Sexual dimorphism modulates the impact of cancer cachexia on lower limb muscle mass and function

Citation

Stephens N, Gray C, MacDonald A, Tan BH, Gallagher IJ, Skipworth RJE, Ross JA, Fearon KCH & Greig C (2012) Sexual dimorphism modulates the impact of cancer cachexia on lower limb muscle mass and function. Clinical Nutrition, 31 (4), pp. 499-505. https://doi.org/10.1016/j.clnu.2011.12.008

Abstract
BACKGROUND & AIMS There is a sparsity of data on the impact of cachexia on human muscle function. This study examined the relationship between cachexia, quality of life and the mass/function/mechanical quality of lower limb skeletal muscle in gastrointestinal cancer patients. METHODS Quadriceps strength and lower limb power were measured in 54 patients with gastrointestinal cancer (n = 24 ≥ 10% weight-loss) and 18 healthy controls. Quadriceps cross-sectional area was measured in 33/54 patients and in all controls using MRI. Muscle mechanical quality was defined as quadriceps strength/unit quadriceps cross-sectional area. Quality of life was assessed using the EORTC QLQ-C30. Patients with weight-loss ≥ 10% were classified as cachectic. RESULTS In male cachectic patients, quadriceps strength (p = 0.003), lower limb power (p = 0.026), quadriceps cross-sectional area (p = 0.019) and muscle quality (p = 0.008) were reduced compared with controls. In female cachectic patients, quadriceps strength (p = 0.001) and muscle quality (p = 0.001) were reduced compared with controls. Physical function (p = 0.013) and fatigue (p = 0.004) quality of life scores were reduced in male cachectic compared with non-cachectic patients, but not in females. CONCLUSIONS Muscle quality is reduced in cancer patients. The degree of impairment of lower limb muscle mass, quality and function and the impact on quality of life varies with weight-loss and sex.

Keywords
Cachexia; Cancer; Muscle strength; Muscle quality; Sexual dimorphism

Journal
Clinical Nutrition: Volume 31, Issue 4