AWGS2019 vs EWGSOP2 for diagnosing sarcopenia to predict longterm prognosis in Chinese patients with gastric cancer after radical gastrectomy

BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatment.However,previous research reported widely differing sarcopenia prevalence due to different criteria.AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.METHODS An observational study was conducted from July 2014 to January 2017,which included 648 consecutive gastric cancer patients who underwent radical gastrectomy.The sarcopenia elements(skeletal muscle index,handgrip strength,and gait speed)were measured within 1 mo or 7 d before surgery.The patients were followed at fixed intervals to gain the outcomes.Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately.The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index(C-index)and area under the time-dependent receiver operating characteristic curve(AUC).The Akaike information criterion(AIC)was applied to compare model fits.RESULTS The prevalence of sarcopenia was 20.5%and 11.3%according to AWGS2019 and EWGSOP2,respectively.Sarcopenia was an independent risk factor for the longterm OS no matter based on AWGS2019 or EWGSOP2,but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio(HR)[2.150(1.547-2.988)]than EWGSOP2-sarcopenia[HR 1.599(1.092-2.339)].Meanwhile,the model with AWGS2019-sarcopenia[C-index 0.773(0.742-0.804);AIC 2193.7;time-dependent AUC 0.812(0.756-0.867)for 1-year OS,0.815(0.778-0.852)for 3-year OS,and 0.809(0.759-0.859)for 5-year OS]had better predictive power and model fits than the model with EWGSOP2-sarcopenia[C-index 0.762(0.729-0.795);AIC 2215.2;timedependent AUC 0.797(0.741-0.854)for 1-year OS,0.804(0.767-0.842)for 3-year OS,and 0.799(0.748-0.850)for 5-year OS].CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy.The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia.AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.

新疆乌鲁木齐地区中老年人肌少症与代谢综合征的相关性研究

【目的】依据2020年更新公布的《肌少症诊断和治疗专家共识2019(AWGS2019)》开展调查,获得乌鲁木齐市中老年人的肌少症患病率并探讨肌少症与代谢综合征(MS)的相关性。【方法】以2018年7月—2019年1月新疆多民族自然人群队列中乌鲁木齐市1438名年龄≥50岁的中老年人为研究对象,采取问卷调查法、体格检查法以及实验室检测等方式收集数据。采用四肢骨骼肌质量、握力以及4 m步速分别表示肌肉质量、肌肉力量和躯体功能;运用生物电阻抗分析法(BIA)测量人体成分;以AWGS2019推荐的肌少症诊断标准为基础获得年龄≥50岁人群肌少症的患病情况,采用多因素logistic回归分析模型探讨不同性别的中老年人群肌少症与MS的相关关系。【结果】肌少症患者194人,患病率为13.49%。其中男性患病率为15.56%,女性患病率为12.12%。男性肌少症患者MS患病率(40.45%)与未患肌少症者MS患病率(38.92%)差异无统计学意义,而女性肌少症患者MS患病率(39.04%)比未患肌少症者(27.56%)高。多因素logistic回归模型的分析结果显示,肌少症是MS的相关因素,与非肌少症者相比,男性肌少症者患有MS的风险更高(OR=2.11,95%CI:1.15~3.88)。【结论】中老年人肌少症会增加MS的患病风险,且在男性中更明显。充分认识肌少症有助于早期识别MS的高危人群,对预防MS的发生具有实际意义。