Body composition and nutritional status in malignant pleural mesothelioma: implications for activity levels and quality of life

Emily Jeffery, Y. C.Gary Lee, Robert U. Newton, Philippa Lyons-Wall, Joanne McVeigh, Anna K. Nowak, Hui Min Cheah, Bella Nguyen, Deirdre B. Fitzgerald, Jenette Creaney, Leon Straker, Carolyn J. Peddle-McIntyre

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Abstract

BACKGROUND/OBJECTIVES: Malignant pleural mesothelioma (MPM) is an incurable cancer and optimizing daily physical activity and quality of life are key goals of patient management. Little is known about the prevalence of pre-sarcopenia and malnutrition in MPM or their associations with patient outcomes. This study aimed to determine the prevalence of pre-sarcopenia and malnutrition in MPM and investigate if activity levels and quality of life differed according to body composition and nutritional status. SUBJECTS/METHODS: Patients with a diagnosis of MPM were recruited. Pre-sarcopenia was defined as low appendicular skeletal muscle mass (≤ 7.26 kg/m2 for men and ≤ 5.45 kg/m2 for women), measured by dual energy X-ray absorptiometry. Malnutrition was defined as a rating of B or C on the Patient-Generated Subjective Global Assessment. Outcome measures included objective activity levels (Actigraph GT3X) and health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy General). RESULTS: Sixty-one people participated (79% male, median age 69 [IQR 62-74] years and median BMI 25.8 [IQR 24.3-28.4] kg/m2). Fifty-four percent were pre-sarcopenic and 38% were malnourished. Percent of time spent in light activity/day was lower in participants with pre-sarcopenia compared with non-sarcopenic participants (median 25.4 [IQR 19.8-32.1]% vs. 32.3 [27.1-35.6]%; p = 0.008). Participants with malnutrition had poorer HRQoL than well-nourished participants (mean 69.0 (16.3) vs. 84.4 (13.3); p < 0.001). CONCLUSION: Participants with MPM had high rates of pre-sarcopenia and malnutrition. Pre-sarcopenia was associated with poorer activity levels, whilst malnutrition was associated with poorer quality of life. Interventions that aim to address reduced muscle mass and weight loss, should be tested in MPM to assess their impact on patient outcomes.

Original languageEnglish
Pages (from-to)1412-1421
Number of pages10
JournalEuropean Journal of Clinical Nutrition
Volume73
Issue number10
DOIs
Publication statusPublished - 1 Oct 2019

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Sarcopenia
Body Composition
Nutritional Status
Malnutrition
Quality of Life
Photon Absorptiometry
Malignant Mesothelioma
Weight Loss
Neoplasms
Skeletal Muscle
Outcome Assessment (Health Care)
Exercise
Light
Muscles

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Jeffery, Emily ; Lee, Y. C.Gary ; Newton, Robert U. ; Lyons-Wall, Philippa ; McVeigh, Joanne ; Nowak, Anna K. ; Cheah, Hui Min ; Nguyen, Bella ; Fitzgerald, Deirdre B. ; Creaney, Jenette ; Straker, Leon ; Peddle-McIntyre, Carolyn J. / Body composition and nutritional status in malignant pleural mesothelioma : implications for activity levels and quality of life. In: European Journal of Clinical Nutrition. 2019 ; Vol. 73, No. 10. pp. 1412-1421.
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title = "Body composition and nutritional status in malignant pleural mesothelioma: implications for activity levels and quality of life",
abstract = "BACKGROUND/OBJECTIVES: Malignant pleural mesothelioma (MPM) is an incurable cancer and optimizing daily physical activity and quality of life are key goals of patient management. Little is known about the prevalence of pre-sarcopenia and malnutrition in MPM or their associations with patient outcomes. This study aimed to determine the prevalence of pre-sarcopenia and malnutrition in MPM and investigate if activity levels and quality of life differed according to body composition and nutritional status. SUBJECTS/METHODS: Patients with a diagnosis of MPM were recruited. Pre-sarcopenia was defined as low appendicular skeletal muscle mass (≤ 7.26 kg/m2 for men and ≤ 5.45 kg/m2 for women), measured by dual energy X-ray absorptiometry. Malnutrition was defined as a rating of B or C on the Patient-Generated Subjective Global Assessment. Outcome measures included objective activity levels (Actigraph GT3X) and health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy General). RESULTS: Sixty-one people participated (79{\%} male, median age 69 [IQR 62-74] years and median BMI 25.8 [IQR 24.3-28.4] kg/m2). Fifty-four percent were pre-sarcopenic and 38{\%} were malnourished. Percent of time spent in light activity/day was lower in participants with pre-sarcopenia compared with non-sarcopenic participants (median 25.4 [IQR 19.8-32.1]{\%} vs. 32.3 [27.1-35.6]{\%}; p = 0.008). Participants with malnutrition had poorer HRQoL than well-nourished participants (mean 69.0 (16.3) vs. 84.4 (13.3); p < 0.001). CONCLUSION: Participants with MPM had high rates of pre-sarcopenia and malnutrition. Pre-sarcopenia was associated with poorer activity levels, whilst malnutrition was associated with poorer quality of life. Interventions that aim to address reduced muscle mass and weight loss, should be tested in MPM to assess their impact on patient outcomes.",
author = "Emily Jeffery and Lee, {Y. C.Gary} and Newton, {Robert U.} and Philippa Lyons-Wall and Joanne McVeigh and Nowak, {Anna K.} and Cheah, {Hui Min} and Bella Nguyen and Fitzgerald, {Deirdre B.} and Jenette Creaney and Leon Straker and Peddle-McIntyre, {Carolyn J.}",
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Body composition and nutritional status in malignant pleural mesothelioma : implications for activity levels and quality of life. / Jeffery, Emily; Lee, Y. C.Gary; Newton, Robert U.; Lyons-Wall, Philippa; McVeigh, Joanne; Nowak, Anna K.; Cheah, Hui Min; Nguyen, Bella; Fitzgerald, Deirdre B.; Creaney, Jenette; Straker, Leon; Peddle-McIntyre, Carolyn J.

In: European Journal of Clinical Nutrition, Vol. 73, No. 10, 01.10.2019, p. 1412-1421.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body composition and nutritional status in malignant pleural mesothelioma

T2 - implications for activity levels and quality of life

AU - Jeffery, Emily

AU - Lee, Y. C.Gary

AU - Newton, Robert U.

AU - Lyons-Wall, Philippa

AU - McVeigh, Joanne

AU - Nowak, Anna K.

AU - Cheah, Hui Min

AU - Nguyen, Bella

AU - Fitzgerald, Deirdre B.

AU - Creaney, Jenette

AU - Straker, Leon

AU - Peddle-McIntyre, Carolyn J.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - BACKGROUND/OBJECTIVES: Malignant pleural mesothelioma (MPM) is an incurable cancer and optimizing daily physical activity and quality of life are key goals of patient management. Little is known about the prevalence of pre-sarcopenia and malnutrition in MPM or their associations with patient outcomes. This study aimed to determine the prevalence of pre-sarcopenia and malnutrition in MPM and investigate if activity levels and quality of life differed according to body composition and nutritional status. SUBJECTS/METHODS: Patients with a diagnosis of MPM were recruited. Pre-sarcopenia was defined as low appendicular skeletal muscle mass (≤ 7.26 kg/m2 for men and ≤ 5.45 kg/m2 for women), measured by dual energy X-ray absorptiometry. Malnutrition was defined as a rating of B or C on the Patient-Generated Subjective Global Assessment. Outcome measures included objective activity levels (Actigraph GT3X) and health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy General). RESULTS: Sixty-one people participated (79% male, median age 69 [IQR 62-74] years and median BMI 25.8 [IQR 24.3-28.4] kg/m2). Fifty-four percent were pre-sarcopenic and 38% were malnourished. Percent of time spent in light activity/day was lower in participants with pre-sarcopenia compared with non-sarcopenic participants (median 25.4 [IQR 19.8-32.1]% vs. 32.3 [27.1-35.6]%; p = 0.008). Participants with malnutrition had poorer HRQoL than well-nourished participants (mean 69.0 (16.3) vs. 84.4 (13.3); p < 0.001). CONCLUSION: Participants with MPM had high rates of pre-sarcopenia and malnutrition. Pre-sarcopenia was associated with poorer activity levels, whilst malnutrition was associated with poorer quality of life. Interventions that aim to address reduced muscle mass and weight loss, should be tested in MPM to assess their impact on patient outcomes.

AB - BACKGROUND/OBJECTIVES: Malignant pleural mesothelioma (MPM) is an incurable cancer and optimizing daily physical activity and quality of life are key goals of patient management. Little is known about the prevalence of pre-sarcopenia and malnutrition in MPM or their associations with patient outcomes. This study aimed to determine the prevalence of pre-sarcopenia and malnutrition in MPM and investigate if activity levels and quality of life differed according to body composition and nutritional status. SUBJECTS/METHODS: Patients with a diagnosis of MPM were recruited. Pre-sarcopenia was defined as low appendicular skeletal muscle mass (≤ 7.26 kg/m2 for men and ≤ 5.45 kg/m2 for women), measured by dual energy X-ray absorptiometry. Malnutrition was defined as a rating of B or C on the Patient-Generated Subjective Global Assessment. Outcome measures included objective activity levels (Actigraph GT3X) and health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy General). RESULTS: Sixty-one people participated (79% male, median age 69 [IQR 62-74] years and median BMI 25.8 [IQR 24.3-28.4] kg/m2). Fifty-four percent were pre-sarcopenic and 38% were malnourished. Percent of time spent in light activity/day was lower in participants with pre-sarcopenia compared with non-sarcopenic participants (median 25.4 [IQR 19.8-32.1]% vs. 32.3 [27.1-35.6]%; p = 0.008). Participants with malnutrition had poorer HRQoL than well-nourished participants (mean 69.0 (16.3) vs. 84.4 (13.3); p < 0.001). CONCLUSION: Participants with MPM had high rates of pre-sarcopenia and malnutrition. Pre-sarcopenia was associated with poorer activity levels, whilst malnutrition was associated with poorer quality of life. Interventions that aim to address reduced muscle mass and weight loss, should be tested in MPM to assess their impact on patient outcomes.

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DO - 10.1038/s41430-019-0418-9

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JO - European Journal of Clinical Nutrition

JF - European Journal of Clinical Nutrition

SN - 0954-3007

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