Malnutrition defined by Global Leadership Initiative on Malnutrition criteria, cachexia, and dietary intake among adult patients with cancer undergoing chemotherapy

Q3 Nursing

Clinical Nutrition Open Science Pub Date : 2025-02-01 DOI:10.1016/j.nutos.2024.11.005

Chipiliro Dannayo , Aaron Thokozani Chikakuda , Richard Nyasosela , Getrude Mphwanthe

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Abstract

Background and aims

Malnutrition is associated with high morbidity and mortality among patients with cancer. In Malawi, there is limited data on the prevalence of malnutrition and cachexia and associated factors among adult out-patients with cancer. We therefore assessed factors associated with malnutrition, cachexia, and dietary intake in adult outpatients with cancer undergoing chemotherapy.

Methods

A cross-sectional study was conducted at the National Cancer Centre in Malawi, targeting adult outpatients with different types of cancer. Data collected included socio-demographic characteristics, anthropometrics, health-related information, inflammatory biomarkers, and dietary intakes. We screened for malnutrition risk using the Malnutrition Screening Tool and assessed for malnutrition and cachexia using the Global Leadership Initiative on Malnutrition and Fearon criteria, respectively. Multivariate logistic and linear regressions examined the factors associated with malnutrition, cachexia, and dietary intake at p<0.05, using SPSS.

Results

Our study included 97 patients with a mean age of 49.24 ± 13.9 years, and 68.0% were female. The common types of cancer were cervical (47.4%) and gastrointestinal (20.6%). Approximately 51.5% of the patients were at risk of malnutrition, 33.0% were malnourished, and 24.7% had cachexia. The estimated median [Interquartile range: IQR] protein (0.99 g/kg/day [0.76; 1.42]; p=0.028) and dietary fiber (19.40 g/day [12.85; 29.50]) intakes were lower than the recommendations. The risk of malnutrition increased with anorexia (p=0.011) and reduced with normal handgrip strength (p=0.037). Gastrointestinal cancer (p=0.016) and high C-reactive protein (p=0.002) were associated with malnutrition. Having gastrointestinal cancer (p=0.040), living with HIV (p=0.030), anorexia (p=0.029), and inadequate energy intake (p=0.012) were associated with cachexia. Furthermore, gastrointestinal cancer was negatively associated with energy (p<0.0001) and protein (p=0.010) intakes.

Conclusions

Malnutrition, cachexia, and inadequate dietary intake are of concern in Malawian patients with cancer. Therefore, tailored dietetic/nutrition interventions are urgently needed in this population.

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由全球领导倡议定义的营养不良标准、恶病质和化疗的成年癌症患者的饮食摄入

背景与目的癌症患者营养不良与高发病率和死亡率相关。在马拉维，关于成年癌症门诊患者中营养不良和恶病质患病率及相关因素的数据有限。因此，我们评估了与接受化疗的成年癌症门诊患者营养不良、恶病质和饮食摄入相关的因素。方法在马拉维国家癌症中心进行了一项横断面研究，针对不同类型癌症的成年门诊患者。收集的数据包括社会人口统计学特征、人体测量学、健康相关信息、炎症生物标志物和饮食摄入量。我们使用营养不良筛查工具筛查营养不良风险，并分别使用营养不良全球领导力倡议和Fearon标准评估营养不良和恶病质。多变量logistic回归和线性回归检验了与营养不良、恶病质和饮食摄入相关的因素，使用SPSS在p<；0.05。结果纳入97例患者，平均年龄49.24±13.9岁，女性占68.0%。常见的癌症类型为子宫颈癌（47.4%）和胃肠道癌（20.6%）。约51.5%的患者存在营养不良风险，33.0%的患者存在营养不良，24.7%的患者存在恶病质。估计中位数[四分位数范围：IQR]蛋白质(0.99 g/kg/天[0.76；1.42);P =0.028)和膳食纤维(19.40 g/d [12.85；29.50])的摄入量低于推荐值。厌食症患者发生营养不良的风险增加（p=0.011），握力正常患者发生营养不良的风险降低（p=0.037）。胃肠道癌（p=0.016）和高c反应蛋白（p=0.002）与营养不良有关。患有胃肠道癌症（p=0.040）、感染艾滋病毒（p=0.030）、厌食症（p=0.029）和能量摄入不足（p=0.012）与恶病质相关。此外，胃肠道癌症与能量（p= 0.0001）和蛋白质（p=0.010）摄入量呈负相关。结论营养不良、恶病质、饮食摄入不足是马拉维癌症患者关注的问题。因此，这一人群迫切需要量身定制的饮食/营养干预措施。

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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