Department of General Practice, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Nutrition. 2021 Apr;84:111044. doi: 10.1016/j.nut.2020.111044. Epub 2020 Oct 30.
The aim of this study was to determine the feasibility of substituting handgrip strength (HGS) for muscle mass as a constituent in the Global Leadership Initiative on Malnutrition (GLIM) to diagnose malnourished patients with gastrointestinal (GI) cancer.
The study included 2209 patients diagnosed with GI cancer from two centers. All patients were evaluated for nutritional risk using Nutritional Risk Screening 2002 within 24 h of admission. The GLIM consensus was then used to diagnose malnourished patients. The evaluation of muscle mass as one of the constituents contained in the GLIM consensus was measured by computed tomography presented as skeletal muscle mass index (SMI) and HGS, respectively. Consistency test was carried out to evaluate the diagnostic value of SMI and HGS.
There were 1042 (47.2%) cases of gastric cancer and 1167 (52.8%) cases of colorectal cancer. Among these cases were 768 patients (34.8%) at nutritional risk. Furthermore, 603 (27.3%) and 593 patients (26.8%) were diagnosed with malnutrition in the GLIM (SMI) group and the GLIM (HGS) group, respectively, and 544 (24.6%) patients in the two groups overlapped. The consistency test results showed that the κ value in the GLIM (HGS) group compared with the GLIM (SMI) group was 0.881 (P < 0.001) in patients with gastric cancer and 0.872 (P < 0.001) in those with colorectal cancer.
HGS can be a substitute for muscle mass as a constituent in the diagnostic criteria of GLIM in patients with GI cancer.
本研究旨在确定用握力（HGS）替代肌肉质量作为全球营养不良倡议（GLIM）诊断胃肠道（GI）癌症营养不良患者组成部分的可行性。
该研究纳入了来自两个中心的 2209 例 GI 癌症患者。所有患者在入院后 24 小时内均接受了营养风险筛查 2002 评估。然后使用 GLIM 共识来诊断营养不良患者。GLIM 共识中包含的一个组成部分的肌肉质量评估分别通过计算机断层扫描（CT）呈骨骼肌质量指数（SMI）和 HGS 进行。一致性检验用于评估 SMI 和 HGS 的诊断价值。
1042 例（47.2%）为胃癌，1167 例（52.8%）为结直肠癌。其中 768 例（34.8%）患者存在营养风险。此外，GLIM（SMI）组和 GLIM（HGS）组分别有 603 例（27.3%）和 593 例（26.8%）患者被诊断为营养不良，两组中有 544 例（24.6%）患者重叠。一致性检验结果显示，胃癌患者 GLIM（HGS）组与 GLIM（SMI）组的κ 值为 0.881（P<0.001），结直肠癌患者的κ 值为 0.872（P<0.001）。
HGS 可以替代肌肉质量作为 GI 癌症患者 GLIM 诊断标准的组成部分。
