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Nutrition in acute and chronic diseases

Absence of risk of sarcopenia protects cancer patients from fatigue



Cancer and its treatments often lead to sarcopenia and fatigue. However, whether these factors are associated remains unproven.


To evaluate whether the risk of sarcopenia predicts the presence of fatigue.


A cross-sectional study was completed and included 198 cancer patients of both sexes, undergoing in- and outpatient treatment. The Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) and the Functional Assessment of Cancer Therapy Fatigue (FACT-F) were used to assess the risk of sarcopenia and the presence of fatigue, respectively. The cut-off values used to identify the risk of sarcopenia and the severity of fatigue scale were SARC-F ≥ 4 and Fatigue <34, respectively. Logistic regression analysis was performed to evaluate the association between SARC-F and the FACT-F.


Out of 198 patients, 35% were at risk of sarcopenia and of these 87% had fatigue. Patients at risk of sarcopenia had lower scores in the FACT-F subscales, lower handgrip strength, lower performance status, were mostly hospitalized and were sedentary. Logistic regression analysis revealed that patients with SARC-F < 4 had a lower risk of fatigue in both models, crude (OR: 0.83; CI 95% [0.79–0.88], p < 0.0001) as well as adjusted for age, gender, BMI, physical activity, current use of alcoholic beverages, smoking, performance status, cancer type, clinical setting and use of supplements (OR: 0.87; CI 95% [0.81–0.92], p < 0.0001).


In patients with cancer, 35% presented risk of sarcopenia and of these 87% had fatigue. In addition, the absence of sarcopenia was considered protective against fatigue.

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TCB, JDP, JSM, and TLNG would like to thank the Capes, Brazil. GDP would like to The Brazilian National Council for Scientific and Technological Development (CNPq, Brazil, 312252/2019–6).

Author information




CSB, TCB, and GDP contributed to study design. CSB, TCB, NPV, TLNG, JDPS, JMS collected the data. CSB, TCB, and GDP performed the statistical analyses. CSB, TCB, and GDP drafted the manuscript. CP, AL, and GDP contributed of critical discussion of data and revised the paper. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Gustavo D. Pimentel.

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Barreto, C.S., Borges, T.C., Valentino, N.P. et al. Absence of risk of sarcopenia protects cancer patients from fatigue. Eur J Clin Nutr (2021).

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