Hospital das Clínicas, Ribeirão Preto Medical School, Department of Health Sciences, Division of Nutrition and Metabolism, University of São Paulo, Ribeirão Preto, Brazil.
Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
Nutr Cancer. 2024;76(10):963-973. doi: 10.1080/01635581.2024.2378504. Epub 2024 Jul 16.
Despite those with hepatocellular carcinoma (HCC) being at increased risk of malnutrition, there is a notable absence of practical approaches for nutritional assessment in clinical practice. We investigated the usefulness of phase angle (PhA) and Total Psoas Area Index (TPAI) for indicating nutritional risk and HCC prognosis. Weight, height, body mass index (BMI), adductor pollicis muscle thickness (APMT), and handgrip strength (HGS) were assessed. The Nutritional Risk Index (NRI) was calculated. Body composition was assessed using bioimpedance spectroscopy and magnetic resonance imaging. The Child-Turcotte-Pugh (CTP) score and Barcelona-Clinic Liver Cancer (BCLC) classification determined the prognosis. Fifty-one males with HCC were enrolled (CTP = 11.8%). PhA showed a moderate positive correlation with APMT ( = 0.450; < 0.001) and HGS ( = 0.418; = 0.002) and a weak positive correlation with TPAI ( = 0.332; = 0.021). PhA had a strong positive correlation with NRI ( = 0.614; < 0.001). Mean PhA values were significantly different according to disease severity (CTP C = 0.001, and BCLC D = 0.053). TPAI had no significant correlation with HGS, CTP, or BCLC. PhA was a superior approach for predicting nutritional risk and prognosis in HCC than TPAI. Lower PhA is associated with disease progression, lower muscle mass and function, greater severity of nutritional risk, and increased mortality in HCC.
尽管肝细胞癌 (HCC) 患者存在营养不良的高风险，但在临床实践中，缺乏实用的营养评估方法。我们研究了相位角 (PhA) 和总腰大肌面积指数 (TPAI) 对指示营养风险和 HCC 预后的有用性。评估了体重、身高、体重指数 (BMI)、内收肌拇指厚度 (APMT) 和手握力 (HGS)。计算了营养风险指数 (NRI)。使用生物电阻抗光谱法和磁共振成像评估身体成分。Child-Turcotte-Pugh (CTP) 评分和 Barcelona-Clinic Liver Cancer (BCLC) 分类确定了预后。共纳入 51 名男性 HCC 患者 (CTP = 11.8%)。PhA 与 APMT ( = 0.450; < 0.001) 和 HGS ( = 0.418; = 0.002) 呈中度正相关，与 TPAI ( = 0.332; = 0.021) 呈弱正相关。PhA 与 NRI 呈强正相关 ( = 0.614; < 0.001)。根据疾病严重程度，PhA 的平均值差异有统计学意义 (CTP C = 0.001，BCLC D = 0.053)。TPAI 与 HGS、CTP 或 BCLC 无显著相关性。与 TPAI 相比，PhA 是预测 HCC 营养风险和预后的更好方法。较低的 PhA 与疾病进展、肌肉量和功能降低、营养风险严重程度增加以及 HCC 死亡率增加相关。
