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肌肉量和营养评估工具在评估局部晚期鼻咽癌患者营养状况中的作用

Role of Muscle Mass and Nutritional Assessment Tools in Evaluating the Nutritional Status of Patients With Locally Advanced Nasopharyngeal Carcinoma.

作者信息

Pan Xi, Liu Hong, Feng Guo, Xiao Jie, Wang Meng, Liu Hua, Xie Xueyi, Rong Zhipeng, Wu Jinru, Liu Min

机构信息

Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China.

Department of Nutrition, The Third Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Nutr. 2021 Mar 8;8:567085. doi: 10.3389/fnut.2021.567085. eCollection 2021.

Abstract

This study was to explore the role and necessity of muscle mass [fat-free mass index (FFMI) and appendicular skeletal muscle index (ASMI) measured by bioelectrical impedance analysis (BIA)] in nutritional status evaluation of patients with locally advanced (III, IVa) nasopharyngeal carcinoma (NPC). One hundred and thirty locally advanced NPC patients were recruited. Their nutritional status was assessed by albumin (ALB), body mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), Patient generated-Subjective Global Assessment (PG-SGA), and muscle mass. Consistency test and McNemar test were used to evaluate the consistency of muscle mass with ALB, BMI, NRS 2002, and PG-SGA, and correlation analysis was performed on muscle mass and PG-SGA or BMI. 61/130 (46.9%) of the patients had nutritional risks according to NRS 2002, 68/130 (53.1%) of the patients had malnutrition according to PG-SGA assessment. FFMI and ASMI could determine the loss of muscle mass that cannot be detected by albumin (30.2 and 65.6%), BMI (28.0 and 35.3%), NRS 2002 (26.1 and 25.0%), and PG-SGA (18.6 and 55.6%). McNemar test showed that the malnutrition results assessed by FFMI and BMI were inconsistent ( <0.001), but further Pearson correlation analysis showed that BMI was positively correlated with FFMI ( = 0.300, = 0.001). The commonly used nutritional assessment scale/parameters cannot identify the muscle mass loss in patients with locally advanced NPC. Analysis of human body composition is important for nutritional assessment in patients with locally advanced NPC.

摘要

本研究旨在探讨肌肉量[通过生物电阻抗分析(BIA)测量的去脂体重指数(FFMI)和四肢骨骼肌指数(ASMI)]在局部晚期(III、IVa期)鼻咽癌(NPC)患者营养状况评估中的作用及必要性。招募了130例局部晚期NPC患者。通过白蛋白(ALB)、体重指数(BMI)、营养风险筛查2002(NRS 2002)、患者主观整体评估(PG-SGA)和肌肉量评估他们的营养状况。采用一致性检验和McNemar检验评估肌肉量与ALB、BMI、NRS 2002和PG-SGA的一致性,并对肌肉量与PG-SGA或BMI进行相关性分析。根据NRS 2002,61/130(46.9%)的患者存在营养风险,根据PG-SGA评估,68/130(53.1%)的患者存在营养不良。FFMI和ASMI能够确定白蛋白(分别为30.2%和65.6%)、BMI(分别为28.0%和35.3%)、NRS 2002(分别为26.1%和25.0%)以及PG-SGA(分别为18.6%和55.6%)无法检测到的肌肉量损失。McNemar检验显示,FFMI和BMI评估的营养不良结果不一致(<0.001),但进一步的Pearson相关性分析显示BMI与FFMI呈正相关(=0.300,=0.001)。常用的营养评估量表/参数无法识别局部晚期NPC患者的肌肉量损失。人体成分分析对于局部晚期NPC患者的营养评估具有重要意义。

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