Abstract：
OBJECTIVE: Our study aims to determine whether myostatin (MSTN) is associated with muscle mass and strength in individuals with cancer or obesity, as well as with cancer cachexia (CC) or sarcopenic obesity (SO).
METHODS: The ACTICA study included individuals with CC (n = 70) or without CC (NC, n = 73). The MYDIASECRET study included individuals with obesity evaluated before (T0) and 3 months (T3) after bariatric surgery (n = 62). Body composition was assessed using bioelectrical impedance analysis (BIA). Skeletal muscle mass (SMM) and appendicular SMM (ASMM) were calculated from Janssen\'s and Sergi\'s equations, respectively, and expressed as indexes (SMMI and ASMMI). Handgrip strength (HGS) was assessed using a Jamar hand-held dynamometer. MSTN plasma levels were measured using ELISA. Spearman\'s coefficient was used to correlate MSTN with muscle mass and strength. Receiver operating characteristic (ROC) curve analysis was performed to identify an optimal MSTN cutoff level for the prediction of CC or SO.
RESULTS: In the ACTICA study, muscle mass and strength were lower in CC individuals than in NC individuals (SMMI: 8.0 kg/m2vs 9.0 kg/m2, p = 0.004; ASMMI: 6.2 kg/m2vs 7.2 kg/m2, p < 0.001; HGS: 28 kg vs 38 kg, p < 0.001). MSTN was also lower in CC individuals than in NC individuals (1434 pg/mL vs 2149 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN (SMMI: R = 0.500, p < 0.001; ASMMI: R = 0.479, p < 0.001; HGS: R = 0.495, p < 0.001). ROC curve analysis showed a MSTN cutoff level of 1548 pg/mL (AUC 0.684, sensitivity 57%, specificity 75%, p < 0.001) for the prediction of CC. In the MYDIASECRET study, muscle mass and strength were reduced at T3 (SMMI: -8%, p < 0.001; ASMMI: -12%, p < 0.001; HGS: -6%, p = 0.005). MSTN was also reduced at T3 (1773 pg/mL vs 2582 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN at T0 and T3 (SMMI-T0: R = 0.388, p = 0.002; SMMI-T3: R = 0.435, p < 0.001; HGS-T0: R = 0.337, p = 0.007; HGS-T3: R = 0.313, p = 0.013). ROC curve analysis showed a MSTN cutoff level of 4225 pg/mL (AUC 0.835, sensitivity 98%, specificity 100%, p = 0.014) for the prediction of SO at T3.
CONCLUSIONS: MSTN is positively correlated with muscle mass and strength in individuals with cancer or obesity, suggesting its potential use as a biomarker of muscle mass and strength. The ROC curve analysis suggests the potential use of MSTN as a screening tool for CC and SO.
METHODS: The ACTICA study included individuals with CC (n = 70) or without CC (NC, n = 73). The MYDIASECRET study included individuals with obesity evaluated before (T0) and 3 months (T3) after bariatric surgery (n = 62). Body composition was assessed using bioelectrical impedance analysis (BIA). Skeletal muscle mass (SMM) and appendicular SMM (ASMM) were calculated from Janssen\'s and Sergi\'s equations, respectively, and expressed as indexes (SMMI and ASMMI). Handgrip strength (HGS) was assessed using a Jamar hand-held dynamometer. MSTN plasma levels were measured using ELISA. Spearman\'s coefficient was used to correlate MSTN with muscle mass and strength. Receiver operating characteristic (ROC) curve analysis was performed to identify an optimal MSTN cutoff level for the prediction of CC or SO.
RESULTS: In the ACTICA study, muscle mass and strength were lower in CC individuals than in NC individuals (SMMI: 8.0 kg/m2vs 9.0 kg/m2, p = 0.004; ASMMI: 6.2 kg/m2vs 7.2 kg/m2, p < 0.001; HGS: 28 kg vs 38 kg, p < 0.001). MSTN was also lower in CC individuals than in NC individuals (1434 pg/mL vs 2149 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN (SMMI: R = 0.500, p < 0.001; ASMMI: R = 0.479, p < 0.001; HGS: R = 0.495, p < 0.001). ROC curve analysis showed a MSTN cutoff level of 1548 pg/mL (AUC 0.684, sensitivity 57%, specificity 75%, p < 0.001) for the prediction of CC. In the MYDIASECRET study, muscle mass and strength were reduced at T3 (SMMI: -8%, p < 0.001; ASMMI: -12%, p < 0.001; HGS: -6%, p = 0.005). MSTN was also reduced at T3 (1773 pg/mL vs 2582 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN at T0 and T3 (SMMI-T0: R = 0.388, p = 0.002; SMMI-T3: R = 0.435, p < 0.001; HGS-T0: R = 0.337, p = 0.007; HGS-T3: R = 0.313, p = 0.013). ROC curve analysis showed a MSTN cutoff level of 4225 pg/mL (AUC 0.835, sensitivity 98%, specificity 100%, p = 0.014) for the prediction of SO at T3.
CONCLUSIONS: MSTN is positively correlated with muscle mass and strength in individuals with cancer or obesity, suggesting its potential use as a biomarker of muscle mass and strength. The ROC curve analysis suggests the potential use of MSTN as a screening tool for CC and SO.
摘要：
目的：我们的研究旨在确定肌肉生长抑制素（MSTN）是否与癌症或肥胖症患者的肌肉质量和力量有关，以及癌症恶病质（CC）或肌萎缩性肥胖（SO）。
方法：ACTICA研究包括有CC（n=70）或无CC（NC，n=73）。MYDIASECRET研究包括在减肥手术前（T0）和术后3个月（T3）评估的肥胖个体（n=62）。使用生物电阻抗分析(BIA)评估身体成分。骨骼肌质量（SMM）和阑尾SMM（ASMM）根据Janssen和Sergi方程计算，分别,并表示为索引（SMMI和ASMMI）。使用Jamar手持式测力计评估握力（HGS）。使用ELISA测量MSTN血浆水平。Spearman系数用于将MSTN与肌肉质量和力量相关联。进行接收器操作特征(ROC)曲线分析以鉴定用于预测CC或SO的最佳MSTN截止水平。
结果：在ACTICA研究中，CC个体的肌肉质量和力量低于NC个体（SMMI：8.0kg/m2vs9.0kg/m2，p=0.004；ASMMI：6.2kg/m2vs7.2kg/m2，p<0.001；HGS：28kgvs38kg，p<0.001)。CC个体的MSTN也低于NC个体（1434pg/mL对2149pg/mL，p<0.001)。肌肉质量和力量与MSTN呈正相关(SMMI:R=0.500,p<0.001;ASMMI:R=0.479,p<0.001;HGS:R=0.495,p<0.001)。ROC曲线分析显示MSTN截止水平为1548pg/mL（AUC0.684，灵敏度57％，特异性75%，p<0.001)用于CC的预测。在MYDIASECRET研究中,肌肉质量和力量在T3时降低(SMMI：-8%，p<0.001；ASMMI：-12%，p<0.001；HGS：-6%，p=0.005)。在T3时MSTN也降低（1773pg/mL对2582pg/mL，p<0.001)。T0和T3时肌肉质量和力量与MSTN呈正相关(SMMI-T0:R=0.388,p=0.002;SMMI-T3:R=0.435,p<0.001;HGS-T0:R=0.337,p=0.007;HGS-T3:R=0.313,p=0.013)。ROC曲线分析显示MSTN截止水平为4225pg/mL(AUC0.835,灵敏度98%,特异性100%，p=0.014），用于T3时SO的预测。
结论：MSTN与癌症或肥胖患者的肌肉质量和力量呈正相关，表明其作为肌肉质量和力量的生物标志物的潜在用途。ROC曲线分析表明MSTN可能用作CC和SO的筛选工具。
方法：ACTICA研究包括有CC（n=70）或无CC（NC，n=73）。MYDIASECRET研究包括在减肥手术前（T0）和术后3个月（T3）评估的肥胖个体（n=62）。使用生物电阻抗分析(BIA)评估身体成分。骨骼肌质量（SMM）和阑尾SMM（ASMM）根据Janssen和Sergi方程计算，分别,并表示为索引（SMMI和ASMMI）。使用Jamar手持式测力计评估握力（HGS）。使用ELISA测量MSTN血浆水平。Spearman系数用于将MSTN与肌肉质量和力量相关联。进行接收器操作特征(ROC)曲线分析以鉴定用于预测CC或SO的最佳MSTN截止水平。
结果：在ACTICA研究中，CC个体的肌肉质量和力量低于NC个体（SMMI：8.0kg/m2vs9.0kg/m2，p=0.004；ASMMI：6.2kg/m2vs7.2kg/m2，p<0.001；HGS：28kgvs38kg，p<0.001)。CC个体的MSTN也低于NC个体（1434pg/mL对2149pg/mL，p<0.001)。肌肉质量和力量与MSTN呈正相关(SMMI:R=0.500,p<0.001;ASMMI:R=0.479,p<0.001;HGS:R=0.495,p<0.001)。ROC曲线分析显示MSTN截止水平为1548pg/mL（AUC0.684，灵敏度57％，特异性75%，p<0.001)用于CC的预测。在MYDIASECRET研究中,肌肉质量和力量在T3时降低(SMMI：-8%，p<0.001；ASMMI：-12%，p<0.001；HGS：-6%，p=0.005)。在T3时MSTN也降低（1773pg/mL对2582pg/mL，p<0.001)。T0和T3时肌肉质量和力量与MSTN呈正相关(SMMI-T0:R=0.388,p=0.002;SMMI-T3:R=0.435,p<0.001;HGS-T0:R=0.337,p=0.007;HGS-T3:R=0.313,p=0.013)。ROC曲线分析显示MSTN截止水平为4225pg/mL(AUC0.835,灵敏度98%,特异性100%，p=0.014），用于T3时SO的预测。
结论：MSTN与癌症或肥胖患者的肌肉质量和力量呈正相关，表明其作为肌肉质量和力量的生物标志物的潜在用途。ROC曲线分析表明MSTN可能用作CC和SO的筛选工具。
