Preoperative evaluation of sarcopenia and nutritional status is a crucial prognostic factor in patients with gastrointestinal malignancies (GIM). Whole-body phase angle (Ph A), measured via bioelectrical impedance analysis (BIA), reflects cellular health and nutritional condition, and has gained attention as a potential prognostic marker.
Methods
This study included 149 patients who underwent surgery for GIM at our department between April 2024 and May 2025. Sarcopenia was assessed using skeletal muscle index (SMI; men: < 7.0, women: < 5.7 kg m2) derived from BIA, and those meeting the criteria were classified as ‘presumed sarcopenia (P-sarcopenia)’. Ph A values were also obtained using BIA, and skeletal muscle volume was measured using SYNAPSE VINCENT to determine the volume of large psoas muscle (PV).
Results
Among the 149 patients, 58 (38.9%) were diagnosed with P-sarcopenia, the breakdown being 31 males (53.4%) and 27 females (46.6%). The median age was 76 years (range: 53–89). Multivariate analysis revealed that low Ph A (odds ratio: 0.537, p < 0.04) and low PV (odds ratio: 0.992, p < 0.007) were significant risk factors for P-sarcopenia. These findings suggest that patients with P-sarcopenia tend to have lower Ph A and PV values.
Conclusions
Patients with GIM who present with P-sarcopenia are more likely to exhibit reduced Ph A and PV, indicating compromised cellular and nutritional status. Ph A, as a non-invasive and easily obtainable parameter via BIA, may serve as a useful screening tool for identifying P-sarcopenia in preoperative settings.
{"title":"Association of Sarcopenia With Phase Angle and Urinary Titin Fragment in Patients With Gastrointestinal Malignancies","authors":"Mitsugi Shimoda, Masahiro Shiihara, Mitsuru Watanabe, Ryoichi Miyamoto, Jiro Shimazaki, Shuji Suzuki","doi":"10.1002/rco2.70025","DOIUrl":"https://doi.org/10.1002/rco2.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preoperative evaluation of sarcopenia and nutritional status is a crucial prognostic factor in patients with gastrointestinal malignancies (GIM). Whole-body phase angle (Ph A), measured via bioelectrical impedance analysis (BIA), reflects cellular health and nutritional condition, and has gained attention as a potential prognostic marker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 149 patients who underwent surgery for GIM at our department between April 2024 and May 2025. Sarcopenia was assessed using skeletal muscle index (SMI; men: < 7.0, women: < 5.7 kg m<sup>2</sup>) derived from BIA, and those meeting the criteria were classified as ‘presumed sarcopenia (P-sarcopenia)’. Ph A values were also obtained using BIA, and skeletal muscle volume was measured using SYNAPSE VINCENT to determine the volume of large psoas muscle (PV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 149 patients, 58 (38.9%) were diagnosed with P-sarcopenia, the breakdown being 31 males (53.4%) and 27 females (46.6%). The median age was 76 years (range: 53–89). Multivariate analysis revealed that low Ph A (odds ratio: 0.537, <i>p</i> < 0.04) and low PV (odds ratio: 0.992, <i>p</i> < 0.007) were significant risk factors for P-sarcopenia. These findings suggest that patients with P-sarcopenia tend to have lower Ph A and PV values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with GIM who present with P-sarcopenia are more likely to exhibit reduced Ph A and PV, indicating compromised cellular and nutritional status. Ph A, as a non-invasive and easily obtainable parameter via BIA, may serve as a useful screening tool for identifying P-sarcopenia in preoperative settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caleb P. Calaway, Ana Raquel Calzada, Michel Huyghe, Colten Brown, Humzah Ali, Kylie Martinez, Bryan Mann, Ihtsham Haq, Joseph F. Signorile
<div> <section> <h3> Background</h3> <p>High-speed resistance training has been shown to be a viable intervention for reducing neuromuscular symptoms in older persons with Parkinson's disease. Velocity-based training, a recently developed resistance training modality, utilizes velocity rather than load to dictate progressions. No study has examined the effects of this training method on muscle structure in Parkinson's patients.</p> </section> <section> <h3> Methods</h3> <p>Sixteen older adults with Parkinson's disease (Hoehn and Yahr Stages 1–3) were randomly assigned to a 10% (<i>n</i> = 7, 6 males, 1 female) or 30% (<i>n</i> = 9, 6 males, 3 females) velocity loss threshold protocol twice weekly for 12 weeks of velocity-based training. Changes in ultrasound measures including muscle thickness, echo intensity, pennation angle, shear wave elastography, and performance measurements including specific force and power of the left and right rectus femoris and vastus lateralis were analysed before and after the intervention period.</p> </section> <section> <h3> Results</h3> <p>Significant improvements were seen for the sample in muscle thickness for the right (MDiff ± SE = 0.19 ± 0.05 cm; <i>p</i> = 0.003) and left (0.20 ± 0.09 cm; <i>p</i> = 0.033) rectus femoris and the right (0.14 ± 0.06 cm; <i>p</i> = 0.04) and left (0.19 ± 0.07 cm; <i>p</i> = 0.018) vastus lateralis. For echo intensity, there were significant improvements for the right rectus femoris (−3.37 ± 1.29 units; <i>p</i> = 0.002) and the left vastus lateralis (−7.11 ± 2.68 units; <i>p</i> = 0.019); however, improvements in the left (<i>p</i> = 0.033) and right (<i>p</i> < 0.001) vastus lateralis were seen only by the 30% velocity loss threshold group. Significant increases in pennation angle were detected in the right rectus femoris (2.47° ± 0.84°; <i>p</i> = 0.011) and reductions in shear wave elastography for the left rectus femoris (−3.33 ± 1.29 kPa; <i>p</i> = 0.013) of the sample. For specific power, significant improvements were seen for the right (0.02 ± 0.01 W·cm<sup>3</sup>; <i>p</i> = 0.040) and left (0.04 ± 0.02 W·cm<sup>3</sup>; <i>p</i> = 0.047) rectus femoris muscles for both groups.</p> </section> <section> <h3> Conclusions</h3> <p>Results indicate that 12 weeks of velocity-based training can produce positive changes in muscle morphology and neuromuscular performance of the lower limbs for individuals with Parkinson's disease. Furthermore, using a 30% velocity loss threshold is more effective than using a 10% velocity loss threshold.</p> <p><
高速阻力训练已被证明是减轻老年帕金森病患者神经肌肉症状的一种可行的干预措施。以速度为基础的训练，是最近发展起来的一种阻力训练方式，利用速度而不是负荷来决定进步。目前还没有研究检验这种训练方法对帕金森病患者肌肉结构的影响。方法将16例老年帕金森病患者（Hoehn和Yahr阶段1 - 3）随机分为10% （n = 7, 6男性，1女性）或30% （n = 9, 6男性，3女性）速度损失阈值方案，每周2次，为期12周的速度训练。分析干预前后肌肉厚度、回声强度、穿刺角度、横波弹性成像等超声指标的变化，以及左右股直肌和股外侧肌比力和功率等性能指标的变化。结果右股直肌（MDiff±SE = 0.19±0.05 cm, p = 0.003）、左股直肌（0.20±0.09 cm, p = 0.033）、右股外侧肌（0.14±0.06 cm, p = 0.04）、左股外侧肌（0.19±0.07 cm, p = 0.018）的肌肉厚度均有显著改善。回声强度方面，右侧股直肌（- 3.37±1.29个单位，p = 0.002）和左侧股外侧肌（- 7.11±2.68个单位，p = 0.019）有显著改善；然而，只有30%速度损失阈值组的左股外侧肌（p = 0.033）和右股外侧肌（p < 0.001）有所改善。右侧股直肌的穿刺角显著增加（2.47°±0.84°，p = 0.011），左侧股直肌的横波弹性图显著减少（- 3.33±1.29 kPa, p = 0.013）。在比功率方面，两组右股直肌（0.02±0.01 W·cm3, p = 0.040）和左股直肌（0.04±0.02 W·cm3, p = 0.047）均有显著改善。结果表明，12周的速度训练可以对帕金森病患者的下肢肌肉形态和神经肌肉性能产生积极的影响。此外，使用30%的速度损失阈值比使用10%的速度损失阈值更有效。试验注册：20220489
{"title":"Velocity-Based-Training Induces Positive Changes in Muscle Morphology in Parkinson's Disease Patients: A Pilot Study","authors":"Caleb P. Calaway, Ana Raquel Calzada, Michel Huyghe, Colten Brown, Humzah Ali, Kylie Martinez, Bryan Mann, Ihtsham Haq, Joseph F. Signorile","doi":"10.1002/rco2.70023","DOIUrl":"https://doi.org/10.1002/rco2.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-speed resistance training has been shown to be a viable intervention for reducing neuromuscular symptoms in older persons with Parkinson's disease. Velocity-based training, a recently developed resistance training modality, utilizes velocity rather than load to dictate progressions. No study has examined the effects of this training method on muscle structure in Parkinson's patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixteen older adults with Parkinson's disease (Hoehn and Yahr Stages 1–3) were randomly assigned to a 10% (<i>n</i> = 7, 6 males, 1 female) or 30% (<i>n</i> = 9, 6 males, 3 females) velocity loss threshold protocol twice weekly for 12 weeks of velocity-based training. Changes in ultrasound measures including muscle thickness, echo intensity, pennation angle, shear wave elastography, and performance measurements including specific force and power of the left and right rectus femoris and vastus lateralis were analysed before and after the intervention period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant improvements were seen for the sample in muscle thickness for the right (MDiff ± SE = 0.19 ± 0.05 cm; <i>p</i> = 0.003) and left (0.20 ± 0.09 cm; <i>p</i> = 0.033) rectus femoris and the right (0.14 ± 0.06 cm; <i>p</i> = 0.04) and left (0.19 ± 0.07 cm; <i>p</i> = 0.018) vastus lateralis. For echo intensity, there were significant improvements for the right rectus femoris (−3.37 ± 1.29 units; <i>p</i> = 0.002) and the left vastus lateralis (−7.11 ± 2.68 units; <i>p</i> = 0.019); however, improvements in the left (<i>p</i> = 0.033) and right (<i>p</i> < 0.001) vastus lateralis were seen only by the 30% velocity loss threshold group. Significant increases in pennation angle were detected in the right rectus femoris (2.47° ± 0.84°; <i>p</i> = 0.011) and reductions in shear wave elastography for the left rectus femoris (−3.33 ± 1.29 kPa; <i>p</i> = 0.013) of the sample. For specific power, significant improvements were seen for the right (0.02 ± 0.01 W·cm<sup>3</sup>; <i>p</i> = 0.040) and left (0.04 ± 0.02 W·cm<sup>3</sup>; <i>p</i> = 0.047) rectus femoris muscles for both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicate that 12 weeks of velocity-based training can produce positive changes in muscle morphology and neuromuscular performance of the lower limbs for individuals with Parkinson's disease. Furthermore, using a 30% velocity loss threshold is more effective than using a 10% velocity loss threshold.</p>\u0000 \u0000 <p><","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Muscle weakness with age precedes muscle mass loss, and muscle quality is an issue in sarcopenia. Muscle tissue fibrosis progresses with age, with an increasing proportion of connective tissue containing collagen fibres. Increased fibrosis reduces the efficiency of force transmission during muscle contraction, leading to decreased muscle tension and overall performance. However, few studies have focused specifically on this condition and examined its treatment and effects. Using senescence-accelerated mouse-prone 8 (SAMP8) models, we aimed to clarify the effects of stretch stimulation on fibrosis and examine muscle function, histological changes in fibrosis and changes in fibrosis-related genes.</p> </section> <section> <h3> Methods</h3> <p>The right side of the gastrocnemius muscle of 8-month-old SAMP8 was the stretch group and the left side the control group (<i>n</i> = 8/group). The intervention was performed 15 times/min, 15 min/day and 5 days/week for 2 weeks. Muscle wet weight (MWW), ankle joint range of motion and passive/active tension were measured to evaluate muscle function. For histological analysis, muscle fibre cross-sectional area (CSA) and collagen content were calculated using haematoxylin and eosin and picrosirius-red staining, respectively. For molecular biological analysis, mRNA expression levels of fibrosis-related genes, transforming growth factor-β, α-smooth muscle actin (SMA), and collagen types I and III were measured using quantitative polymerase chain reaction.</p> </section> <section> <h3> Results</h3> <p>There was no significant difference in body weight and ankle joint's range of motion before and after the intervention. MWW after the intervention was higher in the stretch group (control group, 0.13 ± 0.01 g vs. stretch group, 0.14 ± 0.01 g; <i>p</i> < 0.05). No significant difference occurred in passive tension between groups; active tension was higher in the stretch group (control group, 2.98 ± 0.53 N/g vs. stretch group, 3.67 ± 0.52 N/g; <i>p</i> < 0.05). Histological findings showed a significantly higher CSA (control group, 2065.21 ± 93.98 μm<sup>2</sup> vs. stretch group, 2571.15 ± 187.12 μm<sup>2</sup>; <i>p</i> < 0.05) and a significantly lower collagen content in the stretch group (control group, 1.28 ± 0.47% vs. stretch group, 0.53 ± 0.14%; <i>p</i> < 0.05). Thickening of the perimysium and endomysium was lower in the stretch group. Molecular biological findings showed a significant decrease in the expression levels of fibrosis-related genes, including α-SMA (control group, 1 ± 0.49 vs. stretch group, 0.30 ± 0.16; <i>p</i> < 0.05) and collagen type III (c
背景随着年龄的增长肌肉无力先于肌肉质量的减少，肌肉质量是肌肉减少症的一个问题。肌肉组织纤维化随着年龄的增长而发展，含有胶原纤维的结缔组织的比例增加。纤维化的增加降低了肌肉收缩过程中力传递的效率，导致肌肉张力和整体表现下降。然而，很少有研究专门关注这种情况，并检查其治疗和影响。使用衰老加速小鼠8 （SAMP8）模型，我们旨在阐明拉伸刺激对纤维化的影响，并检查肌肉功能、纤维化组织学变化和纤维化相关基因的变化。方法8月龄SAMP8腓肠肌右侧为拉伸组，左侧为对照组（n = 8/组）。干预15次/分钟，15分钟/天，5天/周，共2周。测量肌肉湿重（MWW）、踝关节活动范围和被动/主动张力来评估肌肉功能。进行组织学分析时，分别采用苏木精、伊红和小红染色法计算肌纤维横截面积（CSA）和胶原蛋白含量。在分子生物学分析方面，采用定量聚合酶链反应法测定了纤维化相关基因、转化生长因子-β、α-平滑肌肌动蛋白（SMA）和ⅰ型和ⅲ型胶原蛋白的mRNA表达水平。结果干预前后患者体重、踝关节活动度无显著差异。拉伸组干预后MWW较高（对照组0.13±0.01 g，拉伸组0.14±0.01 g; p < 0.05）。两组间被动张力无显著差异；张力组主动张力明显高于张力组（对照组为2.98±0.53 N/g，张力组为3.67±0.52 N/g; p < 0.05）。组织学结果显示，拉伸组CSA显著增高（对照组，2065.21±93.98 μm2比拉伸组高，2571.15±187.12 μm2; p < 0.05），胶原含量显著降低（对照组，1.28±0.47%比拉伸组高，0.53±0.14%;p < 0.05）。牵张组肌周和肌内膜增厚较低。分子生物学结果显示，纤维化相关基因α-SMA（对照组，与拉伸组相比，1±0.49,0.30±0.16;p < 0.05）和III型胶原（对照组，与拉伸组相比，1±0.39,0.37±0.23;p < 0.05）的表达水平显著降低。结论拉伸干预SAMP8降低了一些纤维化相关基因的表达，可能导致骨骼肌胶原增殖减少和活性张力增加。
{"title":"Effect of Stretching on Skeletal Muscle Fibrosis in Sarcopenia","authors":"Daiki Nohara, Momoko Nagai-Tanima, Shion Masuda, Misa Toyota, Ryo Nakahara, Kazuhiro Hayashi, Tomoki Aoyama","doi":"10.1002/rco2.70021","DOIUrl":"https://doi.org/10.1002/rco2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle weakness with age precedes muscle mass loss, and muscle quality is an issue in sarcopenia. Muscle tissue fibrosis progresses with age, with an increasing proportion of connective tissue containing collagen fibres. Increased fibrosis reduces the efficiency of force transmission during muscle contraction, leading to decreased muscle tension and overall performance. However, few studies have focused specifically on this condition and examined its treatment and effects. Using senescence-accelerated mouse-prone 8 (SAMP8) models, we aimed to clarify the effects of stretch stimulation on fibrosis and examine muscle function, histological changes in fibrosis and changes in fibrosis-related genes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The right side of the gastrocnemius muscle of 8-month-old SAMP8 was the stretch group and the left side the control group (<i>n</i> = 8/group). The intervention was performed 15 times/min, 15 min/day and 5 days/week for 2 weeks. Muscle wet weight (MWW), ankle joint range of motion and passive/active tension were measured to evaluate muscle function. For histological analysis, muscle fibre cross-sectional area (CSA) and collagen content were calculated using haematoxylin and eosin and picrosirius-red staining, respectively. For molecular biological analysis, mRNA expression levels of fibrosis-related genes, transforming growth factor-β, α-smooth muscle actin (SMA), and collagen types I and III were measured using quantitative polymerase chain reaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant difference in body weight and ankle joint's range of motion before and after the intervention. MWW after the intervention was higher in the stretch group (control group, 0.13 ± 0.01 g vs. stretch group, 0.14 ± 0.01 g; <i>p</i> < 0.05). No significant difference occurred in passive tension between groups; active tension was higher in the stretch group (control group, 2.98 ± 0.53 N/g vs. stretch group, 3.67 ± 0.52 N/g; <i>p</i> < 0.05). Histological findings showed a significantly higher CSA (control group, 2065.21 ± 93.98 μm<sup>2</sup> vs. stretch group, 2571.15 ± 187.12 μm<sup>2</sup>; <i>p</i> < 0.05) and a significantly lower collagen content in the stretch group (control group, 1.28 ± 0.47% vs. stretch group, 0.53 ± 0.14%; <i>p</i> < 0.05). Thickening of the perimysium and endomysium was lower in the stretch group. Molecular biological findings showed a significant decrease in the expression levels of fibrosis-related genes, including α-SMA (control group, 1 ± 0.49 vs. stretch group, 0.30 ± 0.16; <i>p</i> < 0.05) and collagen type III (c","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Cancer cachexia is a multifactorial metabolic syndrome characterized by anorexia and the progressive loss of skeletal muscle and adipose tissue, severely impairing quality of life, shortening survival and reducing treatment efficacy in cancer patients. The development of effective therapies has been hampered by the lack of preclinical models that faithfully replicate the clinical features and underlying mechanisms of cachexia. This study aimed to establish a novel murine model of cancer cachexia using subcutaneous implantation of renal carcinoma (RenCa) cells that align with clinical diagnostic criteria.</p> </section> <section> <h3> Methods</h3> <p>On Day 0, 8-week-old male BALB/c mice were anaesthetised and subcutaneously injected with murine RenCa cells or vehicle (control). A subset of mice was subjected to pair-feeding with RenCa-bearing mice, while another subset underwent subdiaphragmatic vagotomy (SDV) 2 weeks before cell implantation. Plasma levels of acyl-ghrelin and insulin-like growth factor-1 (IGF-1) were measured by ELISA. The gastrocnemius muscle was analysed for gene and protein expression related to atrophy and energy metabolism using quantitative RT-PCR and Western blotting, respectively, and for metabolic alterations using capillary electrophoresis time-of-flight mass spectrometry (CE-TOF-MS).</p> </section> <section> <h3> Results</h3> <p>Mice bearing RenCa tumours exhibited progressive cachexia. By Day 30, compared to controls, RenCa-bearing mice had significantly reduced tumour-free body weight (20.3 vs. 26.1 g), daily food intake (1.8 vs. 3.0 g/day), gastrocnemius muscle mass (112.1 vs. 140.7 mg) and epididymal fat mass (18.6 vs. 307.3 mg; all <i>p</i> < 0.01). Grip strength normalized to body mass remained unchanged even on Day 30. The pair-feeding experiment revealed that anorexia largely contributed to the onset of cachexic-like symptoms. SDV further exacerbated gastrocnemius atrophy (<i>p</i> < 0.05), implicating vagal signalling in the pathogenesis of cachexia, other than anorexia. Muscle expression of <i>Trim63</i> and <i>Fbxo32</i> peaked on Day 20, showing 5.5- and 4.4-fold increases compared with controls, respectively. The expression of <i>Ctsl</i> and <i>4ebp1</i> increased on Day 7 and remained elevated until Day 20. Metabolomic analyses revealed impaired glutathione and Akt-mediated glucose metabolism. Plasma acyl-ghrelin levels were elevated in RenCa-bearing mice (38.5–49.1 pg/mL) compared to controls (33.3–37.9 pg/mL) from Day 14 to Day 30, while IGF-1 levels were significantly reduced on Day 14 (94.6 vs. 220.2 ng/mL; <i>p</i> < 0.05).</p> </section
癌症恶病质是一种多因素代谢综合征，以厌食和骨骼肌和脂肪组织的进行性损失为特征，严重影响癌症患者的生活质量，缩短生存期，降低治疗效果。由于缺乏临床前模型来忠实地复制恶病质的临床特征和潜在机制，有效治疗方法的发展受到阻碍。本研究旨在建立符合临床诊断标准的肾癌（RenCa）细胞皮下植入的新型小鼠癌症恶病质模型。方法在第0天麻醉8周龄雄性BALB/c小鼠，皮下注射小鼠RenCa细胞或对照。一组小鼠与含renca小鼠配对喂养，另一组小鼠在细胞植入前2周进行膈下迷走神经切开术（SDV）。ELISA法检测血浆中酰基生长素和胰岛素样生长因子-1 （IGF-1）水平。使用定量RT-PCR和Western blotting分别分析腓肠肌萎缩和能量代谢相关的基因和蛋白质表达，并使用毛细管电泳飞行时间质谱（CE-TOF-MS）分析代谢变化。结果RenCa肿瘤小鼠表现出进行性恶病质。到第30天，与对照组相比，renca小鼠的无瘤体重（20.3比26.1 g）、每日食物摄入量（1.8比3.0 g/d）、腓肠肌质量（112.1比140.7 mg）和附睾脂肪质量（18.6比307.3 mg，均p <； 0.01）显著减少。握力与体重的比值即使在第30天也保持不变。配对喂养实验显示，厌食症在很大程度上导致了恶病质样症状的出现。SDV进一步加重了肠肌萎缩（p < 0.05），暗示迷走神经信号在恶病质的发病机制中，而不是厌食症。Trim63和Fbxo32的肌肉表达在第20天达到峰值，分别比对照组增加5.5倍和4.4倍。Ctsl和4ebp1的表达在第7天升高，并持续升高至第20天。代谢组学分析显示谷胱甘肽和akt介导的葡萄糖代谢受损。与对照组（33.3-37.9 pg/mL）相比，renca小鼠血浆中酰胃饥饿素水平在第14天至第30天升高（38.5-49.1 pg/mL），而IGF-1水平在第14天显著降低（94.6 vs. 220.2 ng/mL; p < 0.05）。我们建立了renca诱导的癌症恶病质小鼠模型，该模型概括了关键的临床特征，包括进行性厌食症、体重减轻、肌肉萎缩和ghrelin-IGF-1信号改变，为机制研究和治疗开发提供了有价值的工具。
{"title":"A Novel Mouse Model Recapitulating the Clinical Progression of Cancer Cachexia Induced by Renal Carcinoma Cells","authors":"Miaki Uzu, Anzu Aoyama, Takumi Kobayashi, Mayuka Morita, Rumi Murayama, Kenji Hashimoto, Hiroyuki Nakamura","doi":"10.1002/rco2.70018","DOIUrl":"https://doi.org/10.1002/rco2.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer cachexia is a multifactorial metabolic syndrome characterized by anorexia and the progressive loss of skeletal muscle and adipose tissue, severely impairing quality of life, shortening survival and reducing treatment efficacy in cancer patients. The development of effective therapies has been hampered by the lack of preclinical models that faithfully replicate the clinical features and underlying mechanisms of cachexia. This study aimed to establish a novel murine model of cancer cachexia using subcutaneous implantation of renal carcinoma (RenCa) cells that align with clinical diagnostic criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>On Day 0, 8-week-old male BALB/c mice were anaesthetised and subcutaneously injected with murine RenCa cells or vehicle (control). A subset of mice was subjected to pair-feeding with RenCa-bearing mice, while another subset underwent subdiaphragmatic vagotomy (SDV) 2 weeks before cell implantation. Plasma levels of acyl-ghrelin and insulin-like growth factor-1 (IGF-1) were measured by ELISA. The gastrocnemius muscle was analysed for gene and protein expression related to atrophy and energy metabolism using quantitative RT-PCR and Western blotting, respectively, and for metabolic alterations using capillary electrophoresis time-of-flight mass spectrometry (CE-TOF-MS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mice bearing RenCa tumours exhibited progressive cachexia. By Day 30, compared to controls, RenCa-bearing mice had significantly reduced tumour-free body weight (20.3 vs. 26.1 g), daily food intake (1.8 vs. 3.0 g/day), gastrocnemius muscle mass (112.1 vs. 140.7 mg) and epididymal fat mass (18.6 vs. 307.3 mg; all <i>p</i> < 0.01). Grip strength normalized to body mass remained unchanged even on Day 30. The pair-feeding experiment revealed that anorexia largely contributed to the onset of cachexic-like symptoms. SDV further exacerbated gastrocnemius atrophy (<i>p</i> < 0.05), implicating vagal signalling in the pathogenesis of cachexia, other than anorexia. Muscle expression of <i>Trim63</i> and <i>Fbxo32</i> peaked on Day 20, showing 5.5- and 4.4-fold increases compared with controls, respectively. The expression of <i>Ctsl</i> and <i>4ebp1</i> increased on Day 7 and remained elevated until Day 20. Metabolomic analyses revealed impaired glutathione and Akt-mediated glucose metabolism. Plasma acyl-ghrelin levels were elevated in RenCa-bearing mice (38.5–49.1 pg/mL) compared to controls (33.3–37.9 pg/mL) from Day 14 to Day 30, while IGF-1 levels were significantly reduced on Day 14 (94.6 vs. 220.2 ng/mL; <i>p</i> < 0.05).</p>\u0000 </section","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>In the current issue of <i>JCSM Communications</i>, a systematic review and meta-analysis [<span>1</span>] investigated the impact of resistance exercise training (RET) in prehabilitation protocols implemented in the management of colorectal cancer (CRC) patients. The findings suggest that, despite the limited sample size, heterogeneity and risk of bias, exercise improves physical function, supporting the inclusion of RET for prehabilitation in CRC patients scheduled for surgery.</p><p>This work highlights the importance of supportive oncology interventions in the management of cancer patients throughout the whole cancer continuum. The final aim is to be able to significantly impact on patients' quality of life and survival, beyond the outcome of medical and/or surgical cancer treatment.</p><p>According to a recent scoping review [<span>2</span>], prehabilitation is defined as a process from diagnosis to surgery, consisting of one or more preoperative interventions of exercise, nutrition and psychological strategies that aim to enhance functional capacity and physiological reserve to allow patients to withstand surgical stressors, improve postoperative outcomes (e.g., shorter hospital stay, reduced complications) and facilitate recovery. It is remarkable that most of such objectives are shared with anti-cancer cachexia interventions, primarily aiming to counteract body and lean mass wasting and to improve muscle strength, with a potential impact on prehabilitation targets, including postoperative morbidity and recovery.</p><p>Prehabilitation programmes can be very heterogeneous [<span>3</span>] in terms of setting (e.g., home and hospital-based), duration (e.g., 3–4 weeks, months) and components. Most of the interventions typically include (1) a personalized exercise programme combining endurance and resistance training and (2) a nutritional intervention with a balanced macronutrient diet and protein oral nutritional supplements. Both components aim to improve cardiorespiratory fitness, body composition and nutritional status to better tolerate the stress response and disability resulting from surgery and/or other cancer-related treatments.</p><p>It is thus evident that prehabilitation and cachexia research share the focus on sarcopenia, malnutrition, functional capacity and quality of life. Such common interests open an opportunity for merging knowledge and resources, with the potential to cross-fertilize the respective research fields, eventually providing an acceleration in discoveries and new therapy optimization. As an example, with muscle wasting/sarcopenia well characterized during cancer cachexia and current clinical trials ongoing to prevent it, the same drugs may be tested for preventing sarcopenia during cancer patient prehabilitation. Along the same lines, drugs that improve the nutritional status in cachectic individuals, such as ghrelin analogues or GDF-15 blockers, may be efficiently adopted during prehabilitation interventions
{"title":"Prehabilitation Meets Cancer Cachexia: Current Challenges and Opportunities","authors":"Nicolò Pecorelli, Fabio Penna","doi":"10.1002/rco2.70019","DOIUrl":"https://doi.org/10.1002/rco2.70019","url":null,"abstract":"<p>In the current issue of <i>JCSM Communications</i>, a systematic review and meta-analysis [<span>1</span>] investigated the impact of resistance exercise training (RET) in prehabilitation protocols implemented in the management of colorectal cancer (CRC) patients. The findings suggest that, despite the limited sample size, heterogeneity and risk of bias, exercise improves physical function, supporting the inclusion of RET for prehabilitation in CRC patients scheduled for surgery.</p><p>This work highlights the importance of supportive oncology interventions in the management of cancer patients throughout the whole cancer continuum. The final aim is to be able to significantly impact on patients' quality of life and survival, beyond the outcome of medical and/or surgical cancer treatment.</p><p>According to a recent scoping review [<span>2</span>], prehabilitation is defined as a process from diagnosis to surgery, consisting of one or more preoperative interventions of exercise, nutrition and psychological strategies that aim to enhance functional capacity and physiological reserve to allow patients to withstand surgical stressors, improve postoperative outcomes (e.g., shorter hospital stay, reduced complications) and facilitate recovery. It is remarkable that most of such objectives are shared with anti-cancer cachexia interventions, primarily aiming to counteract body and lean mass wasting and to improve muscle strength, with a potential impact on prehabilitation targets, including postoperative morbidity and recovery.</p><p>Prehabilitation programmes can be very heterogeneous [<span>3</span>] in terms of setting (e.g., home and hospital-based), duration (e.g., 3–4 weeks, months) and components. Most of the interventions typically include (1) a personalized exercise programme combining endurance and resistance training and (2) a nutritional intervention with a balanced macronutrient diet and protein oral nutritional supplements. Both components aim to improve cardiorespiratory fitness, body composition and nutritional status to better tolerate the stress response and disability resulting from surgery and/or other cancer-related treatments.</p><p>It is thus evident that prehabilitation and cachexia research share the focus on sarcopenia, malnutrition, functional capacity and quality of life. Such common interests open an opportunity for merging knowledge and resources, with the potential to cross-fertilize the respective research fields, eventually providing an acceleration in discoveries and new therapy optimization. As an example, with muscle wasting/sarcopenia well characterized during cancer cachexia and current clinical trials ongoing to prevent it, the same drugs may be tested for preventing sarcopenia during cancer patient prehabilitation. Along the same lines, drugs that improve the nutritional status in cachectic individuals, such as ghrelin analogues or GDF-15 blockers, may be efficiently adopted during prehabilitation interventions ","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Muscle atrophy is critical to cognitive decline, as evidenced in previous studies which showed that disuse-induced skeletal muscle atrophy in the hind limbs accelerated early cognitive decline in young Alzheimer's model 5XFAD mice and nontransgenic young mice. As physical activity is challenging for individuals with muscle loss due to aging or immobilisation, effective medications are needed to prevent cast immobilisation–induced cognitive decline. Rutin, a candidate medication for preventing muscle loss and cognitive decline, has numerous biological effects but is limited by its low bioavailability owing to water insolubility. EubioQuercetin (ws Rutin), a highly absorbable Rutin formula, offers over 2000-fold improved solubility. This study investigated whether oral water-soluble Rutin (ws Rutin) treatment prevents cast immobilisation–induced memory dysfunction in young mice and explored its underlying mechanism.</p> </section> <section> <h3> Methods</h3> <p>Healthy young male ddY mice (10 weeks old) were used. Tissue distribution of Rutin was determined using LC-MS/MS at 0.5, 3, 6 and 16 h after oral administration of ws Rutin or conventional Rutin. Muscle atrophy was induced via bilateral hindlimb immobilisation by placing them in casts for 17 days. Cognitive function was evaluated using an object recognition test. RNA-seq was used to comprehensively analyse mRNA expression in the hippocampus and triceps surae. Expression levels of candidate molecules, affected by immobilisation and ws Rutin treatment, were confirmed using immunohistochemistry and Western blotting. Cultured hippocampal neurons and myocytes were treated with ws Rutin or Rutin, and parameters such as Klotho expression, axon/dendrite length, neuron numbers, ATP6 expression and myotube length were quantified by immunocytochemistry.</p> </section> <section> <h3> Results</h3> <p>ws Rutin prevented cast immobilisation–induced memory deficits in young mice (<i>n</i> = 9; training vs. test, <i>p</i> = 0.0167) and increased Klotho in mRNA and protein levels in the brain. By orally administering Rutin, Rutin rapidly reached the blood, brain and skeletal muscles. Direct treatment of cultured hippocampal neurons with ws Rutin or conventional Rutin increased Klotho expression (<i>p</i> < 0.0001), axon length (<i>p</i> < 0.0001), dendrite number (<i>p</i> < 0.001) and neuron number (<i>p</i> < 0.0001). Recombinant Klotho treatment also increased hippocampal neuron numbers (<i>p</i> < 0.0001). In skeletal muscles, ws Rutin treatment enhanced mitochondrial protein MTCO1 expression in vivo (<i>n</i> = 5 mice, <i>p</i> = 0.0224). In myocytes,
{"title":"Oral Treatment of Water-Soluble Rutin Protects Against Cast Immobilisation–Induced Cognitive Impairment","authors":"Chihiro Tohda, Mizuho Kaneda, Tsukasa Nagase, Kaori Nomoto","doi":"10.1002/rco2.70016","DOIUrl":"https://doi.org/10.1002/rco2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle atrophy is critical to cognitive decline, as evidenced in previous studies which showed that disuse-induced skeletal muscle atrophy in the hind limbs accelerated early cognitive decline in young Alzheimer's model 5XFAD mice and nontransgenic young mice. As physical activity is challenging for individuals with muscle loss due to aging or immobilisation, effective medications are needed to prevent cast immobilisation–induced cognitive decline. Rutin, a candidate medication for preventing muscle loss and cognitive decline, has numerous biological effects but is limited by its low bioavailability owing to water insolubility. EubioQuercetin (ws Rutin), a highly absorbable Rutin formula, offers over 2000-fold improved solubility. This study investigated whether oral water-soluble Rutin (ws Rutin) treatment prevents cast immobilisation–induced memory dysfunction in young mice and explored its underlying mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Healthy young male ddY mice (10 weeks old) were used. Tissue distribution of Rutin was determined using LC-MS/MS at 0.5, 3, 6 and 16 h after oral administration of ws Rutin or conventional Rutin. Muscle atrophy was induced via bilateral hindlimb immobilisation by placing them in casts for 17 days. Cognitive function was evaluated using an object recognition test. RNA-seq was used to comprehensively analyse mRNA expression in the hippocampus and triceps surae. Expression levels of candidate molecules, affected by immobilisation and ws Rutin treatment, were confirmed using immunohistochemistry and Western blotting. Cultured hippocampal neurons and myocytes were treated with ws Rutin or Rutin, and parameters such as Klotho expression, axon/dendrite length, neuron numbers, ATP6 expression and myotube length were quantified by immunocytochemistry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ws Rutin prevented cast immobilisation–induced memory deficits in young mice (<i>n</i> = 9; training vs. test, <i>p</i> = 0.0167) and increased Klotho in mRNA and protein levels in the brain. By orally administering Rutin, Rutin rapidly reached the blood, brain and skeletal muscles. Direct treatment of cultured hippocampal neurons with ws Rutin or conventional Rutin increased Klotho expression (<i>p</i> < 0.0001), axon length (<i>p</i> < 0.0001), dendrite number (<i>p</i> < 0.001) and neuron number (<i>p</i> < 0.0001). Recombinant Klotho treatment also increased hippocampal neuron numbers (<i>p</i> < 0.0001). In skeletal muscles, ws Rutin treatment enhanced mitochondrial protein MTCO1 expression in vivo (<i>n</i> = 5 mice, <i>p</i> = 0.0224). In myocytes, ","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Fundaun, Valeria Oliva, Sandrine Bédard, Evert Onno Wesselink, Benjamin P. Lynn, Anoosha Pai S., Dario Pfyffer, Merve Kaptan, Nazrawit Berhe, John Ratliff, Serena S. Hu, Zachary A. Smith, Trevor J. Hastie, Sean Mackey, Marnee J. McKay, James M. Elliott, Scott L. Delp, Akshay S. Chaudhari, Christine S. W. Law, Andrew C. Smith, Kenneth A. Weber II
Background
Hand function is critical for daily activities and declines early in many diseases, conditions or disorders affecting the musculoskeletal and neurologic systems. Muscle health markers derived from clinically available magnetic resonance imaging (MRI) scans are strongly associated with functional capacity, may enhance clinical assessment and inform management options. However, traditional muscle MRI assessments require time-intensive manual segmentations. Here, we aim to develop and test a computer-vision model for automated forearm muscle segmentation and investigate associations between MRI-derived muscle markers and age, sex, BMI, functional grip strength and dexterity measures.
Methods
We recruited 42 healthy, right-handed adults (54.8% female, median age 37.3 years, median BMI: 23.0). Grip strength and dexterity were measured using the NIH Toolbox motor battery. Dixon fat-water MRI of the right forearm was acquired at 3.0 T, and forearm flexor and extensor muscle compartments were manually segmented for model training. A 2D U-Net convolutional neural network model was trained and tested for segmentation of the forearm flexors and extensors for the assessment of muscle volume and intramuscular fat. Testing accuracy and reliability were assessed using Sørensen–Dice indices, intraclass correlation coefficients (ICCs) and Bland–Altman analyses. Associations between the MRI-derived muscle markers, demographic factors, muscle metrics and hand function were evaluated using partial correlations and regression models.
Results
The segmentation model showed high test accuracy, achieving mean Sørensen–Dice indices of 0.89 (flexors) and 0.85 (extensors) and ICCs of 0.75–0.99 for muscle volume and intramuscular fat. Muscle volume was positively correlated with BMI (p < 0.001) but not age (p > 0.249). Males had larger muscle volumes than females (p < 0.001), with no sex differences in intramuscular fat (p > 0.141), and no association between intramuscular fat and grip strength or dexterity (p > 0.350). We observed strong positive correlations between grip strength and both flexor (p = 0.004) and extensor (p = 0.001) muscle volumes, while dexterity showed no significant associations.
Conclusions
Our findings highlight the accuracy and reliability of automated forearm muscle segmentation using computer vision. BMI emerged as a key determinant of m
{"title":"Automated Segmentation of Forearm Muscles: Clinical Associations With Hand Function, Muscle Volume and Intramuscular Fat","authors":"Joel Fundaun, Valeria Oliva, Sandrine Bédard, Evert Onno Wesselink, Benjamin P. Lynn, Anoosha Pai S., Dario Pfyffer, Merve Kaptan, Nazrawit Berhe, John Ratliff, Serena S. Hu, Zachary A. Smith, Trevor J. Hastie, Sean Mackey, Marnee J. McKay, James M. Elliott, Scott L. Delp, Akshay S. Chaudhari, Christine S. W. Law, Andrew C. Smith, Kenneth A. Weber II","doi":"10.1002/rco2.70015","DOIUrl":"https://doi.org/10.1002/rco2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hand function is critical for daily activities and declines early in many diseases, conditions or disorders affecting the musculoskeletal and neurologic systems. Muscle health markers derived from clinically available magnetic resonance imaging (MRI) scans are strongly associated with functional capacity, may enhance clinical assessment and inform management options. However, traditional muscle MRI assessments require time-intensive manual segmentations. Here, we aim to develop and test a computer-vision model for automated forearm muscle segmentation and investigate associations between MRI-derived muscle markers and age, sex, BMI, functional grip strength and dexterity measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recruited 42 healthy, right-handed adults (54.8% female, median age 37.3 years, median BMI: 23.0). Grip strength and dexterity were measured using the NIH Toolbox motor battery. Dixon fat-water MRI of the right forearm was acquired at 3.0 T, and forearm flexor and extensor muscle compartments were manually segmented for model training. A 2D U-Net convolutional neural network model was trained and tested for segmentation of the forearm flexors and extensors for the assessment of muscle volume and intramuscular fat. Testing accuracy and reliability were assessed using Sørensen–Dice indices, intraclass correlation coefficients (ICCs) and Bland–Altman analyses. Associations between the MRI-derived muscle markers, demographic factors, muscle metrics and hand function were evaluated using partial correlations and regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The segmentation model showed high test accuracy, achieving mean Sørensen–Dice indices of 0.89 (flexors) and 0.85 (extensors) and ICCs of 0.75–0.99 for muscle volume and intramuscular fat. Muscle volume was positively correlated with BMI (<i>p</i> < 0.001) but not age (<i>p</i> > 0.249). Males had larger muscle volumes than females (<i>p</i> < 0.001), with no sex differences in intramuscular fat (<i>p</i> > 0.141), and no association between intramuscular fat and grip strength or dexterity (<i>p</i> > 0.350). We observed strong positive correlations between grip strength and both flexor (<i>p</i> = 0.004) and extensor (<i>p</i> = 0.001) muscle volumes, while dexterity showed no significant associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight the accuracy and reliability of automated forearm muscle segmentation using computer vision. BMI emerged as a key determinant of m","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reza Lahiji, Gregory Palmateer, Edouard H. Nicaise, Taylor Goodstein, Dattatraya Patil, Benjamin N. Schmeusser, Eric Midenberg, Samay Patel, Ethan Kearns, Kenneth Ogan, Mehmet Asim Bilen, Viraj Master
Introduction
Sarcopenia, defined as the loss of skeletal muscle mass and function, is associated with worse postoperative outcomes and reduced survival in patients undergoing surgery for solid tumours, including renal cell carcinoma (RCC). Although radiographic assessment using the skeletal muscle index (SMI) at the L3 vertebral level has emerged as a method for quantifying sarcopenia, a consensus on optimal sarcopenia thresholds, especially in non-metastatic RCC, remains lacking. This study aims to evaluate which of the existing published SMI thresholds can be utilized to predict overall survival (OS) in a racially diverse non-metastatic (nmRCC) cohort.
Methods
We retrospectively reviewed 343 patients with any T-stage nmRCC who underwent nephrectomy between 2007 and 2022 at our institution. SMI (cm2/m2) values were calculated using cross-sectional imaging at the L3 level. Six published sarcopenia thresholds were applied. Associations between threshold-defined sarcopenia and OS were evaluated using Kaplan–Meier curves and Cox proportional hazards models adjusted for confounding variables.
Results
Three hundred forty-three patients met inclusion criteria, 62.7% were White, and 33.2% were Black. Median follow-up time was 41.5 months (IQR 17.8–61.7 months), during which there were 62 (18.1%) mortality events. Median SMI measurements for males and females in our cohort were 51.1 and 42.4 cm/m2, respectively. Patients defined as radiographically sarcopenic using thresholds by Derstine et al. (HR 2.11 [95% CI 1.14–3.91], p = 0.018) and Tonnesen et al. (HR 2.11 [95% CI 1.15–4.53], p = 0.028) had independently associated worse OS. Notably, these thresholds were constructed from healthy adult populations.
Conclusions
SMI thresholds derived from healthy cohorts, as proposed by Derstine et al., are associated with OS in patients with nmRCC and may serve as clinically practical tools for identifying high-risk patients. Incorporating radiographic sarcopenia assessment into preoperative workflows may facilitate targeted prehabilitation interventions aimed at improving survival outcomes in this population.
骨骼肌减少症，定义为骨骼肌质量和功能的丧失，与包括肾细胞癌（RCC）在内的实体肿瘤手术患者的术后预后恶化和生存率降低有关。尽管在L3椎体水平使用骨骼肌指数（SMI）进行影像学评估已成为量化肌肉减少症的一种方法，但关于最佳肌肉减少症阈值的共识仍然缺乏，特别是在非转移性RCC中。本研究旨在评估现有公布的SMI阈值中哪些可用于预测种族不同的非转移性（nmRCC）队列的总生存（OS）。方法回顾性分析了2007年至2022年在我院接受肾切除术的343例t期nmRCC患者。SMI （cm2/m2）值通过L3水平的横断面成像计算。应用6个已公布的肌肉减少阈值。阈值定义的肌肉减少症与OS之间的关联使用Kaplan-Meier曲线和Cox比例风险模型进行评估，校正了混杂变量。结果343例患者符合纳入标准，白人占62.7%，黑人占33.2%。中位随访时间为41.5个月（IQR为17.8 ~ 61.7个月），随访期间死亡62例（18.1%）。在我们的队列中，男性和女性的SMI测量值中位数分别为51.1和42.4 cm/m2。Derstine等人（风险比2.11 [95% CI 1.14-3.91], p = 0.018）和Tonnesen等人（风险比2.11 [95% CI 1.15-4.53], p = 0.028）使用放射学阈值定义为肌肉减少的患者与较差的OS独立相关。值得注意的是，这些阈值是从健康的成年人群中构建的。Derstine等人提出的来自健康队列的SMI阈值与nmRCC患者的OS相关，可以作为识别高风险患者的临床实用工具。将骨骼肌减少症的影像学评估纳入术前工作流程可能有助于有针对性的康复干预，旨在改善这一人群的生存结果。
{"title":"Sarcopenia Thresholds Derived From Healthy Adult Populations Predict Survival in Patients With Cancer","authors":"Reza Lahiji, Gregory Palmateer, Edouard H. Nicaise, Taylor Goodstein, Dattatraya Patil, Benjamin N. Schmeusser, Eric Midenberg, Samay Patel, Ethan Kearns, Kenneth Ogan, Mehmet Asim Bilen, Viraj Master","doi":"10.1002/rco2.70014","DOIUrl":"https://doi.org/10.1002/rco2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sarcopenia, defined as the loss of skeletal muscle mass and function, is associated with worse postoperative outcomes and reduced survival in patients undergoing surgery for solid tumours, including renal cell carcinoma (RCC). Although radiographic assessment using the skeletal muscle index (SMI) at the L3 vertebral level has emerged as a method for quantifying sarcopenia, a consensus on optimal sarcopenia thresholds, especially in non-metastatic RCC, remains lacking. This study aims to evaluate which of the existing published SMI thresholds can be utilized to predict overall survival (OS) in a racially diverse non-metastatic (nmRCC) cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 343 patients with any T-stage nmRCC who underwent nephrectomy between 2007 and 2022 at our institution. SMI (cm<sup>2</sup>/m<sup>2</sup>) values were calculated using cross-sectional imaging at the L3 level. Six published sarcopenia thresholds were applied. Associations between threshold-defined sarcopenia and OS were evaluated using Kaplan–Meier curves and Cox proportional hazards models adjusted for confounding variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred forty-three patients met inclusion criteria, 62.7% were White, and 33.2% were Black. Median follow-up time was 41.5 months (IQR 17.8–61.7 months), during which there were 62 (18.1%) mortality events. Median SMI measurements for males and females in our cohort were 51.1 and 42.4 cm/m<sup>2</sup>, respectively. Patients defined as radiographically sarcopenic using thresholds by Derstine et al. (HR 2.11 [95% CI 1.14–3.91], <i>p</i> = 0.018) and Tonnesen et al. (HR 2.11 [95% CI 1.15–4.53], <i>p</i> = 0.028) had independently associated worse OS. Notably, these thresholds were constructed from healthy adult populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SMI thresholds derived from healthy cohorts, as proposed by Derstine et al., are associated with OS in patients with nmRCC and may serve as clinically practical tools for identifying high-risk patients. Incorporating radiographic sarcopenia assessment into preoperative workflows may facilitate targeted prehabilitation interventions aimed at improving survival outcomes in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillaume Henin, Alexis Goffaux, Salomé Declerck, Stéphanie André-Dumont, Etienne Pendeville, Maxime Valet, Thierry Lejeune, Géraldine Dahlqvist, Audrey Loumaye, Bernd Schnabl, Peter Stärkel, Nicolas Lanthier
Background
Impaired muscle function is frequent in cirrhosis and potentially participates in liver disease progression. Data from non-cirrhotic patients with steatotic liver disease (SLD) are lacking. Our aims were to determine if muscle function was impaired in a non-cirrhotic cohort of patients with SLD and if the SLD subtype and severity were associated with impaired muscle function.
Methods
Patients with SLD and controls were prospectively recruited. Liver disease was assessed by imaging, vibration-controlled transient elastography and non-invasive tests. Muscle function was assessed by the liver frailty index (LFI) and isokinetic dynamometer. Diet and physical activity habits were recorded using dedicated questionnaires to measure the energetic balance.
Results
One-hundred and fifty patients with non-cirrhotic SLD (75 patients with metabolic dysfunction-associated steatotic liver disease [MASLD] and 75 patients with alcohol-related liver disease [ALD]) and 30 non-SLD controls were prospectively recruited. The LFI negatively correlated to lower limb muscle strength assessed by isokinetic dynamometer in all participant groups (r = 0.82 in the control group; r = 0.69 in the pooled SLD group—p < 0.0001). Both SLD groups showed muscle strength impairment assessed by the LFI compared to age- and gender-matched controls. In multivariate analysis, the presence of SLD was associated with impaired muscle function independently of age, BMI and energetic balance, with a higher risk related to ALD.
Conclusions
Patients with SLD already show impaired muscle function compared to controls independently of age, gender and energetic balance. Taken together, our data support a potential disruption of the liver–muscle axis already occurring in SLD prior to cirrhosis.
Trial Registration
ClinicalTrials.gov identifier: NCT06514300
背景：肝硬化患者经常出现肌肉功能受损，并可能参与肝脏疾病的进展。缺乏非肝硬化脂肪变性肝病（SLD）患者的数据。我们的目的是确定非肝硬化SLD患者队列中肌肉功能是否受损，以及SLD亚型和严重程度是否与肌肉功能受损有关。方法前瞻性招募SLD患者和对照组。肝脏疾病通过影像学、振动控制瞬态弹性成像和非侵入性检查进行评估。采用肝衰弱指数（LFI）和等速测功仪评估肌肉功能。研究人员使用专门的问卷记录了饮食和体育活动习惯，以测量能量平衡。结果150例非肝硬化SLD患者（75例代谢功能障碍相关脂肪变性肝病[MASLD]和75例酒精相关性肝病[ALD]）和30例非SLD对照组被前瞻性招募。在所有参与者组中，LFI与等速肌力计评估的下肢肌力呈负相关（对照组r = 0.82，合并SLD组r = 0.69, p < 0.0001）。与年龄和性别匹配的对照组相比，两个SLD组都表现出LFI评估的肌肉力量损伤。在多变量分析中，SLD的存在与肌肉功能受损相关，与年龄、BMI和能量平衡无关，与ALD相关的风险更高。结论：与对照组相比，SLD患者已经表现出肌肉功能受损，与年龄、性别和能量平衡无关。综上所述，我们的数据支持肝硬化前SLD中已经发生的肝肌轴的潜在破坏。试验注册ClinicalTrials.gov标识符：NCT06514300
{"title":"Non-Cirrhotic Steatotic Liver Disease is Associated With Impaired Muscle Function: A Cross-Sectional Study","authors":"Guillaume Henin, Alexis Goffaux, Salomé Declerck, Stéphanie André-Dumont, Etienne Pendeville, Maxime Valet, Thierry Lejeune, Géraldine Dahlqvist, Audrey Loumaye, Bernd Schnabl, Peter Stärkel, Nicolas Lanthier","doi":"10.1002/rco2.70012","DOIUrl":"https://doi.org/10.1002/rco2.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Impaired muscle function is frequent in cirrhosis and potentially participates in liver disease progression. Data from non-cirrhotic patients with steatotic liver disease (SLD) are lacking. Our aims were to determine if muscle function was impaired in a non-cirrhotic cohort of patients with SLD and if the SLD subtype and severity were associated with impaired muscle function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with SLD and controls were prospectively recruited. Liver disease was assessed by imaging, vibration-controlled transient elastography and non-invasive tests. Muscle function was assessed by the liver frailty index (LFI) and isokinetic dynamometer. Diet and physical activity habits were recorded using dedicated questionnaires to measure the energetic balance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One-hundred and fifty patients with non-cirrhotic SLD (75 patients with metabolic dysfunction-associated steatotic liver disease [MASLD] and 75 patients with alcohol-related liver disease [ALD]) and 30 non-SLD controls were prospectively recruited. The LFI negatively correlated to lower limb muscle strength assessed by isokinetic dynamometer in all participant groups (<i>r</i> = 0.82 in the control group; <i>r</i> = 0.69 in the pooled SLD group—<i>p</i> < 0.0001). Both SLD groups showed muscle strength impairment assessed by the LFI compared to age- and gender-matched controls. In multivariate analysis, the presence of SLD was associated with impaired muscle function independently of age, BMI and energetic balance, with a higher risk related to ALD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with SLD already show impaired muscle function compared to controls independently of age, gender and energetic balance. Taken together, our data support a potential disruption of the liver–muscle axis already occurring in SLD prior to cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06514300</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahad M. Azimuddin, Andrea M. Meinders, Jerica Podrat, Kelvin C. Allenson, Joy Yoo, Enshuo Hsu, Linda W. Moore, Kayla Callaway, Nestor F. Esnaola, Elijah Rockers, Atiya F. Dhala
Background
Variance in skeletal muscle area (SMA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) negatively impacts outcomes after pancreas surgery. We aim to incorporate an existing deep learning algorithm automating body composition segmentation from computed tomography (CT) for accurate and rapid risk identification.
Methods
We conducted a retrospective study of patients having pancreatic surgery at a high-volume centre (2016–2021). Using a deep learning algorithm, we analysed preoperative CT images at the L3 level for SMA, VAT, SAT and IMAT (AutoMATiCA, Cambridge, MA, USA). Two board-certified radiologists validated the analysis. Skeletal muscle index (SMI), VAT and VAT/SAT ratio were calculated. We then evaluated the incidence of pancreas surgery-specific, pulmonary, noninfectious and infectious outcomes.
Results
We reviewed 158 patients: median (IQR) age 67.6 (61.6, 75.3) years; female (52.5%); pancreatic cancer diagnoses (65.8%); and Whipple procedure (81%). Automated body composition calculation time for all patients was 553 s. Patients experiencing composite sepsis complications had higher VAT (193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], p = 0.029). Additionally, patients experiencing composite infectious complications had higher VAT (193.7 [IQR 133.4, 277.5] vs. 143.1 [IQR 72.2, 202.8], p = 0.041). VAT was also higher in patients with noninfectious complications (274.9 [IQR 228.0, 329.8] vs. 148.7 [IQR 90.9, 221.0]; p = 0.020). Other anthropomorphic features, such as SMA, SAT and IMAT, did not have any relation to postoperative composite outcomes.
Conclusions
Higher visceral adipose tissue was associated with worse outcomes after pancreas surgery. Deep learning applied to CT scans may be valuable for identifying at-risk body compositions associated with adverse surgical outcomes. Further studies are needed to confirm these findings.
背景：骨骼肌面积（SMA）、内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的差异会对胰腺手术后的预后产生负面影响。我们的目标是结合现有的深度学习算法，自动从计算机断层扫描（CT）中分割身体成分，以准确快速地识别风险。方法：我们对2016-2021年在大容量中心进行胰腺手术的患者进行回顾性研究。使用深度学习算法，我们分析了SMA、VAT、SAT和IMAT （AutoMATiCA, Cambridge， MA， USA）的L3层术前CT图像。两名委员会认证的放射科医生证实了分析结果。计算骨骼肌指数（SMI）、VAT和VAT/SAT比值。然后我们评估胰腺手术特异性、肺部、非感染性和感染性结局的发生率。结果158例患者：中位（IQR）年龄67.6（61.6,75.3）岁；女性(52.5%);胰腺癌诊断（65.8%）；惠普尔手术（81%）。所有患者的自动体成分计算时间为553秒。合并脓毒症并发症的患者VAT较高（193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], p = 0.029）。此外，出现复合感染并发症的患者VAT更高（193.7 [IQR 133.4, 277.5]比143.1 [IQR 72.2, 202.8], p = 0.041）。非感染性并发症患者的VAT也更高（274.9 [IQR 228.0, 329.8]比148.7 [IQR 90.9, 221.0]; p = 0.020）。其他拟人化特征，如SMA、SAT和IMAT，与术后综合结果没有任何关系。结论胰腺手术后较高的内脏脂肪组织与较差的预后相关。将深度学习应用于CT扫描对于识别与不良手术结果相关的高危身体成分可能很有价值。需要进一步的研究来证实这些发现。
{"title":"Deep Learning to Detect Body Composition and Its Role in Developing Postoperative Pancreatic Surgery Complications","authors":"Ahad M. Azimuddin, Andrea M. Meinders, Jerica Podrat, Kelvin C. Allenson, Joy Yoo, Enshuo Hsu, Linda W. Moore, Kayla Callaway, Nestor F. Esnaola, Elijah Rockers, Atiya F. Dhala","doi":"10.1002/rco2.70013","DOIUrl":"https://doi.org/10.1002/rco2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Variance in skeletal muscle area (SMA), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) negatively impacts outcomes after pancreas surgery. We aim to incorporate an existing deep learning algorithm automating body composition segmentation from computed tomography (CT) for accurate and rapid risk identification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of patients having pancreatic surgery at a high-volume centre (2016–2021). Using a deep learning algorithm, we analysed preoperative CT images at the L3 level for SMA, VAT, SAT and IMAT (AutoMATiCA, Cambridge, MA, USA). Two board-certified radiologists validated the analysis. Skeletal muscle index (SMI), VAT and VAT/SAT ratio were calculated. We then evaluated the incidence of pancreas surgery-specific, pulmonary, noninfectious and infectious outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We reviewed 158 patients: median (IQR) age 67.6 (61.6, 75.3) years; female (52.5%); pancreatic cancer diagnoses (65.8%); and Whipple procedure (81%). Automated body composition calculation time for all patients was 553 s. Patients experiencing composite sepsis complications had higher VAT (193.7 [IQR 132.7, 249.7] vs. 146.2 [IQR 87.3, 220.5], <i>p</i> = 0.029). Additionally, patients experiencing composite infectious complications had higher VAT (193.7 [IQR 133.4, 277.5] vs. 143.1 [IQR 72.2, 202.8], <i>p</i> = 0.041). VAT was also higher in patients with noninfectious complications (274.9 [IQR 228.0, 329.8] vs. 148.7 [IQR 90.9, 221.0]; <i>p</i> = 0.020). Other anthropomorphic features, such as SMA, SAT and IMAT, did not have any relation to postoperative composite outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher visceral adipose tissue was associated with worse outcomes after pancreas surgery. Deep learning applied to CT scans may be valuable for identifying at-risk body compositions associated with adverse surgical outcomes. Further studies are needed to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73544,"journal":{"name":"JCSM rapid communications","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rco2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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