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Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer

Published online by Cambridge University Press:  05 July 2021

Liangyu Yin Open the ORCID record for Liangyu Yin[Opens in a new window] ,
Yang Fan ,
Xin Lin ,
Ling Zhang ,
Na Li ,
Jie Liu ,
Jing Guo ,
Mengyuan Zhang ,
Xiumei He  and
Lijuan Liu
...Show all authors
Liangyu Yin
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing400038, People’s Republic of China
Yang Fan
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Xin Lin
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Ling Zhang
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Na Li
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Jie Liu
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Jing Guo
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Mengyuan Zhang
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Xiumei He
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Lijuan Liu
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Hongmei Zhang
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Muli Shi
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Feifei Chong
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
Xiao Chen
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Chang Wang
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Xu Wang
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Tingting Liang
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Xiangliang Liu
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Li Deng
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Wei Li
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Chunhua Song
Affiliation:
Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan450001, People’s Republic of China
Jiuwei Cui
Affiliation:
Cancer Center of the First Hospital of Jilin University, Changchun, Jilin130021, People’s Republic of China
Hanping Shi
Affiliation:
Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing100038, People’s Republic of China
Hongxia Xu*
Affiliation:
Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing400042, People’s Republic of China
*
*Corresponding author: Hongxia Xu, email hx_xu2015@163.com
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Abstract

The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.

Keywords

MalnutritionGLIMTriceps skinfold thicknessLung cancerSurvival
Type
Research Article
Information
British Journal of Nutrition , Volume 127 , Issue 10 , 28 May 2022 , pp. 1506 - 1516
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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