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. 2019 Jul;8(8):3677-3684.
doi: 10.1002/cam4.2238. Epub 2019 May 21.

Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Johanna Moreau  1   2 , Marie-Amélie Ordan  1 , Coralie Barbe  3 , Camille Mazza  1 , Marine Perrier  1   2 , Damien Botsen  1 , Mathilde Brasseur  1   2 , Christophe Portefaix  4   5 , Yohann Renard  6 , Barbara Tallière  7 , Eric Bertin  8 , Christine Hoeffel  4   5 , Olivier Bouché  1   2
Affiliations

Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Johanna Moreau et al. Cancer Med. 2019 Jul.

Abstract

Background: FIGHTDIGO study has shown the feasibility of handgrip strength (HGS) measurements in 201 consecutive digestive cancer patients undergoing chemotherapy.

Objective: This study focuses on a secondary aim of FIGHTDIGO study: the relationship between muscle mass and HGS.

Design: Two consecutive bilateral measures of HGS were performed using a Jamar dynamometer before the start of each chemotherapy. The highest value was chosen for final evaluation. Dynapenia (loss of muscle strength) was defined as HGS < 30 kg (men) and < 20 kg (women). Muscle mass was measured at lumbar level (L3) on Computed Tomography (CT) scans performed less than 3 weeks before or after the measurement of HGS. Muscle mass loss was defined by skeletal muscle index (SMI) < 53 cm2 /m2 (in men with a body mass index (BMI)> 25 kg/m2 ), < 43 cm2 /m2 (in men with a BMI < 25 kg/m2 ), and < 41 cm2 /m2 (in women regardless of BMI). Sarcopenia was defined by the association of a dynapenia and a loss of muscle mass.

Results: A total of 150 patients were included in this analysis (mean age: 65.6 ± 10.9 years, 87 males (58%), colorectal cancer (47.3%), metastatic stage (76.7%)). A total of 348 CT scans were evaluated. For the 348 measurements, mean SMI and HGS were 41.8 ± 8.7 cm2 /m2 and 32.1 ± 11.0 kg, respectively. Muscle mass loss, dynapenia, or sarcopenia were reported at least once, in 120 (80%), 45 (30%), and 30 (20%) patients, respectively. SMI was significantly correlated with HGS (Pearson coefficient = 0.53, P < 0.0001). At concordance analysis, 188 dyad SMI/HGS (54%) were in agreement (Kappa = 0.14 [95% CI, 0.07-0.21]).

Conclusion: Correlation between the measurements of HGS and SMI is strong but the concordance between dynapenia and muscle mass loss is poor. Further studies should be performed to confirm the diagnostic thresholds, and to study the chronology of dynapenia and loss of muscle mass.

Keywords: digestive system neoplasms; dynapenia; muscle mass; muscle strength; sarcopenia.

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Figures

Figure 1
Figure 1
Selection of lumbar muscle areas with specific thresholds at third lumbar vertebra (L3). Regions of interest (inturquoise blue) corresponding to rectus abdominis, quadratus lumborum, transversus abdominis, external and internal oblique (1), paraspinal (2), and psoas muscles (3). Image from ImageJ software
Figure 2
Figure 2
Patient flow chart: patient identification, inclusion, and exclusion steps
Figure 3
Figure 3
Correlation between handgrip muscle strength (HGS) and skeletal muscle index (SMI). The regression curve is in red. The yellow curves surround 95% of values. The letter r is Pearson coefficient
See this image and copyright information in PMC

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