Abstract

We sought to examine the relationship between the SARC-F score and the Controlling Nutritional Status (CONUT) score in patients with gastrointestinal diseases (GDs, n = 735, median age = 71 years, and 188 advanced cancer cases). The SARC-F score ≥ 4 (highly suspicious of sarcopenia) was found in 93 cases (12.7%). Mild malnutritional condition was seen in 310 cases (42.2%), moderate in 127 (17.3%) and severe in 27 (3.7%). The median SARC-F scores in categories of normal, mild, moderate and severe malnutritional condition were 0, 0, 1 and 1 (overall p < 0.0001). The percentage of SARC-F score ≥ 4 in categories of normal, mild, moderate and severe malnutritional condition were 4.4%, 12.9%, 26.8% and 25.9% (overall p < 0.0001). The SARC-F score was an independent factor for both the CONUT score ≥ 2 (mild, moderate or severe malnutrition) and ≥5 (moderate or severe malnutrition). In the receiver operating characteristic (ROC) curve analysis for the CONUT score ≥ 2, C reactive protein (CRP) had the highest area under the ROC (AUC = 0.70), followed by the SARC-F score (AUC = 0.60). In the ROC analysis for the CONUT score ≥ 5, CRP had the highest AUC (AUC = 0.79), followed by the SARC-F score (AUC = 0.63). In conclusion, the SARC-F score in patients with GDs can reflect malnutritional status.

Highlights

  • Sarcopenia is characterized by generalized loss of muscle mass and muscle functional decline, resulting in physical frailty, cachexia and mortality [1,2]

  • Malnutrition, reticence, advanced malignancy-bearing status and persistent inflammatory status frequently observed in gastrointestinal diseases (GDs) are representative features associated with sarcopenia [1–9]

  • Reduced daily dietary intakes and deterioration of nutritional status can be often seen in patients with GDs [8], and sarcopenia in patients with GDs is associated with poorer patient quality of life (QOL) and prognosis [8,10]

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Summary

Introduction

Sarcopenia is characterized by generalized loss of muscle mass and muscle functional decline, resulting in physical frailty, cachexia and mortality [1,2]. Malnutrition, reticence, advanced malignancy-bearing status and persistent inflammatory status frequently observed in gastrointestinal diseases (GDs) are representative features associated with sarcopenia [1–9]. Reduced daily dietary intakes and deterioration of nutritional status can be often seen in patients with GDs [8], and sarcopenia in patients with GDs is associated with poorer patient quality of life (QOL) and prognosis [8,10]. GD is a prime example of secondary sarcopenia due to the disease burden [10]. Et al reported that out of 199 patients with esophageal cancer, 149 patients (75%) had sarcopenia [11]. Et al reported that out of 173 patients with gastric cancer, 52 (30%) had sarcopenia [12]. In patients with colon cancer, 39–48% patients have been reported to involve sarcopenia [13,14]. In patients with pancreatic cancer, approximately 60% have been reported to have sarcopenia [15]. In patients with hepatocellular carcinoma, 11–66% have been reported to have sarcopenia [6]

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