The global leadership into malnutrition criteria reveals a high percentage of malnutrition which influences overall survival in patients with gastroenteropancreatic neuroendocrine tumours

IF 3.3 4区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Neuroendocrinology Pub Date : 2024-02-22 DOI:10.1111/jne.13376

Dominique S. V. M. Clement, Monique E. van Leerdam, Margot E. T. Tesselaar, Elmie Cananea, Wendy Martin, Martin O. Weickert, Debashis Sarker, John K. Ramage, Rajaventhan Srirajaskanthan

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Abstract

Patients with neuroendocrine tumours located in the gastroenteropancreatic tract (GEP-NETs) and treatment with somatostatin analogues (SSA's) are at risk of malnutrition which has been reported previously evaluating weight loss or body mass index (BMI) only. The global leadership into malnutrition (GLIM) criteria include weight loss, BMI, and sarcopenia, for diagnosing malnutrition. These GLIM criteria have not been assessed in patients with GEP-NETs on SSA. The effect of malnutrition on overall survival has not been explored before. The aim of this study is to describe the presence of malnutrition in patients with GEP-NET on SSA based on the GLIM criteria and associate this with overall survival. Cross-sectional study screening all patients with GEP-NETs on SSA's for malnutrition using the GLIM criteria. Body composition analysis for sarcopenia diagnosis were performed. Bloods including vitamins, minerals, and lipid profile were collected. Overall survival since the date of nutrition screening was calculated. Uni- and multivariate Cox regression analysis were performed to identify malnutrition as risk factor for overall survival. A total of 118 patients, 47% male, with median age 67 years (IQR 56.8–75.0) were included. Overall, malnutrition was present in 88 patients (75%); based on low BMI in 26 (22%) patients, based on weight loss in 35 (30%) patients, and based on sarcopenia in 83 (70%) patients. Vitamin deficiencies were present for vitamin D in 64 patients (54%), and vitamin A in 29 patients (25%). The presence of malnutrition demonstrated a significantly worse overall survival (p-value = .01). In multivariate analysis meeting 2 or 3 GLIM criteria was significantly associated with worse overall survival (HR 2.16 95% CI 1.34–3.48, p-value = .002). Weight loss was the most important risk factor out of the 3 GLIM criteria (HR 3.5 95% CI 1.14–10.85, p-value = .03) for worse overall survival. A high percentage (75%) of patients with GEP-NETs using a SSA meet the GLIM criteria for malnutrition. Meeting more than 1 GLIM criterium, especially if there is weight loss these are risk factors for worse overall survival.

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营养不良标准方面的全球领先地位显示，营养不良的比例很高，影响了胃肠胰神经内分泌肿瘤患者的总体生存率。

患有胃肠胰道神经内分泌肿瘤（GEP-NET）并接受体生长激素类似物（SSA）治疗的患者有营养不良的风险，以前曾有报道称，仅通过评估体重减轻或体重指数（BMI）来判断营养不良。全球领导营养不良（GLIM）诊断标准包括体重减轻、体重指数和肌肉疏松症。这些 GLIM 标准尚未在 SSA 的 GEP-NET 患者中进行评估。营养不良对总生存期的影响之前也未进行过探讨。本研究旨在根据 GLIM 标准描述 SSA 上的 GEP-NET 患者是否存在营养不良，并将营养不良与总生存率联系起来。横断面研究采用 GLIM 标准对所有 SSA 上的 GEP-NET 患者进行营养不良筛查。进行身体成分分析以诊断肌肉疏松症。采集血液，包括维生素、矿物质和血脂。计算自营养筛查之日起的总生存率。进行单变量和多变量 Cox 回归分析，以确定营养不良是影响总存活率的风险因素。共纳入 118 名患者，其中 47% 为男性，中位年龄为 67 岁（IQR 56.8-75.0）。总体而言，88 名患者（75%）存在营养不良；26 名患者（22%）的体重指数较低，35 名患者（30%）体重减轻，83 名患者（70%）肌肉疏松症。64 名患者（54%）缺乏维生素 D，29 名患者（25%）缺乏维生素 A。营养不良会显著降低总生存率（p 值 = .01）。在多变量分析中，符合 2 或 3 项 GLIM 标准与总生存率较低有显著相关性（HR 2.16 95% CI 1.34-3.48，p 值 = .002）。在 3 项 GLIM 标准中，体重减轻是导致总生存率降低的最重要风险因素（HR 3.5 95% CI 1.14-10.85，p 值 = .03）。在使用 SSA 的 GEP-NET 患者中，符合 GLIM 营养不良标准的比例很高（75%）。符合 1 项以上 GLIM 标准，尤其是体重减轻时，是总生存率降低的风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroendocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

6.20%

发文量

137

审稿时长

4-8 weeks

期刊介绍： Journal of Neuroendocrinology provides the principal international focus for the newest ideas in classical neuroendocrinology and its expanding interface with the regulation of behavioural, cognitive, developmental, degenerative and metabolic processes. Through the rapid publication of original manuscripts and provocative review articles, it provides essential reading for basic scientists and clinicians researching in this rapidly expanding field. In determining content, the primary considerations are excellence, relevance and novelty. While Journal of Neuroendocrinology reflects the broad scientific and clinical interests of the BSN membership, the editorial team, led by Professor Julian Mercer, ensures that the journal’s ethos, authorship, content and purpose are those expected of a leading international publication.