全球肌肉疏松症领导者倡议（GLIS）定义的肌肉疏松症会增加食管癌患者食管切除术后的死亡率：一项中国真实世界队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2024-10-05 DOI:10.1016/j.nut.2024.112600

Zhenyu Huo , Siyu Luo , Feifei Chong , Ning Tong , Zongliang Lu , Mengyuan Zhang , Jie Liu , Chunshu Fang , Wei Guo , Na Li , Hongxia Xu

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引用次数: 0

摘要

目的评估在中国队列中，全球领先的 "肌肉疏松症倡议"（GLIS）定义对食管癌（EC）患者食管切除术后死亡率的影响，并验证新的 GLIS 框架在肿瘤学中的有效性：我们在中国陆军军医大学大坪医院的一个中心开展了一项观察性真实世界队列研究，时间跨度为 2014 年 12 月至 2022 年 7 月。我们使用新的 GLIS 框架中肌肉质量和肌肉力量的组合定义来诊断肌少症。通过单变量和多变量分析确定了潜在的协变量。我们使用 Kaplan-Meier 曲线和 Cox 模型估算了 GLIS 定义的肌少症与死亡率之间的关系。我们还进行了分层分析，以评估多变量 Cox 模型的稳定性：研究共纳入了 520 名心血管疾病患者，中位随访时间为 48.7 个月。共有229名EC患者（44.0%）被确认患有GLIS定义的肌少症。根据卡普兰-梅耶曲线（log-rank P = 0.015），GLIS定义的肌肉疏松症患者的总生存率明显较低。年龄、性别、肿瘤、结节、转移分期、血糖、手术出血量和手术时间作为协变量被引入完全调整 Cox 模型。经多变量调整的Cox模型显示，GLIS定义的肌肉疏松症是食管癌切除术后EC患者的一个独立预后因素（危险比为1.87，95%置信区间为1.28-2.74，P = 0.001）。分层分析证实了GLIS定义的肌肉疏松症与心血管疾病患者死亡率之间关系的稳定性：结论：GLIS定义的肌肉疏松症在中国心血管疾病患者中普遍存在，并与食管切除术后死亡率增加有关。这一发现提供了令人信服的证据，为建立 GLIS 肌肉疏松症的操作定义提供了有价值的参考。

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Global Leadership Initiative in Sarcopenia (GLIS)–defined sarcopenia increases the mortality of esophageal cancer patients after esophagectomy: A Chinese real-world cohort study

Objectives

To assess the impact of the definition of the Global Leadership Initiative in Sarcopenia (GLIS) on mortality in esophageal cancer (EC) patients, postesophagectomy, within a Chinese cohort and to validate the effectiveness of a new GLIS framework in oncology.

Methods

We performed an observational real-world cohort study in a single center at Daping Hospital of the Army Medical University in China, spanning from December 2014 to July 2022. We used the combined definition of muscle mass and muscle strength in a new GLIS framework for the diagnosis of sarcopenia. Potential covariates were identified through univariate and multivariate analyses. The association between GLIS-defined sarcopenia and mortality was estimated using Kaplan–Meier curves and Cox models. We also conducted stratified analyses to assess the stability of multivariable Cox models.

Results

A total of 520 EC patients were included in the study, with a median follow-up of 48.7 months. A total of 229 EC patients (44.0%) were identified with GLIS-defined sarcopenia. Patients with GLIS-defined sarcopenia had significantly worse overall survival in Kaplan–Meier curves (log-rank P = 0.015). Age; sex; tumor, node, metastasis stage; blood glucose; bleeding volume in operation; and operating time were introduced as covariates in a fully adjusted Cox model. Multivariable-adjusted Cox models revealed that GLIS-defined sarcopenia was an independent prognostic factor for EC patients postesophagectomy (hazard ratio, 1.87, 95% confidence interval, 1.28–2.74, P = 0.001). Stratified analyses confirmed the stability of the relationship between GLIS-defined sarcopenia and mortality in EC patients.

Conclusions

GLIS-defined sarcopenia is prevalent among Chinese EC patients and is linked to increased mortality risk postesophagectomy. This finding offers compelling evidence and serves as a valuable reference for the establishment of an operational definition of GLIS sarcopenia.

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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.