Association between sarcopenia and gastric carcinogenesis: A health check-up cohort study.

Abstract

46 Background: Insulin resistance which is a mechanism of metabolic syndrome has been known to promote carcinogenesis of various malignancies. In addition, metabolic syndrome is associated with sarcopenia. Thus, the aim was to investigate the association between sarcopenia and gastric carcinogenesis including precancerous conditions: atrophic gastritis (AG), intestinal metaplasia (IM), and gastric adenoma. Methods: The study subjects were an adult population who underwent gastroduodenoscopy at Gangnam Severance Check-up Center. AG and IM were evaluated by endoscopic findings. Sarcopenia based on muscle mass was defined as appendicular skeletal muscle (ASM) as a percentage of body weight that was less than 1 standard deviation below the sex-specific mean for healthy adults aged 20 to 39 years (cutoff point: 29.3% in male and 26.7% in female). Obesity was defined as body mass index (BMI) ≥ 25 kg/m2 according to the Asia-Pacific criteria. Sarcopenic obesity was a condition of combined sarcopenia and obesity. The association between sarcopenia and gastric lesions was evaluated. Results: 8,356 patients were enrolled this study. Among them, 12 (0.14%) and 3,552 (42.5%) patients were diagnosed as gastric cancer and precancerous conditions, respectively. 5 (41.7%) of 12 gastric cancer patients and 594 (16.9%) of 3.552 patients with gastric precancerous conditions were diagnosed with sarcopenia. Both diabetes mellitus (DM) (OR = 5.152, P = 0.005) and sarcopenic obesity (OR = 4.139, P = 0.016) were independent predictive factors for gastric cancer. And smoking, alcohol, DM, hypertension, dyslipidemia, Helicobacter pylori, and sarcopenia were significantly associated with gastric precancerous conditions. Conclusions: Sarcopenia and sarcopenic obesity were significantly associated with gastric carcinogenesis. Thus, sarcopenia may be one of the risk factors for gastric carcinogenesis.