Al-Bayyari Nahla, Hailat Marah, Baylin Ana
Department of Nutrition and Food Processing, Faculty of Al-Huson University College, Al-Balqa Applied University, Al-Salt 19117, Jordan.
Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan.
Nutrients. 2024 Nov 22;16(23):4000. doi: 10.3390/nu16234000.
This study aimed to assess malnutrition and muscle mass depletion risk in gastrointestinal cancer patients, exploring the differences between gastric and colorectal cancer, with a focus on gender0specific variations and dietary intake. It also examined whether muscle depletion mediates the relationship between dietary intake and malnutrition risk.
A sample of 100 Jordanian pre-operative gastrointestinal cancer patients (60 male, 40 female) with gastric or colorectal cancer were assessed for malnutrition risk using the malnutrition universal screening tool (MUST) and for muscle depletion using fat-free mass index (FFMI) and mid-upper arm muscle area (MUAMA).
The study found that 80% (95% CI: 0.708-0.873) of patients were at high risk of malnutrition, with over 60% experiencing severe muscle loss. Gastric cancer patients showed higher, though not statistically significant, malnutrition risk (90.2% vs. 72.9%) and muscle depletion compared to colorectal cancer patients. Advanced cancer stages were associated with significantly higher risk of malnutrition and muscle depletion. Significant gender-specific differences in muscle depletion via FFMI ( = 0.012) and via MUAMA ( = 0.028) were also noted, especially in females with gastric cancer. Additionally, males exhibited a significantly higher malnutrition risk ( < 0.001) based on cancer stage. Patients' dietary intake was significantly ( < 0.001) below the recommended levels for energy, protein, carbohydrates, fiber, and essential fatty acids, which was associated with higher malnutrition risk, muscle depletion, low BMI (<18.5 kg/m), and significant weight loss (>10%). Low dietary intake was strongly linked to increased malnutrition risk and muscle depletion, with muscle loss partially mediating (b = 0.4972, < 0.0001) the relationship between poor dietary intake and malnutrition risk. Additionally, higher muscle mass was protective against malnutrition (OR = 16.0, 95% CI: 1.706-150.507), and cancer type was a significant predictor of malnutrition risk (OR = 14.4, 95% CI: 1.583-130.867).
Malnutrition risk and significant muscle loss are common in GI cancer patients, highlighting the urgent need for tailored nutrition care plans and lifestyle modifications.
本研究旨在评估胃肠道癌症患者的营养不良和肌肉量消耗风险，探究胃癌和结直肠癌之间的差异，重点关注性别特异性差异和饮食摄入情况。同时，研究还考察了肌肉消耗是否介导饮食摄入与营养不良风险之间的关系。
采用营养不良通用筛查工具（MUST）对100例约旦术前胃肠道癌症患者（60例男性，40例女性）进行营养不良风险评估，使用去脂体重指数（FFMI）和上臂中部肌肉面积（MUAMA）评估肌肉消耗情况。
研究发现，80%（95%置信区间：0.708 - 0.873）的患者存在高营养不良风险，超过60%的患者出现严重肌肉流失。与结直肠癌患者相比，胃癌患者的营养不良风险（90.2%对72.9%）和肌肉消耗更高，尽管差异无统计学意义。癌症晚期与更高的营养不良和肌肉消耗风险显著相关。通过FFMI（P = 0.012）和MUAMA（P = 0.028）评估的肌肉消耗存在显著的性别特异性差异，尤其是在患有胃癌的女性中。此外，基于癌症分期，男性的营养不良风险显著更高（P < 0.001）。患者的饮食摄入量显著低于能量、蛋白质、碳水化合物、纤维和必需脂肪酸的推荐水平（P < 0.001），这与更高的营养不良风险、肌肉消耗、低体重指数（<18.5 kg/m²）和显著体重减轻（>10%）相关。低饮食摄入量与营养不良风险增加和肌肉消耗密切相关，肌肉流失部分介导了（b = 0.4972，P < 0.0001）不良饮食摄入与营养不良风险之间的关系。此外，更高的肌肉量对营养不良具有保护作用（OR = 16.0，95%置信区间：1.706 - 150.507），癌症类型是营养不良风险的重要预测因素（OR = 14.4，95%置信区间：1.583 - 130.867）。
营养不良风险和显著的肌肉流失在胃肠道癌症患者中很常见，凸显了制定个性化营养护理计划和改变生活方式的迫切需求。
