Sarcopenia and myosteatosis are accompanied by distinct biological profiles in patients with pancreatic and periampullary adenocarcinomas
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INTRODUCTION: Pancreatic and periampullary adenocarcinomas are associated with abnormal body composition visible on CT scans, including low muscle mass (sarcopenia) and low muscle radiodensity due to fat infiltration in muscle (myosteatosis). The biological and clinical correlates to these features are poorly understood. METHODS: Clinical characteristics and outcomes were studied in 123 patients who underwent pancreaticoduodenectomy for pancreatic or non-pancreatic periampullary adenocarcinoma and who had available preoperative CT scans. In a subgroup of patients with pancreatic cancer (n = 29), rectus abdominus muscle mRNA expression was determined by cDNA microarray and in another subgroup (n = 29) 1H-NMR spectroscopy and gas chromatography-mass spectrometry were used to characterize the serum metabolome. RESULTS: Muscle mass and radiodensity were not significantly correlated. Distinct groups were identified: sarcopenia (40.7%), myosteatosis (25.2%), both (11.4%). Fat distribution differed in these groups; sarcopenia associated with lower subcutaneous adipose tissue (P<0.0001) and myosteatosis associated with greater visceral adipose tissue (P<0.0001). Sarcopenia, myosteatosis and their combined presence associated with shorter survival, Log Rank P = 0.005, P = 0.06, and P = 0.002, respectively. In muscle, transcriptomic analysis suggested increased inflammation and decreased growth in sarcopenia and disrupted oxidative phosphorylation and lipid accumulation in myosteatosis. In the circulating metabolome, metabolites consistent with muscle catabolism associated with sarcopenia. Metabolites consistent with disordered carbohydrate metabolism were identified in both sarcopenia and myosteatosis. DISCUSSION: Muscle phenotypes differ clinically and biologically. Because these muscle phenotypes are linked to poor survival, it will be imperative to delineate their pathophysiologic mechanisms, including whether they are driven by variable tumor biology or host response.
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The trajectories for survival between these groups differed as those with high levels of myosteatosis had overall lower survival rate.
“The trajectories for survival between these groups differed as those with high levels of myosteatosis had overall lower survival rate.”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Stretch et al., 2018
In a group of 100 participants with pancreatic and periampullary adenocarcinomas, 40% were sarcopenic, 25% had myosteatosis, and 11% had both.
“In a group of 100 participants with pancreatic and periampullary adenocarcinomas, 40% were sarcopenic, 25% had myosteatosis, and 11% had both (Stretch et al., 2018).”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Stretch et al., 2018
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- Authors
- Stretch, C., Aubin, J.-M., Mickiewicz, B., Leugner, D., Al-manasra, T., Tobola, E., Salazar, S., Sutherland, F. R., Ball, C. G., Dixon, E., Vogel, H. J., Damaraju, S., Baracos, V. E., & Bathe, O. F.
- Affiliations
- University of Calgary (CA)
- University of Alberta (CA)
- Corresponding author
- Bathe, Oliver F.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-05-03
- Volume
- 13
- Issue
- 5
- Pages
- e0196235
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5933771
- OpenAlex
- W2799934298
- Cited by
- 144
- References
- 41
- Citations by year
- 2026: 13 · 2025: 12 · 2024: 19 · 2023: 20 · 2022: 14 · 2021: 24 · 2020: 23 · 2019: 16 · 2018: 3
- FWCI
- 11.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Alberta Innovates
- Canadian Institutes of Health Research
- Alberta Cancer Foundation
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- sarcopenia, myosteatosis, pancreatic ductal adenocarcinoma, periampullary adenocarcinoma, body composition, rectus abdominis, serum metabolome, subcutaneous adipose tissue, visceral adipose tissue, body fat distribution, survival, oxidative phosphorylation, lipid accumulation, inflammation, carbohydrate metabolism, pancreaticoduodenectomy
- MeSH terms
- Adenocarcinoma, Adipose Tissue, Aged, Body Composition, Duodenal Neoplasms, Female, Humans, Male, Middle Aged, Muscles, Pancreatic Neoplasms, Ampulla of Vater, Gene Expression Profiling, Metabolomics, Sarcopenia
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