Cancer-related fatigue and biochemical parameters among cancer patients with different stages of sarcopenia

  • Bangyan Wang
  • Sudip Thapa
  • Ting Zhou
  • Huiquan Liu
  • Lu Li
  • Guang Peng
  • Shiying YuEmail author
Original Article



Cancer-related fatigue (CRF) is a pervasive symptom experienced by cancer patients. Sarcopenia has been suggested as a treatment target of CRF. This study aims to assess the differences of CRF and biochemical markers among different stages of sarcopenia which remain poorly delineated.


A total of 187 patients were included in this cross-sectional study. Based on muscle mass (skeletal muscle index, SMI), muscle strength (handgrip strength), and physical performance (SARC-F score), patients were divided into four groups (non-sarcopenia, pre-sarcopenia, sarcopenia, and severe sarcopenia). Cancer-related fatigue was measured by the Brief Fatigue Inventory (BFI). Biochemical markers were measured by routine blood tests.


The BFI score was significantly associated with sarcopenia stage (r=0.500; P<0.001). Cancer patients in severe sarcopenia group suffered from worse CRF than those in non-sarcopenia, pre-sarcopenia, and sarcopenia groups (P<0.001). In the multivariate linear regression model (R2=0.542), CRF was significantly correlated with SARC-F score (standardized B=0.519; P<0.001) and high-sensitivity C-reactive protein (standardized B=0.389; P=0.004). Serum albumin and cholinesterase were statistically correlated with both sarcopenia stage and CRF.


The significantly increased occurrence and severity of CRF in cancer patients with sarcopenia suggest that sarcopenia may be a crucial target to improve the management of CRF. Circulating albumin and cholinesterase have the potential to predicting sarcopenia as biomarkers.


Cancer Sarcopenia Muscle Fatigue Albumin Cholinesterase 



This study was supported by the National Natural Science Foundation of China (grant number. 81572961).

Compliance with ethical standards

Demographic and clinical data were obtained from the patients’ medical records. Each patient filled in a questionnaire which consists of SARC-F scale and Brief Fatigue Inventory (BFI). The Eastern Cooperative Oncology Group (ECOG) performance status (PS) of patient was assessed by a clinician. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Cancer Center of Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  2. 2.Department of Clinical Cancer PreventionThe University of Texas MD Anderson Cancer CenterHoustonUSA

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