HANDGRIP STRENGTH IMPROVES MALNUTRITION IDENTIFICATION IN CANCER INPATIENTS
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Abstract
Objectives: To assess the incremental value of handgrip strength (HGS) combined with Body Mass Index (BMI) for identifying PG-SGA-defined malnutrition in cancer inpatients. Methods: A cross-sectional descriptive study was conducted on 108 inpatients treated at Oncology Center, Military Hospital 103. Nutritional status was classified using the PG-SGA A (non-malnutrition) vs. PG-SGA B/C (malnutrition). HGS was measured with a low HGS designed according to the AWGS 2019 criteria. Multivariable linear and logistic regressions model and ROC curve analyses were employed. Results: PG-SGA B/C prevalence was 67.6%. Malnourished patients were older and had lower BMI and HGS compared to PG-SGA A. In the linear regression model, low HGS (B = +2.34; p = 0.030) and the advanced disease stage (B = +4.66; p = 0.002) increased PG-SGA score; BMI was inversely associated (B= -0.68 per kg/m²; p < 0.001). In multivariable logistic regression, BMI served as a protective factor (OR = 0.715; p = 0.001), older age increased the risk of malnutrition (OR = 1.06; p = 0.028); low HGS was not significant after adjustment. ROC analysis revealed AUC values of 0.634 for HGS and 0.708 for BMI, the combined BMI+HGS model achieved an AUC of 0.761, indicating the incremental value of HGS when combined with BMI. Conclusion: In cancer inpatients, lower BMI and older age are independently associated with PG-SGA B/C. HGS elevates PG-SGA scores and improves diagnostic discrimination of malnutrition when combined with BMI. Routine bedside HGS assessment alongside BMI is recommended for malnutrition screening and prioritizing nutritional interventions at admission.
Keywords
Cancer, Malnutrition, PG-SGA, Handgrip strength, BMI
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References
2. Bauer J, S Capra, and M Ferguson. Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002; 56(8):779-785.
3. Min Y, et al. Associations between patient-generated subjective global assessment criteria and all-cause mortality among cancer patients: Evidence from baseline and longitudinal analyses. Nutrition. 2024; 127:112551.
4. Cruz-Jentoft, AJ, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019; 48(1):16-31.
5. Chen, LK, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020; 21(3):300-307e2.
6. Consultation, W.H.O.E. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004; 363(9403):157-163.
7. Phạm Đức Minh và Tạ Việt Hà. Một số yếu tố liên quan đến năng lượng khẩu phần ăn của người bệnh ung thư tại Bệnh viện Quân y 103. Tạp chí Y học Việt Nam. 2021; 503(1).
8. Jager-Wittenaar H, and FD Otter. Assessing nutritional status in cancer: Role of the patient-generated subjective global assessment. Curr Opin Clin Nutr Metab Care. 2017; 20(5):322-329.
9. Nitichai N, et al. Validation of the scored patient-generated subjective global assessment (PG-SGA) in the Thai setting and association with nutritional parameters in cancer patients. Asian Pac J Cancer Prev. 2019; 20(4):1249-1255.
10. De Groot, LM, et al. Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria. Nutrients. 2020; 12(8).