Translation and validation of the Taiwanese SarQoL,a quality of life questionnaire specific to sarcopenia

BackgroundThe Sarcopenia Quality of Life (SarQoL) questionnaire has been translated into various languages. This study validated the Taiwanese version of the SarQoL (SarQoL-TW) questionnaire.MethodsForward–backward translation was conducted, along with a test of the prefinal version of the translated questionnaire. To validate the psychometric properties of the questionnaire, 50 older adults with sarcopenia and 50 older adults without sarcopenia completed the SarQoL-TW, the Short Form12 Health Survey (SF-12), and the EQ-5D-3L questionnaire. Participants with sarcopenia were asked to complete the SarQoL-TW questionnaire once more after 2 weeks. Validating the psychometric properties of the SarQoL-TW questionnaire involved assessing its discriminative power, internal consistency, construct validity, test–retest reliability, and potential floor and ceiling effects.ResultsThe SarQoL-TW questionnaire was translated without major difficulties. The psychometric analysis revealed that older adults with sarcopenia scored significantly lower on the SarQoL-TW, both overall and in some of the domains. The Cronbach's alpha of 0.846 indicated high internal consistency. The SarQoL-TW questionnaire correlated well with similar constructs on the SF-12 and EQ-5D-3L for convergent validity and correlated weakly with distinct domains for divergent validity, confirming its favorable construct validity. The test–retest reliability was excellent (intraclass correlation coefficient: 0.970). Neither floor nor ceiling effects were observed.ConclusionThe SarQoL-TW questionnaire is a reliable and valid questionnaire, useful for assessing quality of life in older adults with sarcopenia in clinical practice and research.     

Is central sarcopenia a predictor of prognosis for patients with pathological fracture?

IntroductionWe aimed to investigate the relationship between central sarcopenia and survival in patients with pathological fracture.MethodsWe reviewed records of patients who were treated for pathological fracture of axial and appendicular skeleton in our clinic between 2011 and 2020. We used the psoas: lumbar vertebral index (PLVI) on axial computer tomographic evaluation to assess for central sarcopenia. A multivariate Cox algorithm was applied to recognize these factors independently associated with one month, six months, one year, and overall survival.ResultsA total of 147 patients [61 (41.4%) male and 86 (58.6%) female] were included, with an average age of 62.4 years. During the study, 108 (73.4%) patients died, and 39 (26.6%) were alive. The survival rates at 1 month, 6 months, and 1 year after surgery were 94.6%, 68.7%, and 53.1%, respectively. PLVI values ranged from 0.21 to 1.20 with a mean of 0.536 and a median of 0.520. According to the median value of PLVI, 68 patients with sarcopenia had low PLVI and 79 patients without sarcopenia had high PLVI. For the first month, only the preoperative albumin level was identified as a prognostic factor. Eastern Cooperative Oncology Group Performance Status (ECOG), American Society of Anesthesia (ASA) scores and primary malignancy (rapid grade) were strong predictor of poor survival. The PLVI was independent significant predictor of first month (HR, 0.083 [95% CI, 0.011–0.649], p = 0.018) and overall survival (HR, 0.129 [95% CI, 0.034–0.492], p = 0.003).ConclusionThe PLVI was a strong predictor of first year, and overall survival in patients with pathological fracture.     

Myosteatosis,but not Sarcopenia,Predisposes NAFLD Subjects to Early Steatohepatitis and Fibrosis Progression

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Prognostic impact of osteosarcopenia in patients with advanced pancreatic cancer receiving gemcitabine plus nab-paclitaxel

BackgroundOsteosarcopenia, defined as the combination of osteoporosis and sarcopenia, has recently gained attention as a novel prognostic factor for survival in patients with cancer. This study aimed to evaluate the prognostic impact of osteosarcopenia in metastatic pancreatic cancer (PC).MethodsWe retrospectively investigated consecutive metastatic PC patients receiving first-line gemcitabine plus nab-paclitaxel (GnP). Skeletal muscle index at the third lumbar vertebra and bone mineral density at the first lumbar vertebra were measured using pretreatment computed tomography. Treatment outcomes of osteosarcopenia and non-osteosarcopenia groups were compared and analyzed. Multivariate analysis was performed to identify variables associated with survival.ResultsAmong 313 patients, osteosarcopenia was present in 59 patients (19%). The osteosarcopenia group was associated with older age, higher proportion of females, worse performance status, and higher modified Glasgow prognostic scores (mGPS). Response rates to chemotherapy, progression-free survival (3.5 months vs. 6.4 months, p < 0.001), and overall survival (5.6 months vs. 13.0 months, p < 0.001) were significantly better in the non-osteosarcopenia group. Osteosarcopenia, performance status of 1–2, mGPS score of 1–2, carcinoembryonic antigen ≥10 ng/mL, and carbohydrate antigen 19-9 ≥ 1000 IU/mL were identified as independent factors predicting shorter survival. Grade 3 or higher anemia and febrile neutropenia occurred more frequently in the osteosarcopenia group.ConclusionsOsteosarcopenia was associated with poor survival in metastatic PC treated with first-line GnP. Screening for osteosarcopenia may be helpful for better management of metastatic PC.     

Diagnostic Value of Sarcopenia Computed Tomography Metrics for Older Patients with or without Cancers with Gastrointestinal Disorders

ObjectivesThe diagnostic utility of poor body composition measures in sarcopenia remains unclear. We hypothesize that the skeletal muscle gauge [combination of skeletal muscle index (SMI) and skeletal muscle density (SMD); SMG = SMI × SMD] would have significant diagnostic and predictive value in certain muscle regions and populations.DesignProspective cross-sectional study.Setting and ParticipantsWe examined inpatients age ≥60 years with or without cancer and with gastrointestinal disorders.MethodsWe used computed tomography (CT) image metrics in the 12th thoracic (T12), third lumbar (L3), erector spinae muscle (ESM), and psoas muscle (PM) regions to establish correlations with the 2019 Asian Working Group for Sarcopenia Consensus and used receiver operating characteristic area under the curve (AUC) to compare differences between metrics. Associations between CT metrics and mortality were reported as relative risk after adjustments.ResultsWe evaluated 385 patients (median age, 69.0 years; 60.8% men) and found consistent trends in cancer (49.6%) and noncancer (50.4%) cohorts. SMG had a stronger correlation with muscle mass than SMD [mean rho: 0.68 (range, 0.59?0.73) vs 0.39 (range, 0.28?0.48); all P < .01] in T12, L3, and PM regions and a stronger correlation with muscle function than SMI [mean rho: 0.60 (range, 0.50?0.77) vs 0.36 (range, 0.22?0.58); all P < .05] in T12, ESM, and L3 regions. SMG outperformed SMI in diagnostic accuracy in all regions, particularly for L3 (AUC: 0.87?0.88 vs 0.80?0.82; both P < .05). PMG (PM gauge) and L3SMG did not differ, whereas EMG (ESM gauge) or T12SMG and L3SMG did (AUC: 0.80?0.82 vs 0.87?0.88; all P < .05). L3SMI, L3SMD, T12SMG, EMG, and PMG showed no association with 1-year cancer-related mortality after adjusting for confounders; however, L3SMG [relative risk = 0.92 (0.85?0.99); P = .023) was.Conclusions and ImplicationsL3SMG covers all features of sarcopenia with more diagnostic value than other metrics, allowing a complete sarcopenia assessment with CT alone and not just in populations with cancer.     

A Nomogram for Optimizing Sarcopenia Screening in Community-dwelling Older Adults: AB3C Model

ObjectivesSarcopenia is associated with significantly higher mortality risk, and earlier detection of sarcopenia has remarkable public health benefits. However, the model that predicts sarcopenia in the community has yet to be well identified. The study aimed to develop a nomogram for predicting the risk of sarcopenia and compare the performance with 3 sarcopenia screen models in community-dwelling older adults in China.DesignCross-sectional study.Setting and ParticipantsA total of 966 community-dwelling older adults.MethodsA total of 966 community-dwelling older adults were enrolled in the study, with 678 participants grouped into the Training Set and 288 participants grouped into the Validation Set according to a 7:3 randomization. Predictors were identified in the Training Set by univariate and multivariate logistic regression and then combined into a nomogram to predict the risk of sarcopenia. The performance of this nomogram was assessed by calibration, discrimination, and clinical utility.ResultsAge, body mass index, calf circumference, congestive heart failure, and chronic obstructive pulmonary disease were demonstrated to be predictors for sarcopenia. The nomogram (named as AB3C model) that was constructed based on these predictors showed excellent calibration and discrimination in the Training Set with an area under the receiver operating characteristic curve (AUC) of 0.930. The nomogram also showed perfect calibration and discrimination in the Validation Set with an AUC of 0.897. The clinical utility of the nomogram was supported by decision curve analysis. Comparing the performance with 3 sarcopenia screen models (SARC-F, Ishii, and Calf circumference), the AB3C model outperformed the other models regarding sensitivity and AUC.Conclusions and ImplicationsAB3C model, an easy-to-apply and cost-effective nomogram, was developed to predict the risk of sarcopenia, which may contribute to optimizing sarcopenia screening in community settings.