同種造血幹細胞移植前のサルコペニア

同種造血幹細胞移植前患者のサルコペニアの有病割合と身体組成、身体機能、疲労、健康関連QOLとの関連をみた論文を紹介します。兵庫医科大学PTの森下さんの論文です。素晴らしいですね。

Shinichiro Morishita, Katsuji Kaida, Takashi Tanaka, Yusuke Itani, Kazuhiro Ikegame, Masaya Okada, Shinichi Ishii, Norihiko Kodama, Hiroyasu Ogawa and Kazuhisa Domen: Prevalence of sarcopenia and relevance of body composition, physiological function, fatigue, and health-related quality of life in patients before allogeneic hematopoietic stem cell transplantation. Supportive Care in Cancer DOI: 10.1007/s00520-012-1460-5

同種造血幹細胞移植前患者164人のうち83人（50.6％）がサルコペニアでした。サルコペニアの患者では有意に筋力が弱い、疲労が強い、身体機能が低い、健康関連QOLの身体的疼痛と活力が低いという結果でした。多変量解析では性別（男性が多い）とBMIのみサルコペニアと有意に関連していました。

健常高齢者ではなく疾患を有する患者を対象に、サルコペニアの有病割合と身体機能やQOLとの関連をみた報告はまだ少ないと思います。2人に1人がサルコペニアというのはかなりの割合ですし、サルコペニアの方にはリハ栄養管理が有益な可能性があると考えます。

Abstract
Purpose
Cachexia in patients with hematological malignancies is often related to sarcopenia. We believe that allogeneic hematopoietic stem cell transplant (allo-HSCT) patients often exhibit sarcopenia prior to transplantation. Here, we aimed to investigate the prevalence of sarcopenia and its relationship with body composition, physiological function, nutrition, fatigue, and health-related quality of life (QOL) in patients before allo-HSCT. We further investigated the confounding factors associated with sarcopenia.

Methods
We included 164 patients with allo-HSCT in this study. Body composition, handgrip, knee extensor strength, and 6-min walk test were evaluated. Furthermore, fatigue, nutritional status, and health-related QOL were also evaluated.

Results
Eighty-three patients (50.6 %) enrolled in our study had sarcopenia prior to allo-HSCT. Patients with sarcopenia experienced decreased muscular strength and increased fatigue compared with patients without sarcopenia (p < 0.05). Patients with sarcopenia showed significantly lower scores in physical functioning, bodily pain, and vitality in health-related QOL than those without sarcopenia. Multivariate regression analysis revealed that only gender and body mass index were significantly related to sarcopenia (gender, odds ratio, 3.09; body mass index, odds ratio, 0.70; p < 0.01).

Conclusions
Sarcopenia is common in patients before allo-HSCT and related to low muscle strength, fatigue, and health-related QOL. Male patients may be more susceptible to sarcopenia than female patients before allo-HSCT. Further study of rehabilitation with gender insight is warranted for patients receiving allo-HSCT.