Different muscle mass indices of the Global Leadership Initiative on Malnutrition in diagnosing malnutrition and predicting survival of patients with gastric cancer.

Qinqin Li, Xi Zhang, Meng Tang, Mengmeng Song, Qi Zhang, Kangping Zhang, Guotian Ruan, Xiaowei Zhang, Yizhong Ge, Ming Yang, Yuying Liu, Hongxia Xu, Chunhua Song, Zhengping Wang, Hanping Shi

Journal: Nutrition (Burbank, Los Angeles County, Calif.) 2021;89():111286

PMID: 34090215

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVE

Malnutrition is common and related to negative prognosis in patients with gastric cancer (GC). The Global Leadership Initiative on Malnutrition (GLIM), a novel consensus for the diagnosis of malnutrition, was proposed recently. However, the roles of GLIM in diagnosing malnutrition and predicting overall survival (OS) in patients with GC have been unclear.

METHOD

We conducted a multicenter, observational cohort study including 877 hospitalized patients with GC 2013 through 2018. Different anthropometric measurements were compared to assess reduced muscle mass. Kaplan-Meier curves and multivariate Cox regression were used to analyze the relationship between GLIM-defined malnutrition and the OS of patients with GC. Independent prognostic variables were incorporated to develop a nomogram for individualized survival prediction. The calibration curve was used to determine the predictive accuracy and discriminatory capacity of the nomogram. In addition, 219 patients with GC were enrolled for external validation.

RESULTS

A total of 464 (53%) patients with GC were diagnosed with malnutrition. Patients diagnosed with severe malnutrition based on either midarm circumference or body weight-standardized hand grip strength had a shorter median survival time (16.7 mo; interquartile range, 8.4-32.7 mo) and a higher hazard ratio (HR, 1.49; 95% CI, 1.15-1.92; P = 0.002). Severe malnutrition was an independent risk factor for OS (HR, 1.32; 95% CI, 1.02-1.71; P = 0.038). The GLIM nomogram showed good performance in predicting 3-y survival in patients with GC.

CONCLUSIONS

Our findings support the effectiveness of GLIM in diagnosing malnutrition and predicting OS in patients with GC.

Address: Institute of Biopharmaceutical, Liaocheng University, Liaocheng, China; Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Department of Oncology, Capital Medical University, Beijing, China; Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.; Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Department of Oncology, Capital Medical University, Beijing, China; Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.; Institute of Biopharmaceutical, Liaocheng University, Liaocheng, China.; Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, China.; Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.; Institute of Biopharmaceutical, Liaocheng University, Liaocheng, China; Liaocheng High-tech Biotechnology Co., Ltd., Liaocheng, China.; Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Department of Oncology, Capital Medical University, Beijing, China; Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China. Electronic address: [email protected].

DOI: 10.1016/j.nut.2021.111286

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MeSH Terms: Hand Strength, Humans, Leadership, Malnutrition, Muscles, Nutrition Assessment, Stomach Neoplasms