Ultrasonographic Detection of Sarcopenia in Patients With Long-Term Gastrectomy: A Study by Using ISarcoPRM Algorithm

Purpose To date, the assessment of sarcopenia, which is an important indicator of quality of life in gastrectomy patients, has been performed by calculating total or appendicular skeletal muscle mass. However, as the anterior thigh (i.e. quadriceps) muscle is affected more commonly/earlier with aging and diseases, we used quadriceps muscle thickness measured by ultrasound (US) in determining regional muscle mass. In our study, we aimed to detect sarcopenia in gastrectomy patients more accurately and practically using the ISarcoPRM algorithm. Methods In this cross-sectional case-control study, patients who underwent total gastrectomy (N=20), distal gastrectomy (N=30), and those without gastrectomy (N=54) were included. The sonographic thickness of anterior thigh muscle adjusted by body mass index (STAR) was used. Sarcopenia was diagnosed according to the ISarcoPRM algorithm using low grip strength (<19 kg for females and <32 kg for males) and/or prolonged CST duration (≥12 seconds) with low STAR values (<1 for females and <1.4 for males). Results The males who underwent total gastrectomy had the lowest body mass index, quadriceps muscle thickness, and hand grip strength values among the groups (all p<0.05). According to binary logistic regression analysis in males, only total gastrectomy [OR=6.961 (95% CI: 1.342-36.092)] was independently associated with the development of sarcopenia (p<0.05). Conclusion By using a novel (ISarcoPRM) algorithm, we found that total (but not distal) gastrectomy seemed to be independently related to sarcopenia (about 7 times higher). We believe that sarcopenia evaluation in gastrectomy patients should be performed with US in terms of its low cost and ease of application.