Prevalence and related factors of malnutrition in patients with progressive non-small cell lung cancer_West China Medical Journal

Authors：

XIE Lingling ¹ , LUO Xiaozhen ² , WU Yu ¹ , LEI Ying ¹ ,  ZHANG Xuemei ¹

1. Center of Geriatrics, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Oncology, Chengdu Shangjin Nanfu Hospital / Shangjin Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P. R. China;

Corresponding author：

ZHANG Xuemei, Email: zxm0709@126.com

Keywords：

Advanced non-small cell lung cancer; Global Leaders Initiative on Malnutrition; malnutrition; related factors

DOI：

10.7507/1002-0179.202304059

Video：

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Objective To assess the prevalence of malnutrition in patients with advanced non-small cell lung cancer (NSCLC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, analyze its associated factors, and explore the adverse effects of malnutrition on advanced NSCLC patients in multiple aspects. Methods Patients with NSCLC who were hospitalized for the first time in the Department of Oncology, Shangjin Hospital, West China Hospital, Sichuan University between January and December 2021 were retrospectively selected as the study objects. Malnutrition assessment was carried out in all patients according to GLIM criteria, and the current situation and related factors of malnutrition were analyzed. The Barthel index scale was used to compare the daily activity ability between the malnourished group and the non-malnourished group, the Quality-of-Life Questionnaire-Core 30 scale was used to compare the quality of life between the two groups, and the adverse reactions of the two groups were compared by the hospital information system course records. Results According to GLIM diagnostic criteria, 134 of 285 patients (47.0%) were diagnosed with malnutrition. The results of binary multiple logistic regression analysis showed that age [60-69 vs. <60 years old: odds ratio (OR)=2.323, 95% confidence interval (CI) (1.277, 4.397); ≥70 vs. <60 years old: OR=10.816, 95%CI (4.185, 27.959)], previous medical history [OR=2.740, 95%CI (1.313, 5.717)], and albumin level [OR=0.905, 95%CI (0.848, 0.965)] were associated with malnutrition in patients with advanced NSCLC (P<0.05). The daily activity ability and quality of life in the malnourished group were significantly worse than those in the non-malnourished group (87.57±12.48 vs. 91.82±6.77, P<0.05; 76.22±11.52 vs. 83.96±9.75, P<0.05), and the incidence of adverse reactions in the malnourished group was higher than that of the non-malnourished group (50.7% vs. 31.8%, P<0.05). Conclusions The prevalence of malnutrition in patients with advanced NSCLC is high, and advanced age, previous medical history and albumin are related factors of malnutrition in patients with advanced NSCLC. Combined malnutrition may have adverse effects on mobility, quality of life and adverse effects of anti-tumor therapy in advanced NSCLC patients.

Citation： XIE Lingling, LUO Xiaozhen, WU Yu, LEI Ying, ZHANG Xuemei. Prevalence and related factors of malnutrition in patients with progressive non-small cell lung cancer. West China Medical Journal, 2023, 38(9): 1354-1359. doi: 10.7507/1002-0179.202304059 Copy

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23.	李周华, 季爽, 胡先纬, 等. 肺癌患者并发肌肉减少症的危险因素分析及其与临床预后的相关性探讨. 中国全科医学, 2021, 24(26): 3310-3315, 3322.
24.	杨志彦, 楚新霞. 化疗前后肺癌患者生活质量、焦虑抑郁情绪变化及生活质量影响因素. 中国医药导报, 2016, 13(5): 122-125.

1. 路友华, 王炳翔, 王家林, 等. 中国居民 1990—2019 年肺癌及其危险因素疾病负担变化趋势分析. 中国公共卫生, 2022, 38(5): 513-517.
2. 李翔, 高申. 1990-2019 年中国居民肺癌发病、患病和死亡趋势分析. 中国慢性病预防与控制, 2021, 29(11): 821-826.
3. 中国临床肿瘤学会指南工作委员会组织. 中国临床肿瘤学会(CSCO)非小细胞肺癌诊疗指南 2020. 北京: 人民卫生出版社, 2020.
4. Zhang Z, Wan Z, Zhu Y, et al. Prevalence of malnutrition comparing NRS2002, MUST, and PG-SGA with the GLIM criteria in adults with cancer: a multi-center study. Nutrition, 2021, 83: 111072.
5. 石汉平. 营养治疗是肿瘤的一线治疗. 临床药物治疗杂志, 2019, 17(4): 20-25.
6. Polański J, Jankowska-Polańska B, Uchmanowicz I, et al. Malnutrition and quality of life in patients with non-small-cell lung cancer. Adv Exp Med Biol, 2017, 1021: 15-26.
7. Bacha S, Mejdoub El Fehri S, Habibech S, et al. Impact of malnutrition in advanced non-small cell lung cancer. Tunis Med, 2018, 96(1): 59-63.
8. Shi B, Liu S, Chen J, et al. Sarcopenia is associated with perioperative outcomes in gastric cancer patients undergoing gastrectomy. Ann Nutr Metab, 2019, 75(4): 213-222.
9. Cederholm T, Jensen GL, Correia MITD, et al. GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community. Clin Nutr, 2019, 38(1): 1-9.
10. 王家良. 临床流行病学. 上海: 上海科技出版社, 2018: 178-180.
11. 徐婷婷, 王陈晨, 陆滢滢, 等. GLIM 定义的营养不良对胃癌患者的预后价值. 肿瘤代谢与营养电子杂志, 2022, 9(6): 786-793.
12. 陈秋, 沈军, 王欣霞, 等. 养老机构老年人营养不良照护研究现状. 解放军护理杂志, 2021, 38(10): 57-60.
13. 侯东哲, 张颖, 巫嘉陵, 等. 中文版 Barthel 指数的信度与效度研究. 临床荟萃, 2012, 27(3): 219-221.
14. Hechtner M, Eichler M, Wehler B, et al. Quality of life in NSCLC survivors - a multicenter cross-sectional study. J Thorac Oncol, 2019, 14(3): 420-435.
15. 陈丽如, 刘承宇, 丁丽丽, 等. 营养不良诊断 GLIM 标准在肺癌患者中的应用研究. 中华临床营养杂志, 2022, 30(1): 9-13.
16. Yin L, Fan Y, Lin X, et al. Fat mass assessment using the triceps skinfold thickness enhances the prognostic value of the Global Leadership Initiative on Malnutrition criteria in patients with lung cancer. Br J Nutr, 2022, 127(10): 1506-1516.
17. 许静涌, 杨剑, 陈伟, 等. 老年肿瘤住院患者营养不良的横断面调查. 中华老年医学杂志, 2019, 38(11): 1298-1303.
18. 随意, 邢凤梅, 朱亮, 等. 中晚期肺癌化疗患者营养状况及影响因素研究. 护理管理杂志, 2018, 18(11): 799-803.
19. 张丽娟, 黄勇, 姜孝娟, 等. 肺癌住院患者营养不良风险调查及其影响因素分析. 现代生物医学进展, 2021, 21(16): 3125-3130.
20. Finicle BT, Jayashankar V, Edinger AL. Nutrient scavenging in cancer. Nat Rev Cancer, 2018, 18(10): 619-633.
21. 王倩, 王素云, 蒋岩, 等. 结直肠癌术后病人发生营养不良影响因素分析及风险预测模型构建. 全科护理, 2021, 19(36): 5053-5058.
22. 吴振林. 终末期肿瘤恶液质患者的营养支持治疗临床分析. 家庭医药, 2018(7): 23.
23. 李周华, 季爽, 胡先纬, 等. 肺癌患者并发肌肉减少症的危险因素分析及其与临床预后的相关性探讨. 中国全科医学, 2021, 24(26): 3310-3315, 3322.
24. 杨志彦, 楚新霞. 化疗前后肺癌患者生活质量、焦虑抑郁情绪变化及生活质量影响因素. 中国医药导报, 2016, 13(5): 122-125.

West China Medical Journal

Prevalence and related factors of malnutrition in patients with progressive non-small cell lung cancer

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