Top

World Journal of Surgery

Published in:

Open Access 01-02-2021 | Sarcopenia | Scientific Review

Prevalence and Impact of Sarcopenia in Chronic Pancreatitis: A Review of the Literature

Authors: Li Lian Kuan, Ashley R. Dennison, Giuseppe Garcea

Published in: World Journal of Surgery | Issue 2/2021

Abstract

Introduction

Malnutrition is a common sequela of chronic pancreatitis (CP). Alterations in body composition and the assessment of sarcopenia have gained the interest of clinicians in recent years. There is a scarcity of data currently available concerning sarcopenia in patients with CP. This review aims to investigate the prevalence and impact of sarcopenia in CP.

Methods

Embase and Medline databases were used to identify all studies that evaluated sarcopenia and outcomes in patients with chronic pancreatitis. Due to paucity of data, conference abstracts were included. PRISMA guidelines for systematic reviews were followed.

Results

Six studies, with a total of 450 individuals were reviewed. Three full-text studies and three conference abstracts met the predetermined eligibility criteria. The prevalence of sarcopenia in CP from all studies ranged from 17–62%. Pancreatic exocrine insufficiency was associated as an independent and significant risk factor for sarcopenia. Sarcopenia was found to be associated with a reduced quality of life, increased hospitalisation, and reduced survival. It was associated with significantly lower islet yield following total pancreatectomy with islet auto transplantation in CP.

Conclusion

The review of these existing studies amalgamates the limited data on sarcopenia and its impact on CP. It has shown that sarcopenia is exceedingly prevalent and an important risk factor in CP patients. The data presented emphasises that sarcopenia has a significant prognostic value and should be included in future prospective analyses in the outcomes of CP.

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(1):16–31CrossRef

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al (2010) Sarcopenia: European consensus on definition and diagnosis. Age Ageing 39(4):412–423CrossRef

Delmonico MJ, Harris TB, Lee JS, Visser M, Nevitt M, Kritchevsky SB et al (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 55(5):769–774CrossRef

Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV et al (2006) The loss of skeletal muscle strength, mass, and quality in older adults: The Health, aging and body composition study. J Gerontol Ser A Biol Sci Med Sci 61(10):1059–1064CrossRef

Sinclair M, Gow PJ, Grossmann M, Angus PW (2016) Review article: sarcopenia in cirrhosis–aetiology, implications and potential therapeutic interventions. Aliment Pharmacol Ther 43(7):765–777CrossRef

Hanai T, Shiraki M, Nishimura K, Ohnishi S, Imai K, Suetsugu A et al (2015) Sarcopenia impairs prognosis of patients with liver cirrhosis. Nutrition 31(1):193–199CrossRef

Nishikawa H, Shiraki M, Hiramatsu A, Moriya K, Hino K, Nishiguchi S (2016) Japan Society of hepatology guidelines for sarcopenia in liver disease: recommendation from the working group for creation of sarcopenia assessment criteria. Hepatol Res 46(10):951–963. https://doi.org/10.1111/hepr.12774CrossRefPubMed

Tieland M, Trouwborst I, Clark BC (2018) Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle 9(1):3–19. https://doi.org/10.1002/jcsm.12238CrossRefPubMed

Marty E, Liu Y, Samuel A, Or O, Lane J (2017) A review of sarcopenia: Enhancing awareness of an increasingly prevalent disease. Bone 105:276–286CrossRefPubMed

10.

Nishikawa H, Enomoto H, Ishii A, Iwata Y, Miyamoto Y, Ishii N et al (2017) Elevated serum myostatin level is associated with worse survival in patients with liver cirrhosis. J Cachexia Sarcopenia Muscle 8(6):915–25. https://doi.org/10.1002/jcsm.12212CrossRefPubMedPubMedCentral

11.

Shintakuya R, Uemura K, Murakami Y, Kondo N, Nakagawa N, Urabe K, Sueda T (2017) Sarcopenia is closely associated with pancreatic exocrine insufficiency in patients with pancreatic disease. Pancreatology 17(1):70–75. https://doi.org/10.1016/j.pan.2016.10.005CrossRefPubMed

12.

Gress TM, Müller-Pillasch F, Lerch MM, Friess H, Büchler M, Beger HG, et al (1994) Balance of expression of genes coding for extracellular matrix proteins and extracellular matrix degrading proteases in chronic pancreatitis. Z Gastroenterol, 32(4):221–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8017097

13.

Mayerle J, Hoffmeister A, Witt H, Lerch MM, Mössner J (2013) Chronic Pancreatitis. Dtsch Aerzteblatt Online, 110(22):387. Available from: https://www.aerzteblatt.de/10.3238/arztebl.2013.0387

14.

Majumder S, Chari ST (2016) Chronic pancreatitis. Lancet 387(10031):1957–1966CrossRef

15.

Kirkegård J, Mortensen FV, Cronin-Fenton D (2017) Chronic pancreatitis and pancreatic cancer risk: a systematic review and meta-analysis. Am J Gastroenterol 112(9):1366–1372 Available from: https://insights.ovid.com/crossref?an=00000434-201709000-00008

16.

Whitcomb DC, Frulloni L, Garg P, Greer JB, Schneider A, Yadav D et al (2016) Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatology 16(2):218–224CrossRef

17.

Bulanova E, Lyadov VK, Mershina EA, Sinitsyn V, Moscow/Ru (2012) CT assessment of sarcopenia in patients with pancreatic cancer and chronic pancreatitis. https://doi.org/10.1594/ecr2012/B-0563

18.

OConnor D, Kok T, Purcell C, Duggan S, Conlon K (2014) Investigating the prevalence of sarcopenia in chronic pancreatitis in an irish cohort: a CT-scan based pilot study. Pancreatology 14(3):S74CrossRef

19.

Olesen SS, Büyükuslu A, Køhler M, Rasmussen HH, Drewes AM (2019) Sarcopenia associates with increased hospitalization rates and reduced survival in patients with chronic pancreatitis. Pancreatology 19(2):245–251CrossRef

20.

Bieliuniene E, Frøkjær JB, Pockevicius A, Kemesiene J, Lukosevičius S, Basevicius A et al (2019) CT-and MRI-based assessment of body composition and pancreatic fibrosis reveals high incidence of clinically significant metabolic changes that affect the quality of life and treatment outcomes of patients with chronic pancreatitis and pancreatic cancer. Med 55(10):649

21.

Trikudanathan G, Feussom G, Teigen L, Munigala S, Price K, Dirweesh A, Beilman G (2020) Pre-operative sarcopenia predicts low islet cell yield following total pancreatectomy with islet autotransplantation (TPIAT) for chronic pancreatitis (CP). Gastroenterology 24(10):2423–2430

22.

Schneider A, Löhr JM, Singer MV (2007) The M-ANNHEIM classification of chronic pancreatitis: Introduction of a unifying classification system based on a review of previous classifications of the disease. J Gastroenterol 42(2):101–119CrossRef

23.

Fitzsimmons D, Kahl S, Butturini G, Van Wyk M, Bornman P, Bassi C, Johnson CD (2005) Symptoms and quality of life in chronic pancreatitis assessed by structured interview and the EORTC QLQ-C30 and QLQ-PAN26. Am J Gastroenterol 100(4):918–926CrossRef

24.

Grimby G, Saltin B (1983) The ageing muscle. Clin Physiol 3(3):209–18. https://doi.org/10.1111/j.1475-097X.1983.tb00704.xCrossRefPubMed

25.

Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9(7):629–635. https://doi.org/10.1016/S1470-2045(08)70153-0CrossRefPubMed

26.

Baracos VE, Arribas L, Baracos VE. Sarcopenic obesity: Hidden muscle wasting and its impact for survival and complications of cancer therapy. Available from: https://academic.oup.com/annonc/article-abstract/29/suppl_2/ii1/4913824

27.

Prado CMM, Wells JCK, Smith SR, Stephan BCM, Siervo M (2012) Sarcopenic obesity: a Critical appraisal of the current evidence. Clin Nutr 31:583–601CrossRef

28.

Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS (2001) Sarcopenia. J Lab Clin Med 137(4):231–243CrossRef

29.

Takagi K, Yagi T, Yoshida R, Umeda Y, Nobuoka D, Kuise T et al (2017) Sarcopenia predicts postoperative infection in patients undergoing hepato-biliary-pancreatic surgery. Int J Surg Open 1(6):12–18CrossRef

30.

Tosato M, Marzetti E, Cesari M, Savera G, Miller RR, Bernabei R et al (2017) Measurement of muscle mass in sarcopenia: from imaging to biochemical markers. Aging Clin Exp Res 29(1):19–27CrossRef

31.

Lou N, Chi CH, Chen XD, Zhou CJ, Wang SL, Zhuang CL et al (2017) Sarcopenia in overweight and obese patients is a predictive factor for postoperative complication in gastric cancer: a prospective study. Eur J Surg Oncol 43(1):188–195CrossRef

32.

Buckinx F, Landi F, Cesari M, Fielding RA, Visser M, Engelke K et al (2018) Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle 9(2):269–278CrossRef

33.

Beaudart C, McCloskey E, Bruyère O, Cesari M, Rolland Y, Rizzoli R et al (2016) Sarcopenia in daily practice: assessment and management. BMC Geriatr 16(1):1–10CrossRef

34.

Martin L, Birdsell L, MacDonald N, Reiman T, Clandinin MT, McCargar LJ et al (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31(12):1539–1547CrossRef

35.

Ghosh S, Meister D, Cowen S, Hannan WJ, Ferguson A (1997) Body composition at the bedside. Eur J Gastroenterol Hepatol 9(8):783–788CrossRef

36.

Mintziras I, Miligkos M, Waechter S, Manoharan J, Maurer E, Bartsch DK (2018) Sarcopenia and sarcopenic obesity are significantly associated with poorer overall survival in patients with pancreatic cancer: systematic review and meta-analysis. Int J Surg 59:19–26CrossRef

37.

Vitali GC, Ronot M, Assalino M, Andres A, Terraz S, Puppa G, et al (2016) Sarcopenia is a predictor of pancreatic fistula occurence after duodenopancreatectomy. HPB 18:e385. https://doi.org/10.1016/j.hpb.2016.03.005CrossRef

38.

Hébuterne X, Hastier P, Péroux JL, Zeboudj N, Delmont JP, Rampal P (1996) Resting energy expenditure in patients with alcoholic chronic pancreatitis. Dig Dis Sci 41(3):533–539CrossRef

39.

Rasmussen HH, Irtun Ø, Olesen SS, Drewes AM, Holst M (2013) Nutrition in chronic pancreatitis. World J Gastroenterol 19(42):7267–7275CrossRef

40.

Chen HT, Chung YC, Chen YJ, Ho SY, Wu HJ (2017) Effects of different types of exercise on body composition, muscle strength, and IGF-1 in the elderly with sarcopenic obesity. J Am Geriatr Soc 65(4):827–832CrossRef

41.

Yoh K, Nishikawa H, Enomoto H, Iwata Y, Ishii A, Yuri Y, Takata R (2018) Clinical influence of exercise therapy on sarcopenia in patients with chronic pancreatitis: a study protocol for a randomised controlled trial. BMJ open gastroenterol 5(1):e000193CrossRef

Title: Prevalence and Impact of Sarcopenia in Chronic Pancreatitis: A Review of the Literature
Authors: Li Lian Kuan
Ashley R. Dennison
Giuseppe Garcea
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Sarcopenia
Chronic Pancreatitis
Pancreatogenic Diabetes
Published in: World Journal of Surgery / Issue 2/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05828-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Prevalence and Impact of Sarcopenia in Chronic Pancreatitis: A Review of the Literature

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2021

An Analysis of 30-Day in-Hospital Trauma Mortality in Four Urban University Hospitals Using the Australia India Trauma Registry

Outcomes in Patients with Chronic Kidney Disease After Liver Resection for Hepatocellular Carcinoma

Predictors of In-Hospital Mortality in Surgical Wards: A Multivariable Retrospective Cohort Analysis of 2,800,069 Hospitalizations

Biosynthetic Resorbable Prosthesis is Useful in Single-Stage Management of Chronic Mesh Infection After Abdominal Wall Hernia Repair

Development of a Clinical Prediction Model for In-hospital Mortality from the South African Cohort of the African Surgical Outcomes Study

Prognostic Impact of Paraaortic Lymph Node Metastasis in Extrahepatic Cholangiocarcinoma