Serum FSTL-1 and AI-assessed muscle parameters in cancer-related malnutrition.

Sarcopenia was identified in nearly half of cancer patients with disease-related malnutrition.

• Total sample included 91 patients diagnosed with cancer and disease-related malnutrition.
• 37 women and 54 men were enrolled, with a mean age of 69.5 ± 10.6 years.
• Sarcopenia was identified in 41 individuals, representing 45.9% of the cohort.

Patients with sarcopenia showed significantly reduced body composition and anthropometric measurements compared to those without sarcopenia.

• Body weight was reduced by -4.1 ± 1.0 kg (P = 0.02) in sarcopenic patients.
• Calf circumference was reduced by -2.5 ± 0.3 cm (P = 0.03).
• Phase angle was reduced by -0.7 ± 0.2° (P = 0.01) and reactance by -6.3 ± 1.3 Ω (P = 0.03).

Sarcopenic patients had significantly lower skeletal muscle mass parameters measured by bioelectrical impedance analysis.

• Skeletal muscle mass was reduced by -2.3 ± 0.3 kg (P = 0.03) in sarcopenic patients.
• Appendicular skeletal muscle mass was reduced by -3.7 ± 0.1 kg (P = 0.02).
• Appendicular skeletal muscle mass index was reduced by -1.3 ± 0.3 kg/m² (P = 0.02).

AI-assisted ultrasound parameters of the rectus femoris were significantly lower in sarcopenic patients.

• Cross-sectional area was reduced by -0.4 ± 0.2 cm² (P = 0.04) in sarcopenic patients.
• Y-axis measurement was reduced by -0.27 ± 0.1 cm (P = 0.03).
• Pennation angle was reduced by -1.1 ± 0.2° (P = 0.02).
• Muscle mass assessment was performed through ultrasound evaluation of the rectus femoris using an AI-based analytical ultrasound system.

Circulating FSTL-1 levels were markedly reduced in patients with sarcopenia.

• Lower FSTL-1 concentrations remained significantly associated with an increased likelihood of sarcopenia in multivariate logistic regression (OR = 1.63, 95% CI: 1.10–4.21; P = 0.03).
• The association was independent of other covariates included in the multivariate model.
• FSTL-1 is described as an emerging myokine linking skeletal and muscle biology.

FSTL-1 demonstrated moderate discriminative capacity for identifying sarcopenia in cancer patients with malnutrition.

• The area under the receiver operating characteristic curve for FSTL-1 was 0.69 (95% CI: 0.51–0.73; P = 0.03).
• The discriminative capacity was described as 'moderate' by the authors.
• These findings suggest FSTL-1 may serve as a biomarker of impaired muscle quality and mass.