Huo Zhenyu, Chong Feifei, Luo Siyu, Li Na, Tong Ning, Lu Zongliang, Guo Jing, Zhang Ling, Lin Xin, Zhang Mengyuan, Zhang Hongmei, Shi Muli, He Xiumei, Liu Jie, Song Chunhua, Shi Hanping, Xu Hongxia
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China; Chongqing Municipal Health Commission Key Laboratory of Intelligent Clinical Nutrition and Transformation, Chongqing, 400042, China.
Department of Clinical Nutrition, the Thirteenth People's Hospital of Chongqing, 400053, China.
J Nutr Health Aging. 2025 Jan;29(1):100409. doi: 10.1016/j.jnha.2024.100409. Epub 2024 Nov 11.
To identify whether the Grip-Strength-Lean-Mass Index (GSLMI) can precisely diagnose sarcopenia and predict prognosis for cancer patients in clinical settings.
A nationwide multicenter cohort study.
8,831 inpatients aged 18 years and older, histologically diagnosed with cancer and receiving anti-cancer therapy.
The GSLMI is the ratio of hand grip strength (HGS) divided by lean mass (LM), calculated by the formula: GSLMI = HGS (kg) / LM (kg). Kaplan-Meier curves and Cox models were used to estimate the association between the GSLMI and survival.
A total of 3,071 (48.40%) male and 3,274 (51.60%) female patients were enrolled in the study. The prevalence of GLIS-defined sarcopenia was 2,646 (41.70%). The optimal sex-specific thresholds with the best diagnostic performance to identify a low GSLMI were determined to be <0.61 for males and <0.47 for females based on the ROC curves. According to Kaplan-Meier curves, patients with a high GSLMI exhibited better overall survival than those with a low GSLMI (HR = 0.664, 95%CI = 0.604-0.729, log-rank P < 0.001). Multivariable survival analysis revealed that the GSLMI showed an independent association with a lower hazard of death as a continuous variable (HR = 0.70, 95% CI = 0.51-0.96).
The GSLMI may serve as a novel diagnostic tool for identifying sarcopenia and may have prognostic value for cancer patients. Using the GSLMI represents a feasible and promising option for better managing the health of patients with cancer.
确定握力-瘦体重指数（GSLMI）能否在临床环境中准确诊断癌症患者的肌肉减少症并预测其预后。
一项全国性多中心队列研究。
8831名18岁及以上的住院患者，经组织学诊断患有癌症并接受抗癌治疗。
GSLMI是握力（HGS）除以瘦体重（LM）的比值，通过公式计算：GSLMI = HGS（千克）/ LM（千克）。采用Kaplan-Meier曲线和Cox模型来估计GSLMI与生存率之间的关联。
本研究共纳入3071名（48.40%）男性和3274名（51.60%）女性患者。GLIS定义的肌肉减少症患病率为2646例（41.70%）。根据ROC曲线，确定用于识别低GSLMI的最佳性别特异性阈值，男性为<0.61，女性为<0.47。根据Kaplan-Meier曲线，GSLMI高的患者总体生存率优于GSLMI低的患者（HR = 0.664，95%CI = 0.604 - 0.729，对数秩检验P < 0.001）。多变量生存分析显示，GSLMI作为连续变量与较低的死亡风险呈独立关联（HR = 0.70，95%CI = 0.51 - 0.96）。
GSLMI可能是一种用于识别肌肉减少症的新型诊断工具，对癌症患者可能具有预后价值。使用GSLMI是更好管理癌症患者健康的一种可行且有前景的选择。
