Combination of Nutritional Risk Index and Handgrip Strength on the Survival of Patients with Cancer Cachexia: A Multi- Center Cohort Study

Xie, Hailun; Ruan, Guo‐Tian; Zhang, Qi; Ge, Yi‐Zhong; Song, Mengmeng; Zhang, Xi; Liu, Xiaoyue; Lin, Shiqi; Zhang, Xiaowei; Li, Xiangrui; Zhang, Kangping; Yang, Ming; Tang, Meng; Ma, Cong; Shi, Hanping

doi:10.2147/jir.s352250

Cited by 9 publications

(7 citation statements)

References 25 publications

(31 reference statements)

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“…Although HGS was suggested to be an independent prognostic factor in patients with cachexia, 34 its prognostic value in the present study was lower than that of the TA. This finding was similar to a previous study showing that a low fat mass index outperforms handgrip weakness and malnutrition in predicting cancer survival 17 .…”

Section: Discussioncontrasting

confidence: 85%

Triceps skinfold–albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study

Yin

Cui

Lin

et al. 2022

J cachexia sarcopenia muscle

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BackgroundThe fat mass and nutritional status play important roles in the onset and progression of cancer cachexia. The present study evaluated the joint prognostic value of the fat mass, as indicated by the triceps skinfold thickness (TSF), and the serum albumin level, for mortality in patients with cancer cachexia. Methods We performed a multicentre cohort study including 5134 patients with cancer cachexia from January 2013 to April 2019. The sum of the TSF (mm) and serum albumin (g/L) was defined as the triceps skinfold-albumin index (TA). Harrell's C index, a time-dependent receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) were used to evaluate the prognostic performance of the TA and other indices. Optimal stratification was used to identify the thresholds to define a low TA, and the association of the TA with all-cause mortality was evaluated using Kaplan-Meier analysis and Cox proportional hazard regression models. ResultsThe study enrolled 2408 women and 2726 men with a median age of 58.6 years and a median follow-up of 44 months. A total of 607 women (TA < 49.9) and 817 men (TA < 45.6) were classified as having a low TA. The TA showed better discrimination performance (C index = 0.621, 95% confidence interval [CI] = 0.607-0.636) to predict mortality in patients with cancer cachexia than the handgrip strength, the nutritional risk index, the prognostic nutritional index, the controlling nutritional status index, the systemic immune-inflammation index, the modified Glasgow prognostic score, and the TSF or albumin alone in the study population (all P < 0.05). The 1-, 3-and 5-year timedependent ROC analyses (AUC = 0.647, 0.625 and 0.630, respectively) showed that the TA had the highest prognostic value among all indices investigated (all P < 0.05). Univariate analysis showed that a lower TA was associated with an increased death hazard (hazard ratio [HR] = 1.859, 95% CI = 1.677-2.062), regardless of the sex and cancer type. Multivariable survival analysis showed that a lower TA was independently associated with an increased death hazard (HR = 1.381, 95% CI = 1.223-1.560). This association was significantly strengthened in patients who did not receive curative chemotherapy (

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Section: Discussioncontrasting

confidence: 85%

Triceps skinfold–albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study

Yin

Cui

Lin

et al. 2022

J cachexia sarcopenia muscle

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“…Patients in the high NRI group had a significantly better OS than those in the low NRI group. Consistent with the results of previous studies in other cancers, our results suggest that malnutrition, as assessed by the NRI, may be a predictor of poor survival in patients with NDMM [22][23][24].…”

Section: Discussionsupporting

confidence: 92%

Prognostic value of the nutritional risk index in patients with newly diagnosed multiple myeloma

et al. 2022

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The nutritional risk index (NRI), which is based on weight and albumin levels, is closely associated with the prognosis of many cancers. However, its prognostic value has not been investigated in patients with newly diagnosed multiple myeloma (NDMM). We aimed to assess the association between the NRI and survival outcomes in patients with NDMM. We retrospectively collected and analyzed clinical and laboratory data from patients with NDMM between 2005 and 2019 at our center. Patients were stratified into the high NRI (> 89) and low NRI (≤ 89) groups for prognostic analysis. The NRI and other variables were also explored to evaluate their prognostic value for overall survival (OS). A total of 638 patients diagnosed with NDMM were retrospectively included. Patients in the high NRI group had a significantly better median OS than those in the low NRI group (64 months vs 43 months, p < 0.001). In the multivariate analysis, a high NRI was shown to be an independent prognostic factor for OS (hazard ratio, 0.758; 95% confidence interval, 0.587–0.977; p = 0.033). Age, performance status, transplant status, and lactate dehydrogenase level were also independent prognostic factors for OS. In conclusion, our study demonstrates that the NRI is a simple and useful predictor of survival outcomes in patients with NDMM.

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“…But in our study, a linear association was found within the grip strength of 34.2 kg, i.e., among people with lower grip strength. One possible reason may be adults over 45 years old in China suffer from early-childhood malnutrition [ 21 ]. Famine can cause malnutrition and deficiencies in body composition, which constituted an extreme loss of life [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Handgrip strength as an indicator for death events in China: A longitudinal cohort study

Xie

Lu²,

Han³

et al. 2022

PLoS ONE

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Studies have shown the indicative role of handgrip strength in health. However, there is limited evidence revealing its potential effect on death events among middle-aged and older adults in China. We aimed to prospectively evaluate if lower handgrip strength is associated with the event of death. Among 17,167 middle-aged and older adults between age 45 to 96, handgrip strength was collected by a handheld dynamometer in a Chinese longitudinal study of aging trend (CHARLS) 2011–2018. Using Cox proportional hazard models with exposures, we assessed the association between handgrip strength and death events. Elevated handgrip strength values were independently associated with the decreased death risk. These results illustrate that lower handgrip strength is an independent indicator of death risks among middle-aged and older Chinese, which highlights the significance of related intercessions. The median values of five levels of handgrip strength in the entire cohort were 16.5,23,28,33,42kg at baseline. A linear association existed between the handgrip strength values and the risk of all-cause death within 34.2kg. Handgrip strength can serve as an independent indicator for death risks.

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Combination of Nutritional Risk Index and Handgrip Strength on the Survival of Patients with Cancer Cachexia: A Multi- Center Cohort Study

Cited by 9 publications

References 25 publications

Triceps skinfold–albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study

Triceps skinfold–albumin index significantly predicts the prognosis of cancer cachexia: A multicentre cohort study

Prognostic value of the nutritional risk index in patients with newly diagnosed multiple myeloma

Handgrip strength as an indicator for death events in China: A longitudinal cohort study

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