股直肌的相位角和超声评估对预测食管癌胃癌患者营养不良和肌肉减少症的作用：一项横断面初步研究
Phase Angle and Ultrasound Assessment of the Rectus Femoris for Predicting Malnutrition and Sarcopenia in Patients with Esophagogastric Cancer: A Cross-Sectional Pilot Study.
作者信息
Vieira Maroun Erika, Argente Pla María, Pedraza Serrano María José, Muresan Bianca Tabita, Ramos Prol Agustín, Gascó Santana Eva, Martín Sanchis Silvia, Durá De Miguel Ángela, Micó García Andrea, Cebrián Vázquez Anna, Durbá Lacruz Alba, Merino-Torres Juan Francisco
机构信息
Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe, 46026 Valencia, Spain.
Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain.
出版信息
Nutrients. 2024 Dec 29;17(1):91. doi: 10.3390/nu17010091.
BACKGROUND
Disease-related malnutrition (DRM) and sarcopenia are prevalent conditions in gastrointestinal cancer patients, whose early diagnosis is essential to establish a nutritional treatment that contributes to optimizing adverse outcomes and improving prognosis. Phase angle (PhA) and rectus femoris ultrasound measurements are considered effort-independent markers of muscle wasting, which remains unrecognized in oncology patients.
OBJECTIVE
This study aimed to evaluate the potential utility of PhA, rectus femoris cross-sectional area (RFCSA), and rectus femoris thickness (RF-Y-axis) in predicting malnutrition and sarcopenia in patients with esophagogastric cancer (EGC).
METHODS
This was a cross-sectional study of patients diagnosed with EGC. PhA was obtained using bioelectrical impedance vector analysis (BIVA) along with ASMMI. The RFCSA and RF-Y-axis were measured using nutritional ultrasound (NU). Muscle capacity was assessed using handgrip strength (HGS), and functionality by applying the Short Physical Performance Battery (SPPB). Malnutrition and sarcopenia were determined according to the GLIM and EWGSOP2 criteria, respectively.
RESULTS
Out of the 35 patients evaluated, 82.8% had malnutrition and 51.4% had sarcopenia. The RFCSA (r = 0.582) and RF-Y-axis (r = 0.602) showed significant, moderate correlations with ASMMI, unlike PhA (r = 0.439), which displayed a weak correlation with this parameter. However, PhA (OR = 0.167, CI 95%: 0.047-0.591, = 0.006), RFCSA (OR = 0.212, CI 95%: 0.074-0.605, = 0.004), and RF-Y-axis (OR = 0.002, CI 95%: 0.000-0.143, = 0.004) all showed good predicting ability for sarcopenia in the crude models, but only the RF-Y-axis was able to explain malnutrition in the regression model (OR = 0.002, CI 95%: 0.000-0.418, = 0.023).
CONCLUSIONS
The RF-Y-axis emerged as the only independent predictor of both malnutrition and sarcopenia in this study, likely due to its stronger correlation with ASMMI compared to PhA and RFCSA.
背景
疾病相关营养不良（DRM）和肌肉减少症在胃肠道癌患者中普遍存在，其早期诊断对于制定有助于优化不良结局和改善预后的营养治疗至关重要。相位角（PhA）和股直肌超声测量被认为是与肌肉消耗无关的肌肉减少标志物，而这在肿瘤患者中尚未得到认识。
目的
本研究旨在评估PhA、股直肌横截面积（RFCSA）和股直肌厚度（RF-Y轴）在预测食管胃癌（EGC）患者营养不良和肌肉减少症方面的潜在效用。
方法
这是一项对诊断为EGC的患者进行的横断面研究。使用生物电阻抗矢量分析（BIVA）并结合ASMMI获得PhA。使用营养超声（NU）测量RFCSA和RF-Y轴。使用握力（HGS）评估肌肉力量，并通过应用简短身体功能测试（SPPB）评估功能。分别根据GLIM和EWGSOP2标准确定营养不良和肌肉减少症。
结果
在评估的35例患者中，82.8%存在营养不良，51.4%存在肌肉减少症。RFCSA（r = 0.582）和RF-Y轴（r = 0.602）与ASMMI显示出显著的中度相关性，而PhA（r = 0.439）与该参数显示出较弱的相关性。然而，PhA（OR = 0.167，95%CI：0.047 - 0.591，P = 0.006）、RFCSA（OR = 0.212，95%CI：0.074 - 0.605，P = 0.004）和RF-Y轴（OR = 0.002，95%CI：0.000 - 0.143，P = 0.004）在粗模型中均显示出对肌肉减少症的良好预测能力，但在回归模型中只有RF-Y轴能够解释营养不良（OR = 0.002，95%CI：0.000 - 0.418，P = 0.023）。
结论
在本研究中，RF-Y轴成为营养不良和肌肉减少症的唯一独立预测指标，可能是因为与PhA和RFCSA相比，它与ASMMI的相关性更强。
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