Preoperative circulating musclin as a candidate biomarker of postoperative skeletal muscle vulnerability in colorectal cancer.

INTRODUCTION

Postoperative skeletal muscle deterioration is associated with impaired recovery and adverse outcomes after colorectal cancer (CRC) surgery, but preoperative circulating markers of subsequent muscle loss remain insufficiently defined. We evaluated whether circulating musclin was associated with postoperative skeletal muscle status and longitudinal skeletal muscle index (SMI) change.

MATERIALS AND

METHODS

This retrospective single-center study included 106 adults undergoing CRC surgery, of whom 95 had postoperative computed tomography (CT) data. Postoperative CT was obtained at a median of 198 days (IQR, 151-220; range, 73-685 days) after preoperative CT. CT-derived body composition was quantified at the third lumbar vertebra, and serum musclin and natriuretic peptides (NPs) were measured by enzyme-linked immunosorbent assay. The primary outcome was postoperative SMI; greater than 5% SMI loss, percentage SMI change, and longitudinal musclin change were also evaluated.

RESULTS

Higher preoperative musclin was associated with higher postoperative SMI in the fully adjusted model (B = 1.872; 95% CI, 0.765-2.979; p = 0.001). Greater than 5% SMI loss occurred in 27 of 95 patients, and higher preoperative musclin was associated with lower odds of this outcome (OR = 0.529; P = 0.038) and with a more favorable percentage SMI change (B = 3.941; P = 0.004). Absolute musclin change was positively associated with postoperative SMI in the baseline-adjusted analysis (B = 5.067; P < 0.001). Musclin-NP interaction terms were not significant.

CONCLUSION

Preoperative circulating musclin was associated with postoperative skeletal muscle status and longitudinal SMI change after CRC surgery. These findings support further prospective evaluation of musclin as a candidate circulating marker of postoperative skeletal muscle vulnerability.