Predictive value of Global Leadership Initiative on Malnutrition criteria combined with handgrip strength for postoperative outcomes in overweight colorectal cancer patients
Weizhe Chen and Dingye Yu contributed equally to this work and are co-first authors on this work.
This study was registered in the China Clinical Trial Registry (No. ChiCTR2200057818).
Declaration of conflict of interest: The authors declare that they have no conflict of interest.
Author contributions: Weizhe Chen: Conceptualization, methodology, investigation, data curation, writing—original draft, review & editing. Dingye Yu: Conceptualization, methodology, software, formal analysis, writing—original draft, review & editing. Qi Ren: Software, formal analysis, review & editing. Zile Shen: Investigation, software, formal analysis, review & editing. Guowei Huang: Investigation, data curation, formal analysis, validation, review & editing. Xiaolei Chen: Conceptualization, methodology, investigation, data curation, review & editing. Qiantong Dong: Conceptualization, validation, review & editing. Zhen Yu: Conceptualization, methodology, supervision, review & editing.
Ethical approval: This study was approved by the ethics committee of the First Affiliated Hospital of Wenzhou Medical University and the Tenth People's Hospital affiliated to Tongji University.
Informed consent: All the participants in this study were aware of the research and signed the informed consent form.
Abstract
Background and Aim
The Global Leadership Initiative on Malnutrition (GLIM) criteria are increasingly used to assess the nutritional status of hospitalized patients and predict the prognosis of patients with malignant tumors; however, malnutrition is often overlooked in overweight individuals, such as colorectal cancer patients. This study aimed to investigate the predictive value of the GLIM criteria combined with handgrip strength (HGS) in overweight colorectal cancer patients.
Methods
This retrospective study enrolled overweight patients who underwent radical resection for colorectal cancer at two centers between 2015 and 2021. Malnutrition was diagnosed based on the GLIM criteria. Skeletal muscle mass was assessed using the skeletal muscle index, and skeletal muscle function was assessed using the HGS test. The risk factors for complications and survival were also evaluated.
Results
A total of 850 patients were enrolled in the study. The incidence of malnutrition in the GLIM and HGS-GLIM groups was 12.4% and 6.4%, respectively. The incidence of total complications in both the malnutrition groups was significantly higher than that in the control group. Patients in the HGS-GLIM-malnutrition group had worse overall survival and disease-free survival. HGS-GLIM was independently associated with postoperative complications (P = 0.046), overall survival (P = 0.037), and disease-free survival (P = 0.047).
Conclusion
The GLIM criteria combined with the HGS test is an effective tool for diagnosing malnutrition. Particularly, these modalities are applicable in overweight colorectal cancer patients. Compared with the standard GLIM criteria, this tool has a better predictive value for postoperative complications and long-term survival.
Open Research
Data availability statement
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. The confidential patient data should not be shared.
