Phase angle: A robust predictor of malnutrition and poor prognosis in gastrointestinal cancer

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2024-04-27 DOI:10.1016/j.nut.2024.112468

Jiajun Yang , Hailun Xie , Lishuang Wei , Guotian Ruan , Heyang Zhang , Jinyu Shi , Hanping Shi , Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) Group

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引用次数: 0

Abstract

Objectives

The aim of this study was to investigate the relationship among phase angle (PA), malnutrition, and prognosis in patients with gastrointestinal cancer.

Methods

In total, 870 patients with gastrointestinal cancer were enrolled. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the association between PA and survival risk. Restricted cubic spline regression was used for flexibility analysis to explore sex-specific associations between PA and survival. Logistic regression was used to assess the relationships among PA, malnutrition, and cachexia.

Results

Low PA was closely associated with poor physical conditions, diminished quality of life, and malnutrition. Patients with low PA had a significantly worse prognosis than those with high PA (60.6% versus 72.8%; log-rank P < 0.001). PA was suitable for the prognostic assessment of patients with advanced-stage tumors. Regardless of sex, patients with lower PA showed significantly poorer survival rates. Cox proportional hazards models identified PA as an independent predictor of prognosis in patients with gastrointestinal cancer (hazard ratio (HR)=0.534; 95% confidence interval (CI)=0.409–0.696, P < 0.001). Subgroup analysis indicated that a high PA was an independent risk factor affecting the prognoses of patients with esophageal, liver, and intrahepatic bile duct cancers. Interestingly, variations in PA had a more significant prognostic effect on survival in men than in women. The logistic regression model confirmed that PA is a valuable indicator for assessing malnutrition and cachexia in patients with gastrointestinal cancer. Among all body composition indicators, PA demonstrated the highest accuracy for prognostic prediction.

Conclusions

PA was identified as a robust predictor of malnutrition and poor prognosis in patients with gastrointestinal cancer.

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相角：胃肠癌患者营养不良和预后不良的可靠预测指标

目的本研究旨在探讨胃肠道癌症患者的相位角（PA）、营养不良和预后之间的关系。方法共纳入 870 名胃肠道癌症患者。采用 Kaplan-Meier 曲线和 Cox 比例危险模型评估 PA 与生存风险之间的关系。限制性三次样条回归用于灵活性分析，以探讨 PA 与生存之间的性别特异性关联。结果低 PA 与身体状况差、生活质量下降和营养不良密切相关。低 PA 患者的预后明显差于高 PA 患者（60.6% 对 72.8%；对数秩 P < 0.001）。PA适用于晚期肿瘤患者的预后评估。无论性别如何，PA较低的患者生存率明显较低。Cox 比例危险模型确定 PA 是胃肠癌患者预后的独立预测因子（危险比 (HR)=0.534; 95% 置信区间 (CI)=0.409-0.696, P < 0.001）。亚组分析表明，高PA是影响食管癌、肝癌和肝内胆管癌患者预后的独立危险因素。有趣的是，PA的变化对男性生存期的预后影响比女性更显著。逻辑回归模型证实，PA 是评估胃肠道癌症患者营养不良和恶病质的重要指标。结论 PA 是预测胃肠道癌症患者营养不良和不良预后的可靠指标。

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

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.