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新型肌肉质量指数在癌症住院成人患者中的预后意义:一项二次分析

Prognostic significance of novel muscle quality index utilization in hospitalized adults with cancer: A secondary analysis.

作者信息

da Costa Pereira Jarson P, Prado Carla M, Gonzalez M Cristina, Cabral Poliana C, de Oliveira Guedes Francisco F, da Silva Diniz Alcides, Fayh Ana P T

机构信息

Department of Nutrition, Postgraduate Program in Nutrition, Federal University of Pernambuco, Recife, Brazil.

Department of Agricultural, Food and Nutritional Science, Human Nutrition Research Unit, University of Alberta, Edmonton, Alberta, Canada.

出版信息

JPEN J Parenter Enteral Nutr. 2025 Jan;49(1):112-121. doi: 10.1002/jpen.2701. Epub 2024 Nov 6.

Abstract

BACKGROUND

This study aimed to investigate and propose novel approaches to calculate muscle quality index (MQI) using muscle mass derived from single-frequency bioelectrical impedance analysis (SF-BIA) and calf circumference in both unadjusted and body mass index (BMI)-adjusted forms. In addition, we examined their prognostic significance in patients with cancer.

METHODS

A secondary analysis was conducted on a prospective cohort study of patients with cancer. Handgrip strength was measured. SF-BIA was conducted to estimate appendicular lean soft tissue (ALST, in kilograms). MQI was calculated using three approaches: (1) the ratio of handgrip strength to ALST (MQI), (2) the ratio of handgrip strength to calf circumference (MQI), and (3) the ratio of handgrip strength to BMI-adjusted calf circumference (MQI). Maximally selected log-rank was calculated to estimate their cutoff values to predict survival.

RESULTS

Two hundred eighty-four patients were included (51.1% men; median age, 61 years). Solid tumors were the most frequent (89.8%). All approaches to MQI (MQI, MQI, and MQI) were independent predictors of 6-month mortality. The found cutoffs were (1) MQI (<1.52 for men, <0.63 for women), (2) MQI (<0.74 for men, <0.24 for women), and (3) MQI (<0.75 for men, <0.25 for women).

CONCLUSION

This study introduces MQI MQI, and MQI as future potential surrogate methods for computing MQI in clinical practice when other robust procedures are unavailable, pending further validation.

摘要

背景

本研究旨在探究并提出新方法,使用单频生物电阻抗分析(SF-BIA)得出的肌肉质量和小腿围度,以未调整和体重指数(BMI)调整的形式计算肌肉质量指数(MQI)。此外,我们还研究了它们在癌症患者中的预后意义。

方法

对一项癌症患者前瞻性队列研究进行二次分析。测量握力。进行SF-BIA以估计四肢瘦软组织(ALST,单位为千克)。使用三种方法计算MQI:(1)握力与ALST的比值(MQI),(2)握力与小腿围度的比值(MQI),以及(3)握力与BMI调整后的小腿围度的比值(MQI)。计算最大选择对数秩以估计其预测生存的临界值。

结果

纳入284例患者(51.1%为男性;中位年龄61岁)。实体瘤最为常见(89.8%)。所有MQI计算方法(MQI、MQI和MQI)都是6个月死亡率的独立预测因素。得出的临界值为:(1)MQI(男性<1.52,女性<0.63),(2)MQI(男性<0.74,女性<0.24),以及(3)MQI(男性<0.75,女性<0.25)。

结论

本研究引入了MQI、MQI和MQI,作为在其他可靠方法不可用时,临床实践中计算MQI的未来潜在替代方法,有待进一步验证。

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