Graduation Date

Summer 8-9-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Corrine Hanson

Second Advisor

Jana Ponce

Third Advisor

Laura Tenner

Fourth Advisor

Kristina Bailey

Abstract

Sarcopenia is a debilitating muscle loss disorder caused by aging or chronic conditions. It decreases quality of life and increases morbidity and mortality. Gastrointestinal cancer patients are at a high risk for the condition given the impact of the disease and its treatments. There is limited consensus on how to identify and screen for sarcopenia. Previous research is limited on the use of clinically available tools currently used for malnutrition and their ability to screen for sarcopenia. This study aimed to investigate the Malnutrition Screening Tool (MST) and the Academy of Nutrition and Dietetics, and the American Society for Parenteral and Enteral Nutrition (AND/ASPEN) malnutrition guidelines use in identifying sarcopenia in the high-risk GI cancer population. In this retrospective chart review, the gold standard for muscle mass assessment, computed tomography (CT) scans, was used to identify sarcopenia. CT scans were analyzed using ImageJ. MST and malnutrition data were collected from the subjects’ medical record at their initial oncology visit and at three-months. At baseline 50 participants were included in the study and 50% were identified as sarcopenic. No statistically significant differences between the sarcopenic and non-sarcopenic group were identified at baseline. Fisher’s exact tests, independent t-tests, and logistic regression were used to examine the relationship between the two tools and sarcopenia. Logistic regression showed a relationship between the MST and sarcopenia status. It showed the odds of being diagnosed with sarcopenia increased by 152% for each one unit increase in the MST (p-value = 0.050). All results comparing malnutrition status using the AND/ASPEN guidelines were not statistically significant. There was a trend towards significance with the independent t-tests (p=0.114) and logistic regression models (p=0.125) looking at skeletal muscle index and malnutrition status. The study did have a small sample size, and further powered studies looking at the malnutrition guidelines and sarcopenia status may better represent this relationship. Overall, the study supported the relationship between the MST and its ability to predict those at risk for sarcopenia.

Comments

2024 Copyright, the authors

Available for download on Saturday, January 18, 2025

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