Dinapenia, sarcopenia e qualidade de vida em mulheres hospitalizadas com excesso de peso e câncer de mama

Abstract

Breast cancer is the most common cancer in women. The associated presence of dynapenia, sarcopenia and obesity increases the possibility of adverse effects that can affect the tolerability of the treatment and possibly the quality of life. Objective: to assess whether there is an association between dynapenia, sarcopenia and sociodemographic, clinical and quality of life characteristics in hospitalized women with excess weight and breast cancer. Method: This is a cross-sectional study, carried out at a Philanthropic Reference Hospital in the city of Salvador. Socioeconomic and demographic data were evaluated; clinicians; Lifestyle; nutritional data; assessment of physical performance and quality of life. The assessment of dynapenia was performed using absolute and relative handgrip strength (FPPR = absolute handgrip strength/weight). For the diagnosis of sarcopenia, the assessment of dynapenia, low muscle mass reserve and low physical performance was used. Quality of life was assessed using the Functional Assessment of Cancer Therapy - Breast (FACT-B) instrument. Results: 97 women participated in the study with a mean age of 52.2 years (SD=11.2), 55% were diagnosed with obesity, 58.8% time since diagnosis was less than 6 months and 56.7% had not been diagnosed with obesity. previously submitted to antineoplastic treatments. Assessing absolute handgrip strength, 72.2% had dynapenia, 11.3% had low muscle mass reserve and 32% had low physical performance. It was observed that 66% had probable sarcopenia, 3.1% sarcopenia and 2.1% severe sarcopenia. And 56.7% had dynapenic obesity. The mean quality of life score, according to FACT-B, was significantly higher among African descendent women (111.7 vs. 99.5, p=0.04). Women diagnosed with probable sarcopenia/sarcopenia scored 6.54 (CI: -11.79 -1.29) points lower on the FACT-B when compared to those without sarcopenia. When adjusting the model, it was observed that the mean quality of life score in women with probable sarcopenia/sarcopenia was even lower (-7.41; CI:-12.97 - 1.85). Patients diagnosed with dynapenic obesity had a mean quality of life score of 8.47 points lower (CI: -13.12 -3.82) when compared to those without dynapenic obesity and, in the adjusted model, the mean quality of life score of life was even shorter (- 8.89). There was an agreement between FPPA and FPPR of 0.779 (p=0.000). In the evaluation of FPPR, women with dynapenia had higher BMI values (34.0, SD=6.2 vs. 30.8, SD=3.6, p=0.002) and WC (103.4, SD=12 .7 vs. 95.9, SD=9.3, p=0.003). A moderate inverse correlation was observed between FPPR and BMI (-0.42, p=0.000), WC (-0.48, p=0.000) and a weak direct correlation with physical performance (0.29, p=0.003). There was a weak direct correlation between FPPR and physical well-being (0.27, p=0.007), emotional well-being (0.21, p=0.035), functional well-being (0.29, p=0.004); moderate direct correlation between the breast cancer subscale (0.32, p=0.001) and FACT-B (0.36, p=0.000). Conclusion: In this study, women with higher BMI, abdominal fat deposition and dynapenia had lower quality of life scores. Relative strength was able to identify greater associations with nutritional variables and quality of life. Thus, FPPR can be used as an adjuvant method for early nutritional assessment, and must be accompanied by every antineoplastic treatment.