Perioperative Glutamine Supplementation and Cachexia

Study Overview
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Brief Summary
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Background Sarcopenia is characterized by the degenerative loss of skeletal muscle and is associated with increased adverse surgical outcomes. Glutamine is considered as an immune-modulating formula, which may stimulate protein synthesis in the skeletal muscle but also inhibited protein-degradation. In this study, the investigators calculate the area and volume psoas major muscle (PMMA; PMMV) of the third lumbar vertebral body as the reference of skeletal muscle. The aim of this study is to investigate whether perioperative glutamine supplementation restores atrophy of psoas muscle.

Detailed Description
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A total of 550 gastric adenocarcinoma (GA) patients undergoing gastrectomy were enrolled for the study. Computed tomography was used to assess the short axis of the psoas muscle, and the change was calculated between preoperative day and three months after gastrectomy. Perioperative glutamine supplementation (PGS) was defined as the subjects with five-day parenteral plus one-month oral use. A linear regression model was performed to predict this association by adjusting clinic-demographics and nutritional calories.

Official Title
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Perioperative Glutamine Supplementation Restores Atrophy of Psoas Muscle in Gastric Adenocarcinoma Patients Undergoing Gastrectomy

Conditions
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Glutamine; Metabolic Disorder, Cachexia

Intervention / Treatment
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* Drug: SYMPT-X Glutamine, Oral Powder for Reconstitution


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: gastric cancer patients undergoing gastrectomy Exclusion Criteria: hepatic or renal failures

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| With glutamine supplementation<br>perioperative glutamine supplementation (PGS) was defined as the subjects with five-day parenteral plus one-month oral use. | Drug: SYMPT-X Glutamine, Oral Powder for Reconstitution<br>* erioperative glutamine supplementation (PGS) was defined as the subjects with five-day parenteral plus one-month oral use.<br>* Other names: SYMPT-X;|
| Without glutamine supplementation<br>no glutamine use | Drug: SYMPT-X Glutamine, Oral Powder for Reconstitution<br>* erioperative glutamine supplementation (PGS) was defined as the subjects with five-day parenteral plus one-month oral use.<br>* Other names: SYMPT-X;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| area psoas major muscle (PMMA; cm2) | We hypothesized that glutamine might play a role in improving sarcopenia. Both the PMMA and total volume of the psoas major muscle (PMMV) represent the severity of sarcopenia, because CT is routinely performed in surgical GA patients to check for cancer recurrence. The reason of including total volume into analysis is that it is considered a better index to define sarcopenia. [21] The primary and secondary endpoints were the perioperative change of PMMA and PMMV, respectively. | 3 month after surgery | 
| volume of psoas major muscle (PMMV; cm3) | We hypothesized that glutamine might play a role in improving sarcopenia. Both the PMMA and total volume of the psoas major muscle (PMMV) represent the severity of sarcopenia, because CT is routinely performed in surgical GA patients to check for cancer recurrence. The reason of including total volume into analysis is that it is considered a better index to define sarcopenia. [21] The primary and secondary endpoints were the perioperative change of PMMA and PMMV, respectively. | 3 month after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gastric cancer, cachexia, psoas muscle, glutamine