ESPEN 2022 Abstract Submission

Topic: Nutrition and chronic disease

Abstract Submission Identifier: ESPEN22-ABS-1408

IMPAIRED MUSCLE FUNCTION IS RARELY SEEN IN MALNOURISHED PATIENTS WITH CHRONIC PANCREATITIS DESPITE PROMINENTLY LOW SKELETAL MUSCLE MASS

M. L. Wiese^*, ¹, S. Gärtner ¹, N. von Essen ¹, J. Doller ¹, F. Frost ¹, Q. T. Tran ¹, F. U. Weiss ¹, F. Meyer ², L. Valentini ², L.-A. Garbe ³, C. C. Metges ⁴, K. Bannert ⁵, L. F. Sautter ⁵, L. Ehlers ⁵, R. Jaster ⁵, G. Lamprecht ⁵, A. Steveling ¹, M. M. Lerch ⁶, A. A. Aghdassi ¹

¹Department of Medicine A, University Medicine Greifswald, Greifswald, ²Institute of Evidence-based Dietetics (NIED), ³Department of Agriculture and Food Sciences, University of Applied Sciences Neubrandenburg, Neubrandenburg, ⁴Institute of Nutritional Physiology “Oskar Kellner”, Research Institute for Farm Animal Biology (FBN), Dummerstorf, ⁵Department of Medicine II, Division of Gastroenterology, Rostock University Medical Center, Rostock, ⁶Ludwig-Maximilians-University of Munich, University Hospital, Munich, Germany

Rationale: Malnutrition and sarcopenia are common complications of chronic pancreatitis (CP) linked to reduced muscle mass and physical performance. However, understanding of the relationship between both conditions is still limited.  

Methods: In a multicenter cross-sectional study we recruited patients with confirmed CP and healthy volunteers as a control group. Skeletal muscle mass, muscle strength, and physical performance were tested by bioelectrical impedance analysis, handgrip dynamometry and 4m gait speed test, respectively. Malnutrition and sarcopenia were diagnosed according to the criteria by the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2).

Results: We included 66 patients (mean (±SD) age: 56.0 (±14.5) yrs; 51 males) and an equal number of age- and sex-matched controls. Moderate and severe malnutrition were found in 21% (n=14) and 42% (n=28) of patients, respectively. Malnourished subjects had lower skeletal muscle mass compared to both non-malnourished patients and healthy controls. While muscle strength of moderately malnourished patients was similar to controls (mean (±SD): 42.1 (±8.6) kg vs. 44.6 (±13.1) kg, p=0.556), a significant reduction was seen for severely malnourished subjects (mean (±SD): 35.9 (±12.9) kg vs. 44.9 (±14.0) kg, p=0.016). There was a significant correlation (rho=0.705, p<0.001) between muscle mass and strength in subjects with CP. However, although 20 patients (30%) showed skeletal muscle mass below diagnostic threshold, only two individuals (3%) presented concomitantly reduced handgrip strength and were thus diagnosed with sarcopenia. In both cases, sarcopenia was graded non-severe as indicated by normal gait speed (> 0.8 m/s).

Conclusion: Reduced skeletal muscle mass is prominent among malnourished patients with CP whereas manifest sarcopenia is rare. The discrepancy between loss of muscle mass and physical impairment suggests compensatory mechanisms, which require further elucidation.

Disclosure of Interest: None Declared

Keywords: Chronic pancreatitis, GLIM, Handgrip strength, Malnutrition, Sarcopenia (EWGSOP2), Skeletal muscle mass