以质量求发展,以服务铸品牌

Journal of Nursing ›› 2023, Vol. 30 ›› Issue (8): 17-22.doi: 10.16460/j.issn1008-9969.2023.08.017

Previous Articles     Next Articles

Current Status of patients with gastrointestinal tumor complicated with preoperative sarcopenia and it influencing factors: a 360-case study

ZHANG Ying1, ZHU Yong-jian2   

  1. 1. School of Nursing, Qingdao University, Qingdao 266000, China;
    2. Yantai Yuhuangding Hospital, Yantai 264000, China
  • Received:2022-10-26 Published:2023-05-12

Abstract: Objective To investigate the occurrence of preoperative sarcopenia in patients with gastrointestinal neoplasms and to analyze its influencing factors. Methods Convenience sampling was used to select 360 patients with gastrointestinal tumors before surgery who were hospitalized in the Gastrointestinal Surgery Department of a tertiary grade-A hospital in Yantai City from March 2021 to January 2022. Body composition analysis, muscle strength and physical function examination of the subjects were performed. The general information questionnaire, Barthel Index Rating Scale and International Physical Activity Questionnaire were used to evaluate and investigate the subjects. The upper arm circumference and waist circumference of the patients were measured. Binary logistic regression was used to analyze the influencing factors of preoperative sarcopenia in patients with gastrointestinal tumors. Results Among 360 patients with gastrointestinal tumors before operation, 81 patients with sarcopenia, with an incidence of 22.5%. Binary Logistic regression analysis showed that drinking history(OR=3.181, P=0.027), tumor stage(OR=6.402, P<0.001), concurrent diabetes mellitus(OR=6.156, P<0.001), and daily living ability(OR=5.297, P=0.003) were risk factors for sarcopenia; body mass index (OR=0.751, P<0.001) and physical activity level (OR=0.101, P<0.001; OR=0.078, P=0.002) were protective factors for sarcopenia. Conclusion There is high incidence of preoperative sarcopenia in patients with gastrointestinal tumors. Drinking history, concurrent diabetes mellitus, tumor stage, body mass index, daily living ability, and physical activity level are important predictors of sarcopenia in patients with gastrointestinal tumors before operation. It is recommended to develop nutrition and exercise intervention measures suitable for patients with gastrointestinal tumors before operation to reduce the risk of sarcopenia.

Key words: gastrointestinal tumor, sarcopenia, physical activity

CLC Number: 

  • R473.73
[1] 罗雯馨,谢敏仪,管晓芳,等.胃肠道肿瘤患者支持性照顾需求的现状及影响因素分析[J]. 天津护理,2021,29(1):25-28.DOI:10.3969/j.issn.1006-9143.2021. 01.007.
[2] 余静,周福祥.肌肉减少症在胃肠道肿瘤中的临床意义[J].肿瘤代谢与营养电子杂志,2017,4(4):483-488.DOI:10.16689/j.cnki.cn11-9349/r.2017.04.020.
[3] Dufour AB,Hannan MT,Murabito JM,et al.Sarcopenia definitions considering body size and fat mass are associated with mobility limitations: the framingham study[J]. J Gerontol A Biol Sci Med Sci, 2013, 68(2):168-174.DOI:10.1093/gerona/gls109.
[4] Gallois C, Bourillon C, Auclin E,et al.Skeletal muscle loss during chemotherapy and its association with survival and systemic treatment toxicity in metastatic colorectal cancer: an AGEO prospective multicenter study[J].Clin Res Hepatol Gastroenterol, 2021, 45(6):101603. DOI:10.1016/j.clinre.2020.101603.
[5] Koh FH,Chua JM,Tan JL,et al.Paradigm shift in gastrointestinal surgery-combating sarcopenia with prehabilitation: multimodal review of clinical and scientific data[J]. World J Gastrointest Surg,2021,13(8):734-755.DOI:10.4240/wjgs.v13.i8.734.
[6] Kim HJ, Lee ES, Kim BJ,et al.Risk factors and clinical outcomes of postgastrectomy sarcopenia newly developed after curative resection for gastric cancer[J].Medicine (Baltimore),2022,101(6):e28699.DOI:10.1097/MD.0000000000028699.
[7] Xiao J,Caan BJ,Cespedes Feliciano EM,et al.The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer[J].Am J Clin Nutr,2019,109(3):615-625.DOI:10.1093/ajcn/nqy328.
[8] Rolland Y,Czerwinski S,van Kan GA,et al.Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives[J]. J Nutr Health Aging,2008,12(7):433-450.DOI:10.1007/BF02982704.
[9] Kortebein P,Ferrando A,Lombeida J,et al.Effect of 10 days of bed rest on skeletal muscle in healthy older adults[J]. JAMA, 2007,297(16):1772-1774.DOI:10.1001/jama.297.16.1772-b.
[10] 高永祥,张晋昕. Logistic回归分析的样本量确定[J].循证医学,2018, 18(2):122-124.DOI:10.12019/j.issn.1671-5144.2018.02.015.
[11] Mahoney FI,Barthel D.Functional evaluation:the Barthel Index[J].Md State Med J,1965,14:56-61.
[12] 侯东哲,张颖,巫嘉陵,等.中文版Barthel指数的信度与效度研究[J].临床荟萃,2012,27(3):219-221.DOI:10.3760/cma.j.issn.0254-1424.2012.05.013.
[13] 李玲,罗经宏.日常生活能力评估在晚期肿瘤病人中的应用[J].全科护理,2021,19(13):1845-1847.DOI:10.12104/j.issn.1674-4748.2021.13.036.
[14] Craig CL,Marshall AL,Sjöström M,et al.International physical activity questionnaire: 12-country reliability and validity[J].Med Sci Sports Exerc, 2003, 35(8):1381-1395.DOI:10.1249/01.Mss.0000078924.61453.Fb.
[15] 屈宁宁,李可基.国际体力活动问卷中文版的信度和效度研究[J].中华流行病学杂志, 2004,25(3):87-90.DOI:10.3760/j.issn:0254-6450.2004.03.021.
[16] 樊萌语,吕筠,何平平.国际体力活动问卷中体力活动水平的计算方法[J].中华流行病学杂志,2014,35(8):961-964.DOI:10.3760/cma.j.issn.0254-6450.2014.08.019.
[17] Chen LK, Woo J,Assantachai P,et al.Asian Working Group for sarcopenia:2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020,21(3):300-307.e2.DOI:10.1016/j.jamda.2019.12.012.
[18] Wang J,Xu L,Huang S,et al.Low muscle mass and charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor:a cross-sectional study[J]. BMC Geriatr, 2021,21(1):730.DOI:10.1186/s12877-021-02683-z.
[19] Aoyama T, Kawabe T, Hirohito F, et al.Body composition analysis within 1 month after gastrectomy for gastric cancer[J].Gastric Cancer,2016, 19(2):645-650.DOI:10.1007/s10120-015-0496-x.
[20] Hong SH,Bae YJ.Association between alcohol consumption and the risk of sarcopenia: a systematic review and meta-Analysis[J]. Nutrients,2022,14(16):3266. DOI:10.3390/nu14163266.
[21] Prokopidis K,Witard OC.Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia[J].Nutr Res Rev,2022,35(2):197-206.DOI:10.1017/S0954422421000135.
[22] Vary TC, Frost RA, Lang CH.Acute alcohol intoxication increases atrogin-1 and MuRF1 mRNA without increasing proteolysis in skeletal muscle[J].Am J Physiol Regul Integr Comp Physiol,2008,294(6):R1777-1789.DOI:10.1152/ajpregu.00056.2008.
[23] Umegaki H.Sarcopenia and diabetes: Hyperglycemia is a risk factor for age-associated muscle mass and functional reduction[J]. J Diabetes Investig,2015,6(6):623-624.DOI:10.1111/jdi.12365.
[24] Yang Y, Breen L, Burd NA,et al.Resistance exercise enhances myofibrillar protein synthesis with graded intakes of whey protein in older men[J]. British Journal of Nutritionr,2012,108(10):1780-1788.DOI:10.1017/S0007114511007422.
[25] 王亚. 慢性乙型肝炎肝硬化患者并发肌少症的相关因素[J].河南医学研究,2022,31(22):4126-4129.DOI:10.3969/j.issn.1004-437X.2002.22.023.
[26] 赵晓蕊,龙云,陈思齐,等.妇科恶性肿瘤患者术后胃肠功能紊乱风险预测模型的构建及验证[J].护理学报,2022,29(3):72-78.DOI:10.16460/j.issn1008-9969.2022.03.072.
[27] Souza BU, Souza NCS,Martucci RB,et al.Factors associated with sarcopenia in patients with colorectal cancer[J]. Nutr Cancer,2018, 70(2):176-183.DOI:10.1080/01635581.2018.1412480.
[28] Tisdale MJ.Mechanisms of cancer cachexia[J].Physiol Rev,2009,89(2):381-410.DOI:10.1152/physrev.00016.2008.
[29] 周岩冰. 胃肠肿瘤患者的术前预康复[J].中华胃肠外科杂志, 2021, 24(2):122-127.DOI:10.3760/cma.j.cn.441530-20200318-00152.
[30] 王建华,冯玫,乔爱春,等. 脑梗死合并肌少症患者的临床特征及相关影响因素研究[J].中华全科医师杂志,2020,19(9):824-828. DOI:10.3760/cma.j.cn114798-20200207-00086.
[31] Bilski J, Pierzchalski P, Szczepanik M,et al.Multifactorial mechanism of sarcopenia and sarcopenic obesity. Role of physical exercise,microbiota and myokines[J]. Cells,2022,11(1):160. DOI:10.3390/cells11010160.
[32] Martins WR, Oliveira RJ,Carvalho RS,et al.Elastic resistance training to increase muscle strength in elderly:a systematic review with meta-analysis[J]. Arch Gerontol Geriatr,2013,57(1):8-15.DOI:10.1016/j.archger.2013.03.002.
[33] Chounghun K, Eunhee C, Gary D, et al.Exercise training attenuates aging-associated mitochondrial dysfunction in rat skeletal muscle:role of PGC-1α[J].Exp Gerontol, 2013, 48(11):1343-1350. DOI:10.1016/j.exger.2013.08.004.
[1] BU Si-si, LI Yu-hong, DING Li-xue, LI Wen-juan. Quality evaluation and content analysis of guidelines of physical activity for pregnant women [J]. Journal of Nursing, 2023, 30(4): 49-54.
[2] LIU Yun, TIAN Min, WANG Ya-fei, LIU Feng, LI Xin, PAN Ning. Development and Psychometric Testing of Knowledge-belief-practice Questionnaire for Nurses to Promote Physical Activity in Cancer Survivors [J]. Journal of Nursing, 2022, 29(23): 7-12.
[3] YU Xiao-mei,YAN Jin. Physical Activity and Its Influencing Factors of Breast Cancer Patients in Convalescence Stage [J]. Journal of Nursing, 2018, 25(10): 5-9.
[4] KANG Dong-qin,LIU Yu-fen,XUE Dong-qun,LIU Qi,LI Yu,CHEN Zhi-qi,YUE Shu-jin. Reliability and Validity of Chinese Version of EPIC Physical Activity Questionnaire [J]. Journal of Nursing, 2017, 24(24): 1-4.
[5] WANG Xiao-qing a,DUAN Pei-bei b,MEI Si-juan c,YANG Li-hua d. Effect of TraditionaI Chinese Medicine Foot Bath on Cancer-reIated Fatigue of Chemotherapy Patients with GastrointestinaI Tumor [J]. Journal of Nursing, 2015, (12): 1-3,4.
Viewed
Full text


Abstract

Cited

  Shared   
[1] . [J]. JOURNAL OF NURSING, 2012, 19(5): 61 -64 .
[2] . [J]. JOURNAL OF NURSING, 2012, 19(8): 68 -69 .
[3] . [J]. , 2016, 23(4): 30 -32,33 .
[4] . [J]. Journal of Nursing, 2018, 25(19): 71 -74 .
[5] . [J]. Journal of Nursing, 2019, 26(8): 61 -64 .
[6] . [J]. Journal of Nursing, 2019, 26(7): 70 -73 .
[7] . [J]. Journal of Nursing, 2019, 26(1): 36 -39 .
[8] . [J]. , 2016, 23(4): 56 -57 .
[9] . [J]. , 2016, 23(20): 60 -63 .
[10] . [J]. Journal of Nursing, 2018, 25(22): 59 -61 .