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老年结直肠癌患者营养状况、身体功能与骨骼肌量的相关性。

The associations between nutritional status, physical function and skeletal muscle mass of geriatric patients with colorectal cancer.

机构信息

Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka, 543-0035, Japan.

Department of Rehabilitation Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka, 543-0035, Japan.

出版信息

Clin Nutr ESPEN. 2021 Feb;41:318-324. doi: 10.1016/j.clnesp.2020.11.009. Epub 2020 Dec 25.

Abstract

BACKGROUND & AIMS: Nutritional status is associated with physical function and body composition. However, these relationships in patients with colorectal cancer remain poorly understood. This study aimed to investigate the association between nutritional status, physical function, and skeletal muscle mass in geriatric patients with colorectal cancer.

METHODS

Preoperative patients diagnosed with colorectal cancer were recruited for this cross-sectional observational study. The correlations were calculated using Spearman's rank correlation coefficient, and the intergroup differences in physical function and skeletal muscle mass between categories according to nutritional assessment were analyzed using the Mann-Whitney U test or Kruskal-Wallis test.

RESULTS

We recruited 127 patients (median age 71.0 years). Hand grip strength was correlated with geriatric nutritional risk index (GNRI) (male: p = 0.033; female: p = 0.014), albumin (male: p = 0.014; female: p = 0.003), and controlling nutritional status (CONUT) score (male: p = 0.004; female: p = 0.011) in both gender, and correlated with body mass index (BMI) (p = 0.027) in male patients. Psoas volume index (PVI) was positively correlated with BMI (male: p = 0.005; female: p < 0.001). In addition, intergroup comparisons for categories according to BMI showed PVI was significantly lower in the malnutrition category (male: p = 0.017; female: p < 0.001). Albumin and CONUT score were correlated with five-times sit-to-stand test (male: p = 0.011; female: p = 0.049, male: p = 0.031; female: p = 0.012, respectively) and short physical performance battery (male: p = 0.065; female: p = 0.028, male: p = 0.002; female: p = 0.006, respectively). Moreover, patients in lower albumin category had longer time on 5-times sit-to-stand test (male: p = 0.018; female: p = 0.009) and had lower scores on short physical performance battery (male: p = 0.027; female: p = 0.039).

CONCLUSIONS

Hand grip strength correlated with various nutritional assessment tools, and PVI was correlated with BMI in particular. Five-times sit-to-stand test and short physical performance battery were correlated with serum albumin concentration and CONUT score. Physical function and skeletal muscle mass are associated with nutritional status, and hand grip strength might be more strongly associated with nutritional status.

摘要

背景与目的

营养状况与身体功能和身体成分有关。然而,结直肠癌患者的这些关系仍知之甚少。本研究旨在调查老年结直肠癌患者的营养状况、身体功能和骨骼肌质量之间的关系。

方法

本研究纳入了经诊断患有结直肠癌的术前患者。采用 Spearman 秩相关系数计算相关性,采用 Mann-Whitney U 检验或 Kruskal-Wallis 检验分析根据营养评估分类的身体功能和骨骼肌质量的组间差异。

结果

共纳入 127 例患者(中位年龄 71.0 岁)。男性患者握力与老年营养风险指数(GNRI)(p=0.033)、白蛋白(p=0.014)和控制营养状况(CONUT)评分(p=0.004)相关,女性患者握力与 GNRI(p=0.014)、白蛋白(p=0.003)和 CONUT 评分(p=0.011)相关,且与男性患者的体质指数(BMI)(p=0.027)相关。腰大肌体积指数(PVI)与 BMI 呈正相关(男性:p=0.005;女性:p<0.001)。此外,根据 BMI 进行的分组比较显示,营养不良组的 PVI 明显较低(男性:p=0.017;女性:p<0.001)。白蛋白和 CONUT 评分与 5 次坐立试验(男性:p=0.011;女性:p=0.049,男性:p=0.031;女性:p=0.012)和简短体能测试(男性:p=0.065;女性:p=0.028,男性:p=0.002;女性:p=0.006)相关。此外,白蛋白水平较低的患者 5 次坐立试验时间较长(男性:p=0.018;女性:p=0.009),简短体能测试得分较低(男性:p=0.027;女性:p=0.039)。

结论

握力与各种营养评估工具相关,而 PVI 与 BMI 特别相关。5 次坐立试验和简短体能测试与血清白蛋白浓度和 CONUT 评分相关。身体功能和骨骼肌质量与营养状况相关,握力可能与营养状况更密切相关。

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