Systematic review of sarcopenia in chronic pancreatitis: prevalence, impact on surgical outcomes, and survival

ABSTRACT

Introduction

Chronic pancreatitis (CP) is characterized by progressive inflammatory changes to the pancreas, leading to loss of endocrine and exocrine function. Emerging literature suggests sarcopenia may adversely affect outcomes for chronic pancreatitis patients. This systematic review examines the evidence surrounding the impact of sarcopenia on patients with CP.

Areas Covered

A systematic literature search of MEDLINE (via PUBMED), Cochrane and EMBASE databases was undertaken to identify articles describing body composition assessment in patients with CP. Data collected included definitions of sarcopenia, sarcopenia assessment methodology, baseline demographics, surgical outcomes, and short- and long-term outcomes.

Expert opinion

In total, nine studies reported on 977 patients with a sarcopenia prevalence of 32.3% (95% CI 22.9–42.6%). CT remains the primary modality to assess for sarcopenia, due to ease of access. None of the studies reporting on post-operative outcomes for patients with chronic pancreatitis found a significant increase in complications among those with sarcopenia. Mortality within 1 year in the outpatient setting from one study of patients with CP was 16% in sarcopenic patients versus 3% (HR: 6.69 (95% CI: 1.79–24.9), p < 0.001) in those with no sarcopenia.

Sarcopenia is prevalent in patients with CP occurring in approximately a third of patients. Sarcopenia is associated with an adverse impact on long-term survival.

KEYWORDS:

• Sarcopenia
• body composition
• chronic pancreatitis
• pancreatitis
• survival
• quality of life

Article highlights

• Sarcopenia is prevalent in patients with chronic pancreatitis affecting a third of patients.

• Sarcopenia is associated with later stages of chronic pancreatitis and has a significantly increased risk of death.

• Sarcopenia in chronic pancreatitis does not appear to be associated with increased rates of post-operative complications.

• Sarcopenia in chronic pancreatitis was associated with a normal or increased BMI in 80% of patients contributing to under detection of sarcopenia in this population.

• Whilst current literature focusses on the detection of sarcopenia in chronic pancreatitis and the impact of this on outcomes, interventions to reduce sarcopenia are an area of unmet need that require further research.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

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Additional information

Funding

This paper was not funded.