate analysis showed that sarcopenia was an independent adverse prognostic factor in the surgery group [hazard ratio (HR) 6.56; 95%CI 1.86 to 14.78; P=0.01]. For patients undergoing postoperative chemotherapy, skeletal muscle mass index was reduced after chemotherapy, and sarcopenia was an independent predictor of poor prognosis (HR 5.77; 95%CI 0.96 to 20.60; P<0.05). Conclusions Sarcopenia is an independent poor prognostic factor for patients with early NSCLC undergoing surgery and postoperative chemotherapy. Assessment of sarcopenia before surgery and postoperative chemotherapy is helpful to improve the prognosis of patients with early NSCLC.
ObjectiveTo systematically review the prevalence of cognitive impairment in patients with sarcopenia. MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies related to the objectives from inception to December 10, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 14.0 software. ResultsA total of 27 studies were included. The overall prevalence rate of cognitive impairment in sarcopenia was 36.1% (95%CI 29.4% to 42.8%). Subgroup analysis showed that the prevalence in Europe was higher than that in other areas. The prevalence of nursing home residents was highest. ConclusionCurrent evidence shows that the prevalence of cognitive impairment in patients with sarcopenia is high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate the efficiency and security of physical exercise with low intensity against malnutrition and sarcopenia in patients with cirrhosis. Methods Between December 2014 and October 2015, 37 patients with cirrhosis were divided into two groups according to their willings, with 19 in the exercise group and 18 in the control group. Endurance of the exercise for 3 months were recorded. Mid-arm circumference, " up and go” time, width of portal vein and Child-Pugh score were compared before and after the research between the two groups. Results Three months later, the mid-arm circumference and the " up and go” time of the exercise group [(33.99±2.15) cm, (9.17±0.35) s] were better than those before the exercise [(32.09±2.58) cm, (9.77±0.46) s] and those in the control group [(31.93±2.04) cm, (9.76±0.30) s], and the differences above were all statistically significant (P<0.05). The change of the width of portal vein was positively correlated with pre-exercise body mass index in overweight patients (r=0.93, P=0.007). Conclusions Physical exercise with low intensity is safe and effective against malnutrition and sarcopenia in patients with cirrhosis. Overweitht patiens or malnutrition at the early stage may benefit more.
ObjectiveTo explore the value of sarcopenia index (SI) in the diagnosis of malnutrition in colorectal cancer patients.MethodsA retrospective study was carried out to study on 126 colorectal cancer patients who underwent chemotherapy in West China Hospital of Sichuan University between January 2015 and June 2019. SI and body mass index (BMI) were used for malnutrition diagnosis, and the detection rate of malnutrition was compared.ResultsThe detection rate of malnutrition diagnosed by SI (92.1%) was higher than that by BMI (38.1%) with a statistical difference (P<0.001). Subgroup analysis showed: the detection rate of malnutrition diagnosed by SI vs. BMI in male patients was 97.0% vs. 28.4%, with a statistical difference (P<0.001), and that in female patients was 86.4% vs. 49.2%, with a statistical difference (P<0.001); the detection rate of malnutrition diagnosed by SI vs. BMI in elderly patients (≥65 years) was 92.6% vs. 27.8%, with a statistical difference (P<0.001), and that in young and middle-aged patients (<65 years) was 91.7% vs. 45.8%, with a statistical difference (P<0.001).ConclusionUsing SI to diagnose malnutrition for colorectal cancer patients is worth popularizing for it can discover hidden malnutrition patients.
Objective To evaluate and summarize the evidence related to non-pharmacological interventions in community-dwelling elderly with sarcopenia and to provide an evidence-based basis for guiding community health professionals to effectively manage older patients with sarcopenia. Methods We searched all evidence about non-pharmacological interventions in community-dwelling elderly with sarcopenia from BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Infobase, American Society for Nutrition, Australian JBI Evidence-Based Health Care Centre Database, CINAHL, PubMed, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP Databases. The types of literature included guidelines, expert consensus, systematic reviews, evidence summaries and meta-analyses. The retrieval time ranged from January 1, 2019 to May 31, 2024. Results A total of 14 publications were included, including 2 guidelines, 3 expert consensuses, and 9 systematic reviews. Twenty-four pieces of evidence were summarized in 3 areas, including screening, assessment, and non-pharmacological interventions for sarcopenia. Conclusion We summarize the best evidence for initial screening, systematic assessment, and comprehensive non-pharmacological interventions for elderly patients with sarcopenia in the community, and provide a guidance and reference for community medical staff to efficiently manage elderly patients with sarcopenia.
Objective To investigate the relevance among sarcopenia, peripheral inflammatory, and nutritional factors, as well as the impact of sarcopenia on the prognosis of gastric cancer. Methods A total of 174 patients with gastric cancer in Department of Gastrointestinal Surgery in West China Hospital of Sichuan University from July 2016 to December 2020 were retrospectively included. The skeletal muscle index (SMI) of the third lumbar vertebra level was calculated using CT images, and male patients with SMI<52.4 cm2/m2 and female patients with SMI<38.5 cm2/m2 were considered sarcopenia. The key clinicopathological features of patients were collected for prognostic analysis. ResultsAmong the 174 patients with gastric cancer, 73 patients (41.95%) were diagnosed with sarcopenia. Compared with those of non-sarcopenia, the patients who were diagnosed with sarcopenia showed a significantly elder age and lower body mass index (BMI). In addition, males demonstrated a significantly higher rate of sarcopenia. Further, patients with sarcopenia showed a significant increasing in the incidence of postoperative pulmonary infections and length of hospitalization than patients without sarcopenia. The two groups showed significant differences in type 2 diabetes, peripheral C-reaction protein (CRP), interleukin-6 (IL-6), albumin, prealbumin, and hemoglobin. Overall, the multivariate analysis and Kaplan-Meier survival curves indicated that sarcopenic patients had a significantly lower survival rate than the non-sarcopenia patients. Conclusion Sarcopenia is closely related to higher levels of inflammation, malnutrition, and poor prognosis in patients with gastric cancer. Therefore, we should diagnose sarcopenia patients as early as possible, and give nutritional support to the patients.
Elderly patients with chronic kidney disease not only suffer from senescence-related muscle strength decline, but also exist muscle attenuation caused by chronic kidney disease. Sarcopenia of this group are more obvious, and falls, incapacity, weakness and death caused by sarcopenia are more prominent. At present, clinicians’ understanding of sarcopenia is still in the aspects of concept popularization and basic research, and there is a lack of practical diagnosis and treatment process and clinical prevention and treatment practice. Starting from the evolution of the definition of sarcopenia, this paper elaborates on the characteristics of sarcopenia in elderly patients with chronic kidney disease, as well as the exercise rehabilitation of sarcopenia in elderly patients with chronic kidney disease, in order to improve the attention and understanding of renal colleagues on sarcopenia in elderly people with chronic kidney disease.
Sarcopenia has the characteristics of high morbidity and mortality, which seriously affects the quality of life of patients. Continuity of care, as an emerging nursing model in recent years, aims to improve self-care abilities of patients and their families, which can effectively reduce the rate of rehospitalization, and improve the quality of life of patients. This article starts with psychological intervention, nutrition guidance, patient exercise and medication guidance, and explores the application of continuity of care in patients with end-stage renal disease complicated with sarcopenia, analyzes the application of continuity of care in patients with end-stage renal diseases, and describes the implementation content and form of continuity of care, aiming to help its further promotion in clinic.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. The team from the National Clinical Research Center for Geriatrics has authored the "Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline" which discuss the specific contents of exercise, nutrition, and drug interventions for sarcopenia. This article provides a comprehensive interpretation of the guideline to facilitate their dissemination, promotion, and application.
ObjectiveTo explore the changes of serum irisin in maintenance hemodialysis (MHD) patients with sarcopenia.MethodsFrom January to June 2019, 56 MHD patients from Shanxi Provincial People’s Hospital were selected. Judging by the results of body composition analyzer, the MHD patients were divided into the sarcopenia group (n=31) and the non-sarcopenia group (n=25). The serum irisin level was detected by enzyme-linked immunosorbent assay. The muscle cross-sectional area at the third lumbar level was measured by CT. SPSS 21.0 software was used for inter-group comparison, correlation analysis, and regression analysis.ResultsThe serum irisin concentration in the sarcopenia group was lower than that in the non-sarcopenia group [medium (lower quartile, upper quartile): 175.46 (126.00, 220.52) vs. 459.10 (233.83, 616.91) pg/mL; Z=−4.195, P<0.001]. The results of Spearman correlation analysis showed that serum irisin level was positively correlated with lean tissue index (rs=0.265, P=0.048), however negatively correlated with serum creatinine level (rs=−0.311, P=0.020). The results of logistic regression analysis showed that serum irisin level [odds ratio (OR)=0.957, 95% confidence interval (CI) (0.925, 0.990), P=0.012], walking speed [OR=0.000, 95%CI (0.000, 0.050), P=0.031], and grip strength [OR=0.658, 95%CI (0.434, 0.997), P=0.048] were protective factors of sarcopenia in MHD patients.ConclusionsThe level of circulating irisin in MHD patients with sarcopenia is lower than that in MHD patients without sarcopenia. Irisin is a protective factor of sarcopenia in MHD patients.