Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/7200 |
Resumo: | Sarcopenia is a syndrome defined as the concomitant condition of low muscle mass and low muscle function that occurs with aging, as well as in chronic diseases, such as cancer. Low muscularity is often observed in patients with cancer and its prevalence varies from 20 to 70%. The present study aimed to evaluate the validity of methods to measure muscle mass in patients with colorectal cancer. The first study of this thesis aimed to explore the determinants of myosteatosis and to investigate whether myosteatosis is associated with frailty components in patients with colorectal cancer. This study showed that body fat and gait speed were the significant and independent determinants of myosteatosis and that myostetatosis was associated with frailty in obese patients. Considering computed tomography (CT) as a reference method, the aim of the second study was to evaluate the muscle mass in patients with colorectal cancer at the third lumbar vertebra region as well as by surrogate methods that are suitable for clinical practice. In addition, this study also sought to investigate: 1) the validity of methods used in clinical practice to evaluate muscle mass (mid-upper arm muscle area, calf circumference, skeletal muscle mass assessed by bioelectrical impedance analysis and muscle deficit by the physical examination from the patient-generated subjective global assessment) compared with CT; 2) the association between different muscle measurements with clinical parameters and nutritional status 3) to identify which substitute method shows the highest prognostic value of low muscularity. The main findings of the second study showed that physical exam was the method with higher agreement with CT to assess muscle mass. Low Muscularity groups had higher proportion of malnourished individuals and lower values of body mass index, body fat percentage and phase angle. The Cox regression models adjusted for age, sex and tumor stage showed that physical exam had the highest hazard ratio and C-statistic value among all methods investigated. In addition, the prevalence of low muscle mass varied from 9.6 to 54.3%, depending on the method applied to evaluate muscle mass. These studies corroborate the importance of assessing muscle mass and muscle quality in patients with cancer, considering the relevance for the diagnosis of sarcopenia, the prevention of nutritional disturbances and the possibility to apply early therapeutic interventions. In addition, methods accessible for use in clinical practice, such as physical exam, showed a good agreement with the gold standard method (CT) for the evaluation of muscle mass in colorectal cancer patients |
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Avesani, Carla Mariahttp://lattes.cnpq.br/3561058635341668Gonzalez, Maria Cristinahttp://lattes.cnpq.br/2868331941630408Daleprane, Júlio Beltramehttp://lattes.cnpq.br/6027048461430935Costa, Danielly Cristiny Ferraz dahttp://lattes.cnpq.br/9617293991265023Koury, Josely Correahttp://lattes.cnpq.br/9039270525512042Bergmann, Ankehttp://lattes.cnpq.br/8708733143383938Wahrlich, VivianCPF:57790221000http://lattes.cnpq.br/6198647788690311http://lattes.cnpq.br/2708116928432805Souza, Nilian Carla Silva2021-01-05T16:38:42Z2019-01-242018-11-26SOUZA, Nilian Carla Silva. Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal. 2018. 127 f. Tese (Doutorado em Alimentação, Nutrição e Saúde) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2018.http://www.bdtd.uerj.br/handle/1/7200Sarcopenia is a syndrome defined as the concomitant condition of low muscle mass and low muscle function that occurs with aging, as well as in chronic diseases, such as cancer. Low muscularity is often observed in patients with cancer and its prevalence varies from 20 to 70%. The present study aimed to evaluate the validity of methods to measure muscle mass in patients with colorectal cancer. The first study of this thesis aimed to explore the determinants of myosteatosis and to investigate whether myosteatosis is associated with frailty components in patients with colorectal cancer. This study showed that body fat and gait speed were the significant and independent determinants of myosteatosis and that myostetatosis was associated with frailty in obese patients. Considering computed tomography (CT) as a reference method, the aim of the second study was to evaluate the muscle mass in patients with colorectal cancer at the third lumbar vertebra region as well as by surrogate methods that are suitable for clinical practice. In addition, this study also sought to investigate: 1) the validity of methods used in clinical practice to evaluate muscle mass (mid-upper arm muscle area, calf circumference, skeletal muscle mass assessed by bioelectrical impedance analysis and muscle deficit by the physical examination from the patient-generated subjective global assessment) compared with CT; 2) the association between different muscle measurements with clinical parameters and nutritional status 3) to identify which substitute method shows the highest prognostic value of low muscularity. The main findings of the second study showed that physical exam was the method with higher agreement with CT to assess muscle mass. Low Muscularity groups had higher proportion of malnourished individuals and lower values of body mass index, body fat percentage and phase angle. The Cox regression models adjusted for age, sex and tumor stage showed that physical exam had the highest hazard ratio and C-statistic value among all methods investigated. In addition, the prevalence of low muscle mass varied from 9.6 to 54.3%, depending on the method applied to evaluate muscle mass. These studies corroborate the importance of assessing muscle mass and muscle quality in patients with cancer, considering the relevance for the diagnosis of sarcopenia, the prevention of nutritional disturbances and the possibility to apply early therapeutic interventions. In addition, methods accessible for use in clinical practice, such as physical exam, showed a good agreement with the gold standard method (CT) for the evaluation of muscle mass in colorectal cancer patientsA sarcopenia consiste em uma síndrome caracterizada pela redução de massa muscular e da capacidade funcional e está presente em enfermidades crônicas inflamatórias, como o câncer, independente da faixa etária. A prevalência de redução de massa muscular em pacientes oncológicos é elevada e pode variar entre 20 a 70%. Desta forma, o presente estudo teve como objetivo avaliar a validade dos métodos de avaliação da massa muscular em pacientes com câncer colorretal. O primeiro artigo gerado a partir desta tese teve como objetivo explorar os determinantes da mioesteatose e sua associação com os componentes da fragilidade em pacientes com câncer colorretal. Esse estudo apresentou como principais achados que a gordura corporal e a velocidade da marcha foram os determinantes significantes e independentes da mioesteatose e que a mioesteatose estava associada à fragilidade em pacientes obesos. No segundo artigo, o objetivo foi avaliar a massa muscular de pacientes com câncer colorretal através da técnica da tomografia computadorizada (TC) na região da terceira vértebra lombar e também por métodos com alta aplicabilidade clínica, sendo que a TC foi considerada o método de referência. Ademais, estabeleceu-se como objetivos específicos avaliar: 1) a validade dos métodos utilizados na prática clínica para avaliação da massa muscular (área muscular do braço corrigida, circunferência da panturrilha, massa muscular esquelética obtida pela impedância bioelétrica e exame físico de massa muscular obtido a partir da avaliação subjetiva global produzida pelo paciente) em comparação com a TC; 2) a associação entre a redução da massa muscular, avaliada por diferentes métodos, e os parâmetros clínicos e de estado nutricional; 3) identificar qual método substitutivo apresenta maior valor prognóstico para mortalidade no diagnóstico de redução de massa muscular. Os principais achados mostram que o exame físico foi o método com maior concordância com a TC para avaliar a massa muscular. O grupo com redução de massa muscular avaliada por diferentes métodos apresentou maior prevalência de desnutrição e menores valores de índice de massa corporal, gordura corporal e ângulo de fase. O modelo de regressão de Cox ajustado para idade, sexo e estadiamento mostrou que o exame físico apresentou maior valor preditivo para mortalidade entre os métodos investigados. Ademais, notou-se que a prevalência de redução de massa muscular variou de 9,6 a 54,3%, a depender do método utilizado para avaliar a massa muscular. Esses estudos sugerem a importância de se avaliar a massa e a qualidade muscular em pacientes com câncer, considerando sua necessidade para o diagnóstico da sarcopenia, na prevenção de alterações do estado nutricional e pela possibilidade de iniciar intervenções terapêuticas mais precoces. Além disso, métodos mais acessíveis na prática clínica, como o exame físico, apresentaram boa concordância com método ouro (TC) para a avaliação da massa muscular em pacientes com câncer colorretalSubmitted by Boris Flegr (boris@uerj.br) on 2021-01-05T16:38:42Z No. of bitstreams: 1 Tese_Nilian Carla Silva Souza.pdf: 7869769 bytes, checksum: 4d185ec51b50f5969bcf03a21579187e (MD5)Made available in DSpace on 2021-01-05T16:38:42Z (GMT). No. of bitstreams: 1 Tese_Nilian Carla Silva Souza.pdf: 7869769 bytes, checksum: 4d185ec51b50f5969bcf03a21579187e (MD5) Previous issue date: 2018-11-26application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Alimentação, Nutrição e SaúdeUERJBRCentro Biomédico::Instituto de NutriçãoColorectal cancerMuscle massMyosteatosisComputed tomographyMioesteatoseSarcopeniaTomografia computadorizadaNutriçãoCâncer colorretalMassa muscularCNPQ::CIENCIAS DA SAUDE::NUTRICAOEstudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretalStudy of muscle mass and muscle quality assessed by computed tomography in patients with colorectal cancerinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese_Nilian Carla Silva Souza.pdfapplication/pdf7869769http://www.bdtd.uerj.br/bitstream/1/7200/1/Tese_Nilian+Carla+Silva+Souza.pdf4d185ec51b50f5969bcf03a21579187eMD511/72002024-02-23 16:15:33.385oai:www.bdtd.uerj.br:1/7200Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-23T19:15:33Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
dc.title.alternative.eng.fl_str_mv |
Study of muscle mass and muscle quality assessed by computed tomography in patients with colorectal cancer |
title |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
spellingShingle |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal Souza, Nilian Carla Silva Colorectal cancer Muscle mass Myosteatosis Computed tomography Mioesteatose Sarcopenia Tomografia computadorizada Nutrição Câncer colorretal Massa muscular CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
title_short |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
title_full |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
title_fullStr |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
title_full_unstemmed |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
title_sort |
Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal |
author |
Souza, Nilian Carla Silva |
author_facet |
Souza, Nilian Carla Silva |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Avesani, Carla Maria |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3561058635341668 |
dc.contributor.advisor-co1.fl_str_mv |
Gonzalez, Maria Cristina |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/2868331941630408 |
dc.contributor.referee1.fl_str_mv |
Daleprane, Júlio Beltrame |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/6027048461430935 |
dc.contributor.referee2.fl_str_mv |
Costa, Danielly Cristiny Ferraz da |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9617293991265023 |
dc.contributor.referee3.fl_str_mv |
Koury, Josely Correa |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/9039270525512042 |
dc.contributor.referee4.fl_str_mv |
Bergmann, Anke |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/8708733143383938 |
dc.contributor.referee5.fl_str_mv |
Wahrlich, Vivian |
dc.contributor.referee5ID.fl_str_mv |
CPF:57790221000 |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/6198647788690311 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2708116928432805 |
dc.contributor.author.fl_str_mv |
Souza, Nilian Carla Silva |
contributor_str_mv |
Avesani, Carla Maria Gonzalez, Maria Cristina Daleprane, Júlio Beltrame Costa, Danielly Cristiny Ferraz da Koury, Josely Correa Bergmann, Anke Wahrlich, Vivian |
dc.subject.eng.fl_str_mv |
Colorectal cancer Muscle mass Myosteatosis Computed tomography |
topic |
Colorectal cancer Muscle mass Myosteatosis Computed tomography Mioesteatose Sarcopenia Tomografia computadorizada Nutrição Câncer colorretal Massa muscular CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
dc.subject.por.fl_str_mv |
Mioesteatose Sarcopenia Tomografia computadorizada Nutrição Câncer colorretal Massa muscular |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::NUTRICAO |
description |
Sarcopenia is a syndrome defined as the concomitant condition of low muscle mass and low muscle function that occurs with aging, as well as in chronic diseases, such as cancer. Low muscularity is often observed in patients with cancer and its prevalence varies from 20 to 70%. The present study aimed to evaluate the validity of methods to measure muscle mass in patients with colorectal cancer. The first study of this thesis aimed to explore the determinants of myosteatosis and to investigate whether myosteatosis is associated with frailty components in patients with colorectal cancer. This study showed that body fat and gait speed were the significant and independent determinants of myosteatosis and that myostetatosis was associated with frailty in obese patients. Considering computed tomography (CT) as a reference method, the aim of the second study was to evaluate the muscle mass in patients with colorectal cancer at the third lumbar vertebra region as well as by surrogate methods that are suitable for clinical practice. In addition, this study also sought to investigate: 1) the validity of methods used in clinical practice to evaluate muscle mass (mid-upper arm muscle area, calf circumference, skeletal muscle mass assessed by bioelectrical impedance analysis and muscle deficit by the physical examination from the patient-generated subjective global assessment) compared with CT; 2) the association between different muscle measurements with clinical parameters and nutritional status 3) to identify which substitute method shows the highest prognostic value of low muscularity. The main findings of the second study showed that physical exam was the method with higher agreement with CT to assess muscle mass. Low Muscularity groups had higher proportion of malnourished individuals and lower values of body mass index, body fat percentage and phase angle. The Cox regression models adjusted for age, sex and tumor stage showed that physical exam had the highest hazard ratio and C-statistic value among all methods investigated. In addition, the prevalence of low muscle mass varied from 9.6 to 54.3%, depending on the method applied to evaluate muscle mass. These studies corroborate the importance of assessing muscle mass and muscle quality in patients with cancer, considering the relevance for the diagnosis of sarcopenia, the prevention of nutritional disturbances and the possibility to apply early therapeutic interventions. In addition, methods accessible for use in clinical practice, such as physical exam, showed a good agreement with the gold standard method (CT) for the evaluation of muscle mass in colorectal cancer patients |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-11-26 |
dc.date.available.fl_str_mv |
2019-01-24 |
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2021-01-05T16:38:42Z |
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SOUZA, Nilian Carla Silva. Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal. 2018. 127 f. Tese (Doutorado em Alimentação, Nutrição e Saúde) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2018. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/7200 |
identifier_str_mv |
SOUZA, Nilian Carla Silva. Estudo da massa e qualidade muscular por tomografia computadorizada em pacientes com câncer colorretal. 2018. 127 f. Tese (Doutorado em Alimentação, Nutrição e Saúde) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2018. |
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http://www.bdtd.uerj.br/handle/1/7200 |
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UERJ |
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BR |
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Centro Biomédico::Instituto de Nutrição |
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Universidade do Estado do Rio de Janeiro |
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