Background and aim Malnutrition is common in patients with cancer, and its early diagnosis can reduce or prevent further complications and improve the clinical and nutritional prognosis. Adductor Pollicis Muscle Thickness (APMT) and Handgrip Strength have been explored in this population to identify a reduction in strength and muscle mass prior to the use of conventional methods. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA). Methods A cross-sectional study was conducted with 80 patients diagnosed with cancer who were candidates for surgery. Nutritional status was obtained from the PG-SGA. Conventional anthropometric measurements were taken, as well as APMT and Handgrip Strength. Pearson’s correlation analysis and multivariate linear regression were applied to detect the influence of variables on APMT and HGS. A significance level of 5.0% was considered. Results A high prevalence of malnutrition and the need for dietotherapic intervention was found, identified by the PG-SGA. Correlations between APMT and Handgrip Strength with anthropometric variables and with the PG-SGA score were observed. After regression adjustments, the variables that interacted with APMT were TSF and AC, and the PG-SGA score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength. Conclusion Correlations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention.

ResumenIntroducción: la nutrición parenteral (NP) en la infancia es un tratamiento cuyas características son muy variables en función de la edad y la patología que presente el paciente. Material y métodos: el grupo de Estandarización y Protocolos de la Sociedad Española de Nutrición Parenteral y Enteral (SENPE) es un grupo interdisciplinar formado por miembros de la SENPE, Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP) y Sociedad Española de Farmacia Hospitalaria (SEFH) que pretende poner al día este tema. Para ello, se ha realizado una revisión pormenorizada de la literatura buscando las evidencias que nos permiten elaborar una Guía de Práctica Clínica siguiendo los criterios del Oxford Centre for Evidence-Based Medicine. Resultados: este manuscrito expone de forma resumida las recomendaciones en cuanto a indicaciones, vías de acceso, requerimientos, modifi caciones en situaciones especiales, componentes de las mezclas, prescripción y estandarización, preparación, administración, monitorización, complicaciones y NP domiciliaria. El documento completo se publica como número monográfi co. Conclusiones: esta guía pretende servir de apoyo para la prescripción de la NP pediátrica. Constituye la base para tomar decisiones en el contexto de la evidencia existente. Ninguna guía puede tener en cuenta todas las circunstancias clínicas individuales. Abstract

Background: The malnutrition is generally seen in the hospital environment and it is a serious potentially condition in cancer patients. Measurement of serum proteins can be a useful indicator in the evaluation of nutritional status. Objective: To evaluate the association of transthyretin with nutritional status in cancer patients. Methods: This is a cross-sectional study, conducted with patients with a cancer confirmed diagnosis. Nutritional status was defined by the Subjective Global Assessment, anthropometric measurements, serum albumin and transthyretin. Results: Seventy patients were evaluated, the median age was 58.51±14.85years, 51.4%(n=36) were elderly and female. Cancer of the lower gastrointestinal tract was the most prevalent, affecting 42.9%(n=30) patients. Subjective Global Assessment, transthyretin and serum albumin showed that 71.56%(n= 50), 50.0%(n= 35) and 32.9%(n=23) patients were malnourished, respectively. There were no differences between them. Significant correlations were found between transthyretin, arm circumference (p=0.025), arm muscle circumference (p=0.008) and corrected arm muscle area (p=0.001). Transthyretin showed sensitivity of 58.0%, specificity of 70.0%, positive predictive value of 83.0%, and negative predictive value of 61.0%. Discussion: The findings showed the association of transthyretin with the anthropometric variables used to evaluate nutritional status, especially those that evaluate the reduction of energy and protein reserves. Conclusion: Transthyretin was moderately associated with anthropometric variables. Given the limitations, transthyretin may be a complementary tool in nutritional evaluation, because it is feasible, easy to interpret and undergoes changes in a short period.