Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia
Issued Date
2023-01-01
Resource Type
ISSN
21905991
eISSN
21906009
Scopus ID
2-s2.0-85169831575
Pubmed ID
37667992
Journal Title
Journal of Cachexia, Sarcopenia and Muscle
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Cachexia, Sarcopenia and Muscle (2023)
Suggested Citation
Arai H., Maeda K., Wakabayashi H., Naito T., Konishi M., Assantachai P., Auyeung W.T., Chalermsri C., Chen W., Chew J., Chou M.Y., Hsu C.C., Hum A., Hwang I.G., Kaido T., Kang L., Kamaruzzaman S.B., Kim M., Lee J.S.W., Lee W.J., Liang C.K., Lim W.S., Lim J.Y., Lim Y.P., Lo R.S.K., Ong T., Pan W.H., Peng L.N., Pramyothin P., Razalli N.H., Saitoh M., Shahar S., Shi H.P., Tung H.H., Uezono Y., von Haehling S., Won C.W., Woo J., Chen L.K. Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia. Journal of Cachexia, Sarcopenia and Muscle (2023). doi:10.1002/jcsm.13323 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90005
Title
Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia
Author(s)
Arai H.
Maeda K.
Wakabayashi H.
Naito T.
Konishi M.
Assantachai P.
Auyeung W.T.
Chalermsri C.
Chen W.
Chew J.
Chou M.Y.
Hsu C.C.
Hum A.
Hwang I.G.
Kaido T.
Kang L.
Kamaruzzaman S.B.
Kim M.
Lee J.S.W.
Lee W.J.
Liang C.K.
Lim W.S.
Lim J.Y.
Lim Y.P.
Lo R.S.K.
Ong T.
Pan W.H.
Peng L.N.
Pramyothin P.
Razalli N.H.
Saitoh M.
Shahar S.
Shi H.P.
Tung H.H.
Uezono Y.
von Haehling S.
Won C.W.
Woo J.
Chen L.K.
Maeda K.
Wakabayashi H.
Naito T.
Konishi M.
Assantachai P.
Auyeung W.T.
Chalermsri C.
Chen W.
Chew J.
Chou M.Y.
Hsu C.C.
Hum A.
Hwang I.G.
Kaido T.
Kang L.
Kamaruzzaman S.B.
Kim M.
Lee J.S.W.
Lee W.J.
Liang C.K.
Lim W.S.
Lim J.Y.
Lim Y.P.
Lo R.S.K.
Ong T.
Pan W.H.
Peng L.N.
Pramyothin P.
Razalli N.H.
Saitoh M.
Shahar S.
Shi H.P.
Tung H.H.
Uezono Y.
von Haehling S.
Won C.W.
Woo J.
Chen L.K.
Author's Affiliation
Chung-Ang University Hospital
Siriraj Hospital
National Yang Ming Chiao Tung University
Aichi Medical University Hospital
Lee Kong Chian School of Medicine
Deutsches Zentrum für Herz-Kreislauf-Forschung e. V.
Seoul National University Bundang Hospital
Beijing Shijitan Hospital
Juntendo University
The Jikei University School of Medicine
Tokyo Women's Medical University Hospital
St. Luke's International Hospital Tokyo
Universiti Malaya
KyungHee University College of Medicine
Academia Sinica, Institute of Biomedical Sciences
National Center for Geriatrics and Gerontology
Prince of Wales Hospital Hong Kong
Shizuoka Cancer Center
Veterans General Hospital-Kaohsiung Taiwan
Universitätsmedizin Göttingen
Veterans General Hospital-Taipei
School of Medicine
Peking Union Medical College Hospital
Uppsala Universitet
Chinese University of Hong Kong
Tan Tock Seng Hospital
Universiti Kebangsaan Malaysia
National Center for Geriatrics and Welfare Research
Siriraj Hospital
National Yang Ming Chiao Tung University
Aichi Medical University Hospital
Lee Kong Chian School of Medicine
Deutsches Zentrum für Herz-Kreislauf-Forschung e. V.
Seoul National University Bundang Hospital
Beijing Shijitan Hospital
Juntendo University
The Jikei University School of Medicine
Tokyo Women's Medical University Hospital
St. Luke's International Hospital Tokyo
Universiti Malaya
KyungHee University College of Medicine
Academia Sinica, Institute of Biomedical Sciences
National Center for Geriatrics and Gerontology
Prince of Wales Hospital Hong Kong
Shizuoka Cancer Center
Veterans General Hospital-Kaohsiung Taiwan
Universitätsmedizin Göttingen
Veterans General Hospital-Taipei
School of Medicine
Peking Union Medical College Hospital
Uppsala Universitet
Chinese University of Hong Kong
Tan Tock Seng Hospital
Universiti Kebangsaan Malaysia
National Center for Geriatrics and Welfare Research
Other Contributor(s)
Abstract
Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three-round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (<28 kg in men and <18 kg in women), or elevated C-reactive protein levels (>5 mg/L [0.5 mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3–6 month period and suggested a tentative cut-off value of 21 kg/m2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ-5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient-reported outcomes. The AWGC consensus offers a comprehensive definition and user-friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co-morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.