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Associations between nutrition risk scores and sarcopenia in gastrointestinal cancer patients: a cross-sectional study

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Supportive Care in Cancer Aims and scope Submit manuscript

A Correction to this article was published on 08 February 2022

This article has been updated

Abstract

Purpose

Sarcopenia is an independent risk factor for poor prognosis of cancers. The nutritional risk screening 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) tools are widely used tools for nutrition risk screening and assessing. The purpose of this study was to investigate whether NRS2002 and PG-SGA scores are associated with sarcopenia in gastrointestinal cancers.

Methods

A consecutive cohort comprised of 432 gastrointestinal cancer patients was conducted. We used NRS2002 and PG-SGA to assess their nutrition status. Sarcopenia was diagnosed with CT scan at the third lumber vertebra level. The correlations of nutritional scores with SMI, nutritional categories with sarcopenia were assessed by Spearman’s correlation test and point biserial correlation. The cut-off value of nutritional scores for identifying sarcopenia was obtained by maximum Youden index. Logistic regression was used to confirm the associations.

Results

Sarcopenia patients had higher NRS2002 (2.63 ± 1.16 vs. 2.15 ± 1.20, p < 0.001) and PG-SGA (8.69 ± 1.16 vs. 5.56 ± 3.28, p < 0.001) scores. The NRS2002 (r = −0.198, p < 0.001) and PG-SGA (r = −0.409, p < 0.001) scores were significantly and negatively correlated with skeletal muscle mass index. The cut-off value of PG-SGA score for predicting sarcopenia was 7. In multivariate logistic regression, the PG-SGA exceeded 7 score (OR = 7.489, 95% CI: 4.122–13.608, p < 0.001) was significantly associated with increased risk of sarcopenia, while NRS2002 score showed no significant association with sarcopenia.

Conclusions

PG-SGA ≥ 7 was associated with increased risk of sarcopenia and could serve as a useful criterion for capturing sarcopenia in gastrointestinal cancers. Routine PG-SGA evaluation for patient with gastrointestinal cancers is important.

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Data availability

The datasets analyzed in the present study are available from the corresponding authors on reasonable request.

Change history

Abbreviations

NRS 2002:

Nutritional risk screening 2002

PG-SGA:

Patient-generated subjective global assessment

BMI:

Body mass index

BIA:

Bioelectrical impedance analysis

CT:

Computed tomography

SMI:

Skeletal muscle mass index

HU:

Hounsfield unit

AJCC:

The American Joint Committee on Cancer

SD:

Standard deviation

ROC:

Receiver operating characteristics curve

AUROC:

Area under receiver operating characteristics curve

WBC:

White blood cell

HDL-C:

High-density lipoprotein cholesterol

LDL-C:

Low-density lipoprotein cholesterol

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

GFR:

Glomerular filtration rate

CEA:

Carcinoembryonic antigen

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Acknowledgements

We acknowledge all the patients participated in the study. We are also grateful to all the staff who have helped us in the study.

Funding

The research was funded by the National Natural Science Foundation of China (81700463), the Institute of Hospital Management, Nanjing University (NDYG2019020), and Jiangsu Provincial Hospital Management Innovation Research Project (JSYGY-3-2019-305).The Institute of Hospital Management, Nanjing University ,NDYG2019020,Xiaotian Chen ,Graduate Research and Innovation Projects of Jiangsu Province,JSYGY-3-2019-305,Bo Gao ,National Natural Science Foundation of China,81700463,Chao Ding

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Authors and Affiliations

  1. Department of Clinical Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China

    Bo Gao, Wenqing Chen, Yuan Li, Xiangrui Li & Xiaotian Chen

  2. Department of Obstetrics and Gynecology, The affiliated Obstetrics and Gynecology Hospital with, Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfeixiang, Mochou Road, Qinhuai District, Nanjing, China

    Yu Liu

  3. Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China

    Chao Ding & Wenxian Guan

  4. Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China

    Guifang Xu

Authors
  1. Bo Gao
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  3. Yu Liu
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  4. Yuan Li
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  7. Wenxian Guan
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  9. Xiaotian Chen
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Contributions

All authors contributed to the study conception and design. Bo Gao, methodology, data curation, project administration, writing; Wenqing Chen, data curation, project administration, software, manuscript writing; Yu Liu, helped in English editing and revised the article. Yuan Li, methodology, project administration; Xiangrui Li, data acquisition and collection; Wenxian Guan, investigation, resources; Guifang Xu, study design, manuscript supervision; Chao Ding and Xiaotian Chen, study design, financial support, manuscript supervision. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Chao Ding, Guifang Xu or Xiaotian Chen.

Ethics declarations

Ethics approval

The observational study was in accordance with the ethics principles of the Declaration of Helsinki and was approved by the Clinical Research Ethics Committee of Nanjing Drum Tower Hospital.

Consent to participate

Written informed consent was obtained from all the participants.

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Not applicable

Competing interest

All authors declare no competing interests.

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Bo Gao, Wenqing Chen and Yu Liu contributed equally to this article as co-first authors.

The original version of this article was revised. Missing author contribution and is now corrected.

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Gao, B., Chen, W., Liu, Y. et al. Associations between nutrition risk scores and sarcopenia in gastrointestinal cancer patients: a cross-sectional study. Support Care Cancer 30, 3269–3277 (2022). https://doi.org/10.1007/s00520-021-06729-1

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  • DOI: https://doi.org/10.1007/s00520-021-06729-1

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