Feasibility of substituting handgrip strength for muscle mass as a constituent standard in the Global Leadership Initiative on Malnutrition for diagnosing malnutrition in patients with gastrointestinal cancers

Li-Ping Zhou; Ding-Ye Yu; Bing-Wei Ma; Zi-Le Shen; Hong-Bo Zou; Xian-Zhong Zhang; Xia-Lin Yan; Cheng-Le Zhuang; Zhen Yu

doi:10.1016/j.nut.2020.111044

Feasibility of substituting handgrip strength for muscle mass as a constituent standard in the Global Leadership Initiative on Malnutrition for diagnosing malnutrition in patients with gastrointestinal cancers

Nutrition. 2021 Apr:84:111044. doi: 10.1016/j.nut.2020.111044. Epub 2020 Oct 30.

Authors

Li-Ping Zhou¹, Ding-Ye Yu², Bing-Wei Ma³, Zi-Le Shen⁴, Hong-Bo Zou⁵, Xian-Zhong Zhang⁴, Xia-Lin Yan⁴, Cheng-Le Zhuang⁶, Zhen Yu⁷

Affiliations

¹ Department of General Practice, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
² Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
³ Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
⁴ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
⁵ Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
⁶ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China. Electronic address: zhuangchengle@126.com.
⁷ Department of General Practice, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China. Electronic address: yuzhen0577@gmail.com.

PMID: 33517155
DOI: 10.1016/j.nut.2020.111044

Abstract

Objectives: The aim of this study was to determine the feasibility of substituting handgrip strength (HGS) for muscle mass as a constituent in the Global Leadership Initiative on Malnutrition (GLIM) to diagnose malnourished patients with gastrointestinal (GI) cancer.

Methods: The study included 2209 patients diagnosed with GI cancer from two centers. All patients were evaluated for nutritional risk using Nutritional Risk Screening 2002 within 24 h of admission. The GLIM consensus was then used to diagnose malnourished patients. The evaluation of muscle mass as one of the constituents contained in the GLIM consensus was measured by computed tomography presented as skeletal muscle mass index (SMI) and HGS, respectively. Consistency test was carried out to evaluate the diagnostic value of SMI and HGS.

Results: There were 1042 (47.2%) cases of gastric cancer and 1167 (52.8%) cases of colorectal cancer. Among these cases were 768 patients (34.8%) at nutritional risk. Furthermore, 603 (27.3%) and 593 patients (26.8%) were diagnosed with malnutrition in the GLIM (SMI) group and the GLIM (HGS) group, respectively, and 544 (24.6%) patients in the two groups overlapped. The consistency test results showed that the κ value in the GLIM (HGS) group compared with the GLIM (SMI) group was 0.881 (P < 0.001) in patients with gastric cancer and 0.872 (P < 0.001) in those with colorectal cancer.

Conclusion: HGS can be a substitute for muscle mass as a constituent in the diagnostic criteria of GLIM in patients with GI cancer.

Keywords: GLIM; Gastrointestinal cancer; Handgrip strength; Malnutrition; Skeletal muscle mass.

MeSH terms

Feasibility Studies
Gastrointestinal Neoplasms* / complications
Gastrointestinal Neoplasms* / diagnosis
Hand Strength
Humans
Leadership
Malnutrition* / diagnosis
Muscle, Skeletal