Exploration of Phase Angel Combined with Fat Free Mass Index or Relative Appendicular Skeletal Muscle Index to Define Malnutrition of peri- Hematopoietic Stem Cell Transplantation Patients
FENG Guo, LIU Hong, WANG Meng,et al
The Third Xiangya Hospital, Central South University, Changsha, 410013
Abstract 【Objective】 This research is aimed to explore the significance of phase angle(PA) combined with fat-free body mass index(FFMI) or relative limb skeletal muscle index(RAMS) in the evaluation of malnutrition in peri-hematopoietic stem cell transplantation(HSCT) patients. 【Methods】A total of 98 patients treated with HSCT were recruited for the study. The nutritional risk was assessed by Nutritional Risk Screening 2002(NRS2002) and malnutrition status was diagnosed according to standard of GLIM. PA, FFMI and RAMS were tested by Bio Impedance Analysis(BIA). Correlations among PA, FFMI and RAMS were analyzed by Pearson analysis. The combined data of PA and FFMI and combined data of PA and RAMS of 98 patients were calculated by Logistic analysis. The ROC analysis was used to detect the area under the curve(AUC) of PA, FFMI, RAMS, PA combined with FFMI, and PA combined with RAMS. 【Results】The positive rate of NRS2002 in peri-hematopoietic stem cell transplantation patients was 100%. It showed the strong positive relationship of PA with FFMI and PA with RAMS(P<0.01). Using GLIM criteria as the standard for the diagnosis of malnutrition, the area under the ROC curve of PA, FFMI, and RAMS were 0.308, 0.204 and 0.270, respectively(P<0.01). The area under the ROC curve of the combined data of PA and FFMI and the combined data of PA and RAMS were 0.791 and 0.737(P<0.01). 【Conclusion】PA, FFMI and RAMS alone have poor accuracy in diagnosing malnutrition, but the combined data of PA and FFMI and the combined data of PA and RAMS are more accurate in diagnosing malnutrition. It is suggested that combining PA with FFMI and PA with RAMS may provide evidence for malnourished diagnosis.
[1] LOCHS H. Introductory to the ESPEN Guidelines on Enteral Nutrition:Terminology, definitions and general topics[J].Clin Nutr,2006,25(2):180-186. [2] DALY L E, POWER D G, CUSHEN S J,et al. Loss of skeletal muscle during systemic chemotherapy is prognostic of poor survival in patients with foregut cancer[J].J Cachexia Sarcopenia Muscle,2018,9(2):315-325. [3] 张献娜, 蒋朱明,于康, 等 NRS 2002营养风险筛查暨GLIM第二步诊断营养不良(目前不用肌肉量理由)[J].中华临床营养杂志,2020,28(1):1-6. [4] CHEN L K. Asian working group for sarcopenia:2019 consensus update on sarcopenia diagnosis and treatment[J].J Am Med Dir Assoc,2020,21(3):300-307. [5] DENT E, MORLEY J E, CRUZ-JENTOFG A J, et al. Physical frailty:icfsr international clinical practice guidelines for identification and management[J].J Nutr Health Aging,2019,23(9):771-787. [6] CALLEJA FERNANDEZ A, PINTOR DE L A MAZA B, VIDAL CASARIEGO A, et al. Food intake and nutritional status influence outcomes in hospitalized hematology-oncology patients[J].Nutr Hosp,2015,31(6):2598-2605. [7] KONDRUP J. ESPEN guidelines for nutrition screening 2002[J].Clin Nutr,2003,22(4):415-421. [8] CEDERHOLM T, JENSEN GL, CORREIA M, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community[J].Clin Nutr,2019,38(1):1-9. [9] LI Q, ZHANG X, TANG M, et al. Different muscle mass indices of the Global Leadership Initiative on Malnutrition in diagnosing malnutrition and predicting survival of patients with gastric cancer[J].Nutrition,2021,89(2):111-286. [10] XU J Y, ZHANG X N, JIANG Z M, et al. Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS2002:Reanalysis of a cohort study[J].Nutrition,2020,79-80:110802. [11] KURBAN M.Role of human body composition analysis and malnutrition risk questionnaire in the assessment of nutritional status of patients with initially diagnosed crohn's disease[J].Front Med(Lausanne),2020,7:106. [12] SOUOUZA THOMPSON, MOTTA R, ALVES CASTANHO I, et al. Cutoff point of the phase angle in pre-radiotherapy cancer patients[J].Nutr Hosp,2015,32(5):2253-2260.
2021, Vol. 38 
