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

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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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19.	張麗娟, 黃勇, 姜孝娟, 等. 肺癌住院患者營養不良風險調查及其影響因素分析. 現代生物醫學進展, 2021, 21(16): 3125-3130.
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22.	吳振林. 終末期腫瘤惡液質患者的營養支持治療臨床分析. 家庭醫藥, 2018(7): 23.
23.	李周華, 季爽, 胡先緯, 等. 肺癌患者并發肌肉減少癥的危險因素分析及其與臨床預后的相關性探討. 中國全科醫學, 2021, 24(26): 3310-3315, 3322.
24.	楊志彥, 楚新霞. 化療前后肺癌患者生活質量、焦慮抑郁情緒變化及生活質量影響因素. 中國醫藥導報, 2016, 13(5): 122-125.

1. 路友華, 王炳翔, 王家林, 等. 中國居民 1990—2019 年肺癌及其危險因素疾病負擔變化趨勢分析. 中國公共衛生, 2022, 38(5): 513-517.
2. 李翔, 高申. 1990-2019 年中國居民肺癌發病、患病和死亡趨勢分析. 中國慢性病預防與控制, 2021, 29(11): 821-826.
3. 中國臨床腫瘤學會指南工作委員會組織. 中國臨床腫瘤學會(CSCO)非小細胞肺癌診療指南 2020. 北京: 人民衛生出版社, 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. 石漢平. 營養治療是腫瘤的一線治療. 臨床藥物治療雜志, 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. 臨床流行病學. 上海: 上海科技出版社, 2018: 178-180.
11. 徐婷婷, 王陳晨, 陸瀅瀅, 等. GLIM 定義的營養不良對胃癌患者的預后價值. 腫瘤代謝與營養電子雜志, 2022, 9(6): 786-793.
12. 陳秋, 沈軍, 王欣霞, 等. 養老機構老年人營養不良照護研究現狀. 解放軍護理雜志, 2021, 38(10): 57-60.
13. 侯東哲, 張穎, 巫嘉陵, 等. 中文版 Barthel 指數的信度與效度研究. 臨床薈萃, 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. 陳麗如, 劉承宇, 丁麗麗, 等. 營養不良診斷 GLIM 標準在肺癌患者中的應用研究. 中華臨床營養雜志, 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. 許靜涌, 楊劍, 陳偉, 等. 老年腫瘤住院患者營養不良的橫斷面調查. 中華老年醫學雜志, 2019, 38(11): 1298-1303.
18. 隨意, 邢鳳梅, 朱亮, 等. 中晚期肺癌化療患者營養狀況及影響因素研究. 護理管理雜志, 2018, 18(11): 799-803.
19. 張麗娟, 黃勇, 姜孝娟, 等. 肺癌住院患者營養不良風險調查及其影響因素分析. 現代生物醫學進展, 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, 蔣巖, 等. 結直腸癌術后病人發生營養不良影響因素分析及風險預測模型構建. 全科護理, 2021, 19(36): 5053-5058.
22. 吳振林. 終末期腫瘤惡液質患者的營養支持治療臨床分析. 家庭醫藥, 2018(7): 23.
23. 李周華, 季爽, 胡先緯, 等. 肺癌患者并發肌肉減少癥的危險因素分析及其與臨床預后的相關性探討. 中國全科醫學, 2021, 24(26): 3310-3315, 3322.
24. 楊志彥, 楚新霞. 化療前后肺癌患者生活質量、焦慮抑郁情緒變化及生活質量影響因素. 中國醫藥導報, 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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