Skip to main content

Advertisement

SpringerLink
Log in

Sarcopenia is an independent risk factor for depression in patients with advanced lung cancer

  • Research
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

Depression is the most prevalent psychological issue among cancer patients and can seriously affect patients’ life and disease prognosis and even lead to suicide. Sarcopenia is a manifestation of cancer cachexia, a chronic progressive process. It is accompanied by a sustained decrease in skeletal muscle mass, muscle strength, and physical function and likewise has various negative effects on the patient. This study aimed to evaluate sarcopenia and other factors that may affect depression in patients with lung cancer and to further analyze and discuss.

Methods

A total of 104 eligible patients were enrolled in this cross-sectional study, using the Hamilton Depression Scale to assess depression, obtaining the psoas muscle index (PMI) by computed tomography (CT), and performing the diagnosis of sarcopenia. Clinical and personal characteristics were collected by electronic medical records.

Results

We evaluated a total of 104 hospitalized cancer patients in this analysis, with mean age = 57.8 ± 11.0 years, and 65.38% (68) were female. We found that up to 31.7% (33) of the participants had depression and 61.5% (64) of the participants had sarcopenia, and no statistical differences were found among depressed and non-depressed patients in relation to age, smoking, gender, performance status, and pathology. Patients with sarcopenia have more than four times the risk of suffering from depression than patients without sarcopenia (OR = 4.133, 95%CI = 1.390–12.287; p = 0.011). Similarly, the possibility of depression in patients with PD (progressive disease) as efficacy evaluation increased by 13.482 times (95%CI = 2.121–85.679, p = 0.006).

Conclusion

In individuals with terminal lung cancer, depression and sarcopenia are prevalent. A strong association between the two is now thought to exist. Sarcopenia and efficacy evaluation are independent risk factors for depression. The correlation between sarcopenia and depression underscores the need for early intervention by our clinicians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

References

  1. Daan Brandenbarg, Maass Saskia WMC, Geerse Olaf P et al (2019) A systematic review on the prevalence of symptoms of depression, anxiety and distress in long-term cancer survivors: implications for primary care. Eur J Cancer Care (Engl) 28:e13086

    Google Scholar 

  2. Manning M, Bettencourt BA (2011) Depression and medication adherence among breast cancer survivors: bridging the gap with the theory of planned behaviour. Psychol Health 26(9):1173–1187

    Article  PubMed  Google Scholar 

  3. Zhou L, Sun H (2021) The longitudinal changes of anxiety and depression, their related risk factors and prognostic value in colorectal cancer survivors: a 36-month follow-up study. Clin Res Hepatol Gastroenterol 45(4):101511

    Article  PubMed  Google Scholar 

  4. Schuch FB, Vancampfort D, Firth J et al (2018) Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry 175(7):631–648

    Article  PubMed  Google Scholar 

  5. Fearon K, Strasser F, Anker SD et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495

    Article  PubMed  Google Scholar 

  6. Hamaguchi Y, Kaido T, Okumura S, Kobayashi A et al (2016) Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults. Nutrition 32(11–12):1200–5

    Article  PubMed  Google Scholar 

  7. Zhang XM, Zhang ZB, Chen W, Wu X (2022) The association between handgrip strength and depression in cancer survivors: a cross-sectional study. Bmc Geriatr 22(1):111

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Pedersen BK (2019) Physical activity and muscle-brain crosstalk. Nat Rev Endocrinol 15(7):383–392

    Article  PubMed  Google Scholar 

  9. Pinquart M, Duberstein PR (2010) Depression and cancer mortality: a meta-analysis. Psychol Med 40(11):1797–1810

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Zimmerman M, Martinez JH, Young D et al (2013) Severity classification on the Hamilton Depression Rating Scale. J Affect Disord 150(2):384–8

    Article  PubMed  Google Scholar 

  11. Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R (1985) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (1985) 85(1):115–22

    Article  Google Scholar 

  12. Budui SL, Rossi AP, Zamboni M (2015) The pathogenetic bases of sarcopenia. Clin Cases Miner Bone Metab 12(1):22–6

    PubMed  PubMed Central  Google Scholar 

  13. Hallgren M, Herring MP, Owen N et al (2016) Exercise, Physical activity, and sedentary behavior in the treatment of depression: broadening the scientific perspectives and clinical opportunities. Front Psychiatry 7:36

    Article  PubMed  PubMed Central  Google Scholar 

  14. Booth FW, Roberts CK, Laye MJ (2012) Lack of exercise is a major cause of chronic diseases. Compr Physiol 2(2):1143–1211

    Article  PubMed  PubMed Central  Google Scholar 

  15. Cole MG, Dendukuri N (2003) Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry 160(6):1147–1156

    Article  PubMed  Google Scholar 

  16. Alexopoulos GS (2005) Depression in the elderly. Lancet 365(9475):1961–70

    Article  PubMed  Google Scholar 

  17. Hughes MM, Connor TJ, Harkin A (2016) Stress-related immune markers in depression implications for treatment. Int J Neuropsychopharmacol 19(6):pyw001

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fukumori N, Yamamoto Y, Takegami M, Yamazaki S et al (2015) Association between hand-grip strength and depressive symptoms: locomotive syndrome and health outcomes in Aizu Cohort Study (LOHAS). Age Ageing 44(4):592–8

    Article  PubMed  Google Scholar 

  19. Světláková L, Sláma O, Světlák M et al (2019) Prevalence of anxiety and depression and their impact on the quality of life of cancer patients treated with palliative antineoplasic therapy - results of the PALINT trial. Klin Onkol 32(3):201–207

    Article  PubMed  Google Scholar 

  20. Walker J, Mulick A, Magill N, Symeonides S et al (2021) Major depression and survival in people with cancer. Psychosom Med 83(5):410–416

    Article  PubMed  Google Scholar 

  21. Walker J, Magill N, Mulick A et al (2020) Different independent associations of depression and anxiety with survival in patients with cancer. J Psychosom Res 138:110218

    Article  PubMed  Google Scholar 

  22. Zhang MF, Wen YS, Liu WY, Peng LF et al (2015) Effectiveness of mindfulness-based therapy for reducing anxiety and depression in patients with cancer: a meta-analysis. Medicine (Baltimore) 94(45):e0897

    Article  CAS  Google Scholar 

  23. Barrera I, Spiegel D (2014) Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression. Int Rev Psychiatry 26(1):31–43

    Article  PubMed  Google Scholar 

  24. Laoutidis ZG, Mathiak K (2013) Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. Bmc Psychiatry 16(13):140

    Article  Google Scholar 

  25. Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Writing group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the extended group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(4):601–618

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nipp RD, Fuchs G, El-Jawahri A, Mario J et al (2018) Sarcopenia is associated with quality of life and depression in patients with advanced cancer. Oncologist 23(1):97–104

    Article  PubMed  Google Scholar 

  27. Li Z, Tong X, Ma Y, Bao T, Yue J (2022) Prevalence of depression in patients with sarcopenia and correlation between the two diseases: systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 13(1):128–144

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Byeon CH, Kang KY, Kang SH et al (2016) Sarcopenia is not associated with depression in Korean adults: results from the 2010–2011 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 37(1):37–43

    Article  PubMed  PubMed Central  Google Scholar 

  29. Gao L, Gao YH (2021) Advances in the research on the relationship between sarcopenia and depression[J]. Journal of Internal Medicine Concepts & Practice 16(06):442–446

  30. Illman J, Corringham R, Robinson D Jr, Davis HM et al (2005) Are inflammatory cytokines the common link between cancer-associated cachexia and depression? J Support Oncol 3(1):37–50

    CAS  PubMed  Google Scholar 

  31. Jeejeebhoy KN (2012) Malnutrition, fatigue, frailty, vulnerability, sarcopenia and cachexia: overlap of clinical features. Curr Opin Clin Nutr Metab Care 15(3):213–219

    Article  CAS  PubMed  Google Scholar 

  32. Dy SM, Lorenz KA, Naeim A et al (2008) Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea. J Clin Oncol 26(23):3886–95

    Article  PubMed  Google Scholar 

  33. Martin L, Birdsell L, Macdonald N, Reiman T et al (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31(12):1539–47

    Article  PubMed  Google Scholar 

  34. Rathbun AM, Shardell MD, Ryan AS, Hochberg MC et al (2020) Association between disease progression and depression onset in persons with radiographic knee osteoarthritis. Rheumatology Oxford 59(11):3390–3399

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ubachs J, Ziemons J, Minis-Rutten IJG et al (2019) Sarcopenia and ovarian cancer survival: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 10(6):1165–1174

    Article  PubMed  PubMed Central  Google Scholar 

  36. Shiroyama T, Nagatomo I, Koyama S et al (2019) Impact of sarcopenia in patients with advanced non-small cell lung cancer treated with PD-1 inhibitors: a preliminary retrospective study. Sci Rep 9(1):2447

    Article  PubMed  PubMed Central  Google Scholar 

  37. Jehn CF, Becker B, Flath B et al (2015) Neurocognitive function, brain-derived neurotrophic factor (BDNF) and IL-6 levels in cancer patients with depression. J Neuroimmunol 287:88–92

    Article  CAS  PubMed  Google Scholar 

  38. Lebena A, Vegas O, Gomez-Lazaro E et al (2014) Melanoma tumors alter proinflammatory cytokine production and monoamine brain function, and induce depressive-like behavior in male mice. Behav Brain Res 272:83–92

    Article  CAS  PubMed  Google Scholar 

  39. Hughes S, Jaremka LM, Alfano CM et al (2014) Social support predicts inflammation, pain, and depressive symptoms: longitudinal relationships among breast cancer survivors. Psychoneuroendocrinology 42:38–44

    Article  PubMed  PubMed Central  Google Scholar 

  40. Kurz K, Schroecksnadel S, Weiss G, Fuchs D (2011) Association between increased tryptophan degradation and depression in cancer patients. Curr Opin Clin Nutr Metab Care 14(1):49–56

    Article  CAS  PubMed  Google Scholar 

  41. Wei YC, Zhou FL, He DL, Bai JR et al (2009) Oxidative stress in depressive patients with gastric adenocarcinoma. Int J Neuropsychopharmacol 12(8):1089–1096

    Article  CAS  PubMed  Google Scholar 

  42. Bortolato B, Hyphantis TN, Valpione S et al (2017) Depression in cancer: the many biobehavioral pathways driving tumor progression. Cancer Treat Rev 52:58–70

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China

    Dinglong Xue, Ning Li, Lijun Li, Yaru Huang, Kaiya Men, Qingwei Meng & Shuai Zhang

Authors
  1. Dinglong Xue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ning Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lijun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yaru Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kaiya Men
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qingwei Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shuai Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study concept and design. Material preparation and data collection and analysis were performed by Dinglong Xue and Ning Li. Data interpretation was done by Dinglong Xue and Ning Li. The first draft of the manuscript was written by Dinglong Xue and Lijun Li, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Qingwei Meng or Shuai Zhang.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by a certified medical ethics committee.

Consent to participate

Written informed consent was obtained from the participants.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dinglong Xue and Ning Li are co-first authors in the making of this manuscript.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xue, D., Li, N., Li, L. et al. Sarcopenia is an independent risk factor for depression in patients with advanced lung cancer. Support Care Cancer 30, 9659–9665 (2022). https://doi.org/10.1007/s00520-022-07384-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-022-07384-w

Keywords

Search

Navigation