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| Initial exploration of predicting sarcopenia in colorectal cancer based on mid - upper arm circumference and
calf circumference |
| 1Liao Xin,1Su Wenyi,1Jiang Qilan,1Han Ming,2Lyu Muhan,1Wang Min |
| 1Department of Clinical Nutrition The Affiliated Hospital of Southwest Medical University Luzhou 646000 Sichuan China
2Department of
Gastroenterology The Affiliated Hospital of Southwest Medical University Luzhou 646000 Sichuan China |
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Abstract Objective To investigate the predictive value of mid-upper arm circumference MAC and calf circumference CC for
sarcopenia in patients with colorectal cancer CRC . Method This is a cross-sectional study that includes 372 patients who were
diagnosed with CRC for the first time at the Department of Gastrointestinal Surgery Affiliated Hospital of Southwest Medical University
from April 2022 to August 2023 with appendicular skeletal muscle mass ASM and appendicular skeletal muscle mass index ASMI
measured by bioelectrical impedance analysis BIA and MAC CC hand grip strength and 6-Meter Walk test measured with
comparison of basic conditions by grouping by sarcopenia. Grouped by gender ROC curves were used to compare the predictive value
of MAC and CC for sarcopenia in patients with CRC and to determine the optimal cut-off value and Kappa values were calculated to
determine the consistency of MAC and CC with the diagnostic criteria for sarcopenia. Result Among 372 CRC patients 233 62. 6%
were male and 139 37. 4% were female and 81 21. 8% were diagnosed with sarcopenia. The ROC curves showed that the optimal
cut-off values for MAC to predict sarcopenia were 24. 9 cm in males sensitivity 81. 8% specificity 73. 0% and 23. 7 cm in females
sensitivity 80. 8% specificity 72. 6% and for CC to predict the best cut - off values for sarcopenia were 32. 4 cm sensitivity
74. 5% specificity 80. 9% in men and 31. 0 cm sensitivity 88. 5% specificity 66. 4% in women. The AUC values of MAC CC
and the combination of the two for the prediction of sarcopenia were 0. 824 0. 851 0. 864 for male patients and 0. 819 0. 801 0. 828
for female patients respectively which showed a higher value of the combined one. Comparing with the diagnostic criteria of
sarcopenia the Kappa values of MAC and CC were 0. 443 0. 493 for male and 0. 385 0. 334 for female respectively. Analysis by gender
age history of smoking alcohol consumption clinical stage and body mass index BMI subgroups revealed that mPG-SGA showed strong
consistency for good/ mild malnutrition moderate malnutrition and severe malnutrition among patients with BMI<18. 5 kg / m
2
Kappa=0. 762
P=0. 001 . All subgroups with the exception of BMI<18. 5 kg / m
2
showed almost perfect consistency for the three different nutritional stages
Kappa>0. 9 P<0. 001 . Conclusion Both MAC and CC have good predictive value for sarcopenia in patients with CRC and the combination
of them has a better predictive effect.
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20240803
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