The efficacy of fat-free mass index and appendicular skeletal muscle mass index in cancer malnutrition: a propensity score match analysis

Abstract

BackgroundReduced muscle mass (RMM) is a phenotypic criterion for malnutrition; the appendicular skeletal muscle mass index (ASMI) and fat-free mass index (FFMI) are both applicable indicators in the global leadership initiative on malnutrition (GLIM) guideline. However, their sensitivity and prognostic effect remain unclear.MethodsClinical data of 2,477 patients with malignant tumors were collected. Multi-frequency bioelectrical impedance analysis was used to obtain ASMI and FFMI. RMM was confirmed by ASMI (< 7.0 kg/m2 for men and < 5.7 kg/m2 for women) or FFMI (< 17 kg/m2 for men and < 15 kg/m2 for women). Propensity score match analysis and logistic regression analysis were used to evaluate the efficacy of FFMI and ASMI in diagnosing severe malnutrition and multivariate Cox regression analysis to determine the efficacy of RMM in predicting survival.ResultsIn total, 546 (22.0%) and 659 (26.6%) participants were diagnosed with RMM by ASMI (RMM.ASMI group) and FFMI (RMM.FFMI group); 375 cases overlapped. Body mass index (BMI), midarm circumference, triceps skinfold thickness, and maximum calf circumference were all significantly larger in the RMM.FFMI group for both sexes (P < 0.05). A 1:1 matched dataset constructed by propensity score match contained 810 cases. RMM.FFMI was an influential factor of severe malnutrition with HR = 3.033 (95% CI 2.068–4.449, P < 0.001), and RMM.ASMI was a predictive factor of overall survival (HR = 1.318, 95% CI 1.060–1.639, P = 0.013 in the RMM.ASMI subgroup, HR = 1.315, 95% CI 1.077–1.607, P = 0.007 in the RMM.FFMI subgroup).ConclusionIn general, RMM indicates negative clinical outcomes; when defined by FFMI, it predicts nutritional status, and when defined by ASMI, it is related to poor survival in cancer patients.

Effect of skinfold thickness on arm venous access port in cancer patients

“…For anthropometric assessment, weight, height, and two skinfolds (triceps brachii and suprailiac, respectively) were measured according to criteria accepted by certified International Society for the Advancement of Anthropometry (ISAK) level 1 experts 20,21 . Skinfold calipers are commonly used instruments for skinfold thickness measurement 36,37 . Studies have shown that skinfold thickness is associated with the nutritional health status of the human body 38–40 .…”

“…20,21 Skinfold calipers are commonly used instruments for skinfold thickness measurement. 36,37 TA B L E 3 Relevant information of port catheterization in the two groups. Studies have shown that skinfold thickness is associated with the nutritional health status of the human body.…”

Influence of the Results of Control of Intakes, Proteins and Anthropometry Nutritional Screening, Sarcopenia and Body Composition on the Clinical Evolution of Hospitalized Patients

“…Body composition has been studied in many pathologies, but not so much in heterogeneous hospitalized patients of different ages. In the study by Ji et al [ 11 ], they found that reduced muscle mass determined by ASMI in cancer patients was associated with worse survival. Cereda et al [ 10 ] analyzed the FFM index (FFMI) in a cohort of cancer patients, observing that patients with a decreased FFMI had higher mortality and lower quality of life.…”

“…A mortality of 17.3% of the total sample was observed at 6 months, 7.5% of early readmission and a median stay of 14 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) days.…”

“…In the assessment of body composition, the BIA is based on the principle of the resistance that the body offers to an electric current, and the FFM can be estimated using predictive equations [ 9 ]. Different studies have shown that altered results of these items are associated with worse prognostic outcomes [ 10 , 11 ].…”