Is hand grip strength a necessary supportive index in the phenotypic criteria of the GLIM-based diagnosis of malnutrition in patients with cancer?

Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE

Original Publication: Berlin : Springer International, c1993-

Hand Strength/*physiology ; Malnutrition/*diagnosis ; Neoplasms/*complications ; Quality of Life/*psychology; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Phenotype ; Prospective Studies

Background: The Global Leadership Initiative on Malnutrition (GLIM) has the potential to gain global acceptance for diagnosing malnutrition. Of which, calf circumference (CC) was proposed as an alternative to evaluate the reduced muscle mass (RMM). The present study aimed to evaluate whether including the hand grip strength (HGS) was helpful for diagnosing malnutrition under the GLIM framework.
Methods: We performed a multicenter, observational cohort study including 3998 patients with cancer at two teaching hospitals. The RMM criterion was separately assessed using the calf circumference (CC), or the CC and HGS combined. Accordingly, two methods of GLIM diagnosis were independently developed to determine the nutritional status of the patients. The diagnostic concordance, baseline characteristics, and outcomes of patients were compared across the malnourished-CC-HGS, malnourished-CC+HGS, and well-nourished groups. The Patient-Generated Subjective Global Assessment (PG-SGA) was used as a comparator to identify the optimal method.
Results: Malnutrition was identified in 1120 (28%) patients by the CC method and 1060 (26.5%) patients by the CC+HGS method. Compared to the well-nourished group, the malnourished-CC+HGS group (60 patients, 1.5%) had poorer nutritional characteristics, poorer Karnofsky Performance Status scores, poorer global quality of life scores, and higher Nutritional Risk Screening 2002 scores. The severity of malnutrition diagnosed using the CC method (Kappa = 0.136) showed higher agreement with the PG-SGA than the CC+HGS method (Kappa = 0.127).
Conclusion: Compared to CC+HGS, the CC alone appears to be adequate to evaluate RMM under the GLIM framework. A simpler method might facilitate the application of these criteria in clinical settings by increasing efficacy and minimizing missed diagnoses.

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81673167 National Natural Science Foundation of China; cstc2018jscx-msybX0094 Chongqing Technology Innovation and Application Demonstration Project for Social Livelihood; 2017YFC1309200 National Key Research and Development Program

Keywords: Calf circumference; Global Leadership Initiative on Malnutrition; Hand grip strength; Patient-Generated Subjective Global Assessment; Quality of life

Date Created: 20210105 Date Completed: 20210611 Latest Revision: 20210611

20221213

10.1007/s00520-020-05975-z

33398429