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.
Objective To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients.Methods The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%.Results The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age.Conclusion The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive.
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.
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