title: Sexual dimorphism modulates the impact of cancer cachexia on lower limb muscle mass and function.
abstract: OBJECTIVE
  There is a sparsity of data on the impact of cachexia on human muscle function. This study examined the relationship between cachexia, quality of life and the mass/function/mechanical quality of lower limb skeletal muscle in gastrointestinal cancer patients.
  
  
  METHODS
  Quadriceps strength and lower limb power were measured in 54 patients with gastrointestinal cancer (n = 24 ≥ 10% weight-loss) and 18 healthy controls. Quadriceps cross-sectional area was measured in 33/54 patients and in all controls using MRI. Muscle mechanical quality was defined as quadriceps strength/unit quadriceps cross-sectional area. Quality of life was assessed using the EORTC QLQ-C30. Patients with weight-loss ≥ 10% were classified as cachectic.
  
  
  RESULTS
  In male cachectic patients, quadriceps strength (p = 0.003), lower limb power (p = 0.026), quadriceps cross-sectional area (p = 0.019) and muscle quality (p = 0.008) were reduced compared with controls. In female cachectic patients, quadriceps strength (p = 0.001) and muscle quality (p = 0.001) were reduced compared with controls. Physical function (p = 0.013) and fatigue (p = 0.004) quality of life scores were reduced in male cachectic compared with non-cachectic patients, but not in females.
  
  
  CONCLUSIONS
  Muscle quality is reduced in cancer patients. The degree of impairment of lower limb muscle mass, quality and function and the impact on quality of life varies with weight-loss and sex.
authors.affiliation: Department of Clinical and Surgical Sciences Surgery, School of Clinical Sciences and Community Health, University of Edinburgh, Royal Infirmary, 51 Little France Crescent, Edinburgh EH16 4SA, UK. nathanas@doctors.org.uk
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Stephens
authors.forename: Calum
authors.initials: C
authors.lastname: Gray
authors.forename: Alisdair J
authors.initials: AJ
authors.lastname: MacDonald
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Tan
authors.forename: Iain J
authors.initials: IJ
authors.lastname: Gallagher
authors.forename: Richard J E
authors.initials: RJ
authors.lastname: Skipworth
authors.forename: James A
authors.initials: JA
authors.lastname: Ross
authors.forename: Kenneth C H
authors.initials: KC
authors.lastname: Fearon
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Greig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002100:Cachexia / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D016022:Case-Control Studies; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009142:Musculoskeletal Physiological Phenomena; D052097:Quadriceps Muscle / Q000503:physiopathology*; D011788:Quality of Life; D012727:Sex Characteristics