The Impact of Edema on Skeletal Muscle Changes among Patients with Pancreatic Ductal Adenocarcinoma.
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Davis Evan W, Park Margaret A, Basinski Toni L, Arnoletti J Pablo, Bloomston Mark, Carson Tiffany L, Biachi De Castria Tiago, Chen Dung-Tsa, Cortizas Elena M, Crowder Sylvia L, Genilo-Delgado Maria, Douglas Wade G, Huguet Kevin L, Jiang Kun, Hodul Pamela J, Karolak Aleksandra, Kim Dae Won, Koomen John M, Menon Anjana A, Mo Qianxing, Mok Shaffer R, Molina-Vega Manuel A, Moreno-Urazan Lina, Ahmed Sabeen, Parker Nathan H, Pimiento Jose M, Rasool Ghulam, Sparks Lauren M, Stewart Paul A, Tassielli Alexandra F, Teer Jamie K, Trevino Jose G, Velanovich Vic, Wang Xuefeng, Whelan Christopher J, Judge Sarah M, Judge Andrew R, Fleming Jason B, Malafa Mokenge P, Jeong Daniel, Permuth Jennifer B, Florida Pancreas Collaborative
Аннотация
METHODS: Body composition was measured using CT scans at diagnosis and follow-up from 95 patients enrolled in the Florida Pancreas Collaborative cohort study. Edema was assessed by opacifications in subcutaneous fat, and tSMA and pSMA changes were expressed as percent change between diagnosis and follow-up. We used multivariable generalized linear models to estimate mean tSMA and pSMA changes overall and by edema status. Spearman correlation was used to measure interrelationships of tSMA and pSMA.
RESULTS: tSMA increased between diagnosis and follow-up (Δ = 0.66) but only in patients with edema (Δ = 3.35) whereas non-edematous patients lost tSMA (Δ = -2.03). Conversely, pSMA decreased regardless of edema status. Furthermore, tSMA and pSMA were strongly correlated overall (r = 0.75) and in non-edematous patients (r = 0.83).
CONCLUSIONS: Edema inflated estimates of tSMA at follow-up in patients with PDAC, but pSMA was impervious to edema and may represent a suitable proxy for tSMA.
IMPACT: pSMA is a reliable measure of muscle and muscle loss and should be considered in future studies assessing muscle loss in patients with PDAC.