Endocrine Abstracts

Background: Sarcopenia is characterised by a loss of muscle mass and function and is negatively correlated with quality of life and clinical outcomes. It may be present despite a healthy or even high body mass index (BMI). Up to a quarter of NET patients are at risk of malnutrition, which may impact treatment outcomes and length of hospital stay. Research has shown that patients with pancreatic and intestinal NETs are at higher risk of weight loss than bronchial NETs. With an increased incidence of bronchial NETs, this study aimed to determine the nutritional status of these patients on diagnosis.

Methods: Newly diagnosed patients being seen in a NET outpatient clinic between March 2017 and January 2018 were assessed using an amended Royal Free-Subjective Global Assessment, overseen by a qualified dietitian. Factors impacting nutritional intake and losses were collected. Anthropometric measurements included: weight, height, BMI, hand-grip strength (HGS), mid upper arm circumference, and triceps skin-fold thickness. Mid arm muscle circumference (MAMC) was also calculated.

Results: Thirteen patients (11 female, 2 male, aged 19–77 years) with a new bronchial NET diagnosis consented. On measuring, 2/13 patients had a healthy BMI (20–24.9 kg/m²), 6/13 were overweight (25–29.9 kg/m²), 4/13 were obese (≥30 kg/m²), and 1 was excluded from measuring BMI due to pregnancy. Despite being well nourished according to BMI, 75% of patients whose HGS was measured had a reading below normal for age (9/12 patients; 1 was unable to use the dynamometer). Of those with a BMI ≥25 kg/m², 3 had a MAMC below 5th percentile. Weight loss was reported in 3/13 patients and 3/13 had low fat stores. A small proportion of patients reported symptoms impacting on nutrition.

Conclusion: Reduced muscle function was observed in the majority of patients with a new bronchial NET diagnosis regardless of BMI and other parameters. Though a small sample size, this study demonstrated the importance of using functional measures to assess nutrition rather than relying on standard measures which risk missing signs of sarcopenia. It also highlighted the importance of a multidisciplinary approach to NET treatments involving structured diet and exercise advice.