Muscle mass, not radiodensity, predicts physical function in cancer patients with or without cachexia
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Lindsey J. Anderson1, Nicole Chong1, Dorota Migula1, Adam Sauer1, Michelle Garrison3, Peter Wu2,4, Atreya Dash5,6 and Jose M. Garcia1,7
1 Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
2 Department of Surgery, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
3 Department of Health Services, University of Washington, Seattle, Washington, USA
4 Department of Surgery, University of Washington, Seattle, Washington, USA
5 Department of Urology, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
6 Department of Urology, University of Washington, Seattle, Washington, USA
7 Gerontology and Geriatric Medicine-Department of Medicine, University of Washington, Seattle, Washington, USA
|Jose M. Garcia,||email:||[email protected]|
Keywords: cancer cachexia; physical function; computed tomography; muscle radiodensity
Received: February 24, 2020 Accepted: April 27, 2020 Published: May 19, 2020
Background: There is a need to better understand the relationship between functional impairment and muscle mass in cancer cachexia. This study aimed to establish the relationship between computed tomography (CT)-derived muscle cross-sectional area (CSA), radiodensity, and skeletal muscle index (SMI) and dual energy X-ray absorptiometry (DXA) parameters with functional performance in cancer patients.
Materials and Methods: Handgrip strength, stair climb power (SCP), one-repetition maximum (1RM) strength, and body composition (CT and DXA) were compared across cancer patients with cachexia (CAC; N = 28), without cachexia (CNC; N = 28), and non-cancer patients (CON; N = 19). Multivariate regression was performed to find predictors of function.
Results: CAC had lower CT muscle CSA and SMI and lower DXA appendicular lean mass (ALM) than CNC or CON (p ≤ 0.011). Muscle radiodensity was not different across groups despite larger proportion of low CT SMI in CAC, and CAC performed worse in SCP than CON (p = 0.018). In cancer patients, DXA ALM and CT muscle CSA each predicted physical function (p ≤ 0.05); muscle radiodensity did not, and DXA ALM explained more variability in SCP and 1RM than CT muscle CSA.
Conclusions: Stair climb power was reduced in cancer cachexia; muscle radiodensity was not. Muscle mass by CT or DXA, but not radiodensity, predicted functional performance in cancer patients.
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