Malnutrition Is Highly Prevalent in Patients With Chronic Pancreatitis and Characterized by Loss of Skeletal Muscle Mass but Absence of Impaired Physical Function

Mats L Wiese; Simone Gärtner; Nele von Essen; Julia Doller; Fabian Frost; Quang Trung Tran; Frank Ulrich Weiss; Fatuma Meyer; Luzia Valentini; Leif-A Garbe; Cornelia C Metges; Karen Bannert; Lea Franziska Sautter; Luise Ehlers; Robert Jaster; Georg Lamprecht; Antje Steveling; Markus M Lerch; Ali A Aghdassi

doi:10.3389/fnut.2022.889489

Malnutrition Is Highly Prevalent in Patients With Chronic Pancreatitis and Characterized by Loss of Skeletal Muscle Mass but Absence of Impaired Physical Function

Front Nutr. 2022 Jun 1:9:889489. doi: 10.3389/fnut.2022.889489. eCollection 2022.

Authors

Mats L Wiese¹, Simone Gärtner¹, Nele von Essen¹, Julia Doller¹, Fabian Frost¹, Quang Trung Tran^{1

2}, Frank Ulrich Weiss¹, Fatuma Meyer³, Luzia Valentini³, Leif-A Garbe⁴, Cornelia C Metges⁵, Karen Bannert⁶, Lea Franziska Sautter⁶, Luise Ehlers⁶, Robert Jaster⁶, Georg Lamprecht⁶, Antje Steveling¹, Markus M Lerch^{1

7}, Ali A Aghdassi¹

Affiliations

¹ Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
² Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
³ Institute of Evidence-Based Dietetics (NIED), University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany.
⁴ Department of Agriculture and Food Sciences, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany.
⁵ Institute of Nutritional Physiology "Oskar Kellner", Research Institute for Farm Animal Biology (FBN), Dummerstorf, Germany.
⁶ Department of Medicine II, Division of Gastroenterology, Rostock University Medical Center, Rostock, Germany.
⁷ Ludwig Maximilian University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.

Abstract

Background/aims: Patients with chronic pancreatitis (CP) have an increased risk of malnutrition, a condition linked to reduced muscle mass and physical performance. We have investigated the risk factors, phenotypic presentation, and health implications associated with malnutrition in CP.

Materials and methods: In a multicenter cross-sectional study we recruited patients with confirmed CP and healthy volunteers as a control group. Malnutrition was diagnosed according to the criteria proposed by the Global Leadership Initiative on Malnutrition. We performed detailed examinations of body composition and physical function as well as testing of routine blood parameters and markers of inflammation.

Results: We included 66 patients [mean (±SD) age: 56.0 (±14.5) years; 51 males] and an equal number of age- and sex-matched controls. Moderate malnutrition was diagnosed in 21% (n = 14) and severe malnutrition in 42% (n = 28) of patients. Besides weight loss malnourished patients showed lower fat and skeletal muscle mass compared to both non-malnourished subjects and healthy controls. Only in severe malnutrition, blood parameters reflected elevated inflammation and reduced muscle reserves. Handgrip strength in patients did not differ by nutritional status but there was a significant correlation (rho = 0.705, p < 0.001) with skeletal muscle mass. Although 20 patients (30%) had pathologically reduced skeletal muscle mass, only two individuals (3%) had sarcopenia with concomitantly reduced handgrip strength.

Conclusion: Malnutrition is a frequent complication of CP characterized by loss of skeletal muscle mass. As this condition becomes evident only at an advanced stage, regular testing for altered body composition is recommended. Suitable biomarkers and the link between loss of muscle mass and physical function require further investigation.

Clinical trial registration: [https://clinicaltrials.gov/ct2/show/NCT04474743], identifier [NCT04474743].

Keywords: GLIM; chronic pancreatitis; handgrip strength; malnutrition; sarcopenia.

Associated data

ClinicalTrials.gov/NCT04474743