The International Journal of Biochemistry & Cell Biology
ReviewClinical outcomes related to muscle mass in humans with cancer and catabolic illnesses☆
Introduction
A wide body of evidence suggests that excessive loss of skeletal muscle is detrimental. Specific degenerative conditions of muscle, such as Duchenne muscular dystrophy, are fatal by 25 years of age. Muscle wasting is pervasive and not limited to rare disorders. Muscle wasting is an outcome of many chronic illnesses. Cancer, chronic obstructive pulmonary disease, heart failure and chronic renal failure, for example, are characterized by progressive involuntary weight loss and skeletal muscle loss. Muscle wasting is characteristic of such a broad range of physiological and pathological conditions that it has been considered to be part of a stereoptypical response to nutrient deprivation and systemic stress (Lecker et al., 2004). Indeed, different types of muscle atrophy appear to share a common transcriptional program that is activated in many systemic diseases (Lecker et al., 2004).
In this review we discuss the emergence of muscle mass measurement using diagnostic imaging and the relationship between muscle mass and clinical outcome.
Section snippets
Muscle mass measured from early times to the present
The diagnosis of muscle wasting has been documented since ancient times and this diagnosis was based on physiognomy for many centuries. Hippocrates remarked upon the facial features characteristic of temporal muscle wasting, “the nose sharp, the eyes sunken, the temples fallen in”. Tinsley reminded physicians of the value of these facial features in diagnosis and prognosis (Tinsley, 1918). Advanced old age, independent of the presence of any underlying disease is also associated with a
Muscle mass in human populations
There is variation in the absolute muscularity in any population of normal healthy individuals. Sex is a major determinant of muscularity, however there is a considerable degree of overlap between men and women (Baracos et al., 2010, Kelly et al., 2009, Martin et al., 2013, Shen et al., 2004). While the most muscular individuals are mostly male, the most muscular women are equally muscular as some men (Baracos et al., 2010, Kelly et al., 2009, Martin et al., 2013, Shen et al., 2004). Genetic
Clinical findings on skeletal muscle mass, atrophy and hypertrophy
High resolution CT images are normally found in the clinical record of a variety of patient groups (such as in oncology and hepatology), and some authors have advocated for the extraction of the body composition data from these records (MacDonald et al., 2011, Prado et al., 2009a). This approach makes maximal use of existing information and has permitted numerous retrospective and prospective studies. Thirty-three papers cited in this review report evaluations of muscle cross sectional area in
Conclusion
Sensitive and specific methods for the quantification of skeletal muscle in humans are providing new opportunities for translation of fundamental research in muscle biology from animal experimental systems to humans. Muscle wasting occurs in epidemic proportions in older individuals affected by chronic diseases and is prognostic of disease- and treatment specific morbidity and mortality. Individuals with severe muscle depletion are not merely unfit in the sense of their ability to perform work,
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This article is part of a Directed Issue: Molecular basis of muscle wasting.