title: Sarcopenia is closely associated with pancreatic exocrine insufficiency in patients with pancreatic disease.
abstract: OBJECTIVE
  The loss of skeletal muscle mass (sarcopenia) is associated with the poor prognosis of pancreatic cancer. It has been reported pancreatic exocrine insufficiency (PEI) is associated with serum nutritional markers in chronic pancreatitis. However, there has been no report about the relationship between sarcopenia and PEI. The aim of this study is to determine whether body composition, including skeletal muscle (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), intramuscular adipose tissue content (IMAC), and serum nutritional markers are associated with pancreatic exocrine function in patients with pancreatic disease.
  
  
  METHODS
  Data were collected prospectively on 132 patients with pancreatic disease. SM, SAT, VAT and IMAC were assessed by computed tomography. Patients underwent a13C-labeled mixed triglyceride breath test to measure pancreatic exocrine function. Serum nutritional markers were measured at the same time of13C-labeled mixed triglyceride breath test. Patients were stratified by quartiles according to each body component, and for each component the lowest group was defined as the lowest quartile, treating men and women separately. The lowest group for SM was defined as sarcopenia. PEI was defined as a percentage13CO2cumulative dose at 7 h below 5%.
  
  
  RESULTS
  Sarcopenia was associated with PEI in both men (P < 0.001) and women (P = 0.012). Serum albumin was associated with PEI in men only (P = 0.005). Among all patients, sarcopenia (P = 0.001) and serum albumin (P = 0.058) were associated with PEI. On multivariate analysis, only sarcopenia remained independently associated with PEI (P < 0.001).
  
  
  CONCLUSIONS
  Sarcopenia is independently associated with PEI in patients with pancreatic disease.
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: shintakuya0826@yahoo.co.jp.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Shintakuya
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Naru
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakagawa
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Urabe
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okano
authors.affiliation: Department of Diagnostic Radiology, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.affiliation: Department of Diagnostic Radiology, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Higaki
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D010188:Exocrine Pancreatic Insufficiency / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000473:pathology; D016017:Odds Ratio; D011446:Prospective Studies; D055948:Sarcopenia / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D012709:Serum Albumin / Q000378:metabolism; D050151:Subcutaneous Fat / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D012709:Serum Albumin
keywords: Body component; Pancreatic exocrine insufficiency; Sarcopenia