摘要
目的探讨上臂围(MAC)和小腿围(CC)对结直肠癌(CRC)患者肌肉减少症的预测价值。方法本研究为横断面研究,纳入2022年4月至2023年8月于西南医科大学附属医院胃肠外科首次诊断为CRC的372例患者,通过生物电阻抗法(BIA)测定四肢骨骼肌质量(ASM)和四肢骨骼肌质量指数(ASMI),测定MAC、CC、握力和6米步速等,按肌肉减少症分组比较肌肉减少症患者与非肌肉减少症患者基线情况差异。按照性别分组主要参考既往相似文献,男女性MAC和CC的大小差异大,所以本研究按照性别分层分析得出不同性别的截止点,采用ROC曲线比较MAC和CC对CRC患者肌肉减少症的预测价值并确定最佳截止点,计算Kappa值判断MAC、CC与肌肉减少症诊断标准的一致性。结果372例CRC患者中,男性233例(62.6%),女性139例(37.4%),肌肉减少症81例(21.8%)。ROC曲线示,MAC预测肌肉减少症的最佳截止点为男性24.9cm(敏感度81.8%,特异度73.0%),女性23.7 cm(敏感度80.8%,特异度72.6%);CC预测肌肉减少症的最佳截止点为男性32.4 cm(敏感度74.5%,特异度80.9%),女性31.0 cm(敏感度88.5%,特异度66.4%)。男性患者的MAC、CC及两者联合预测肌肉减少症的AUC值分别为0.824、0.851、0.864,女性患者分别为0.819、0.801、0.828,联合预测的价值更高。与肌肉减少症诊断标准进行一致性比较,男性MAC和CC的Kappa值分别为0.443、0.493,女性MAC和CC的Kappa值分别为0.385、0.334。结论CRC患者MAC、CC对肌肉减少症均具有较好的预测价值,且两者联合的预测效果更好。
Objective To investigate the predictive value of mid-upper arm circumference(MAC)and calf circumference(CC)for sarcopenia in patients with colorectal cancer(CRC).Method This is a cross-sectional study that includes 372 patients who were diagnosed with CRC for the first time at the Department of Gastrointestinal Surgery,Affiliated Hospital of Southwest Medical University,from April 2022 to August 2023,with appendicular skeletal muscle mass(ASM)and appendicular skeletal muscle mass index(ASMI)measured by bioelectrical impedance analysis(BIA),and MAC,CC,hand grip strength,and 6-Meter Walk test measured,with comparison of basic conditions by grouping by sarcopenia.Grouped by gender,ROC curves were used to compare the predictive value of MAC and CC for sarcopenia in patients with CRC and to determine the optimal cut-off value,and Kappa values were calculated to determine the consistency of MAC and CC with the diagnostic criteria for sarcopenia.Result Among 372 CRC patients,233(62.6%)were male and 139(37.4%)were female,and 81(21.8%)were diagnosed with sarcopenia.The ROC curves showed that the optimal cut-off values for MAC to predict sarcopenia were 24.9 cm in males(sensitivity 81.8%,specificity 73.0%)and 23.7 cm in females(sensitivity 80.8%,specificity 72.6%);and for CC to predict the best cut-off values for sarcopenia were 32.4 cm(sensitivity 74.5%,specificity 80.9%)in men and 31.0 cm(sensitivity 88.5%,specificity 66.4%)in women.The AUC values of MAC,CC and the combination of the two for the prediction of sarcopenia were 0.824,0.851,0.864 for male patients and 0.819,0.801,0.828for female patients,respectively,which showed a higher value of the combined one.Comparing with the diagnostic criteria of sarcopenia,the Kappa values of MAC and CC were 0.443,0.493 for male and 0.385,0.334 for female respectively.Analysis by gender,age,history of smoking,alcohol consumption,clinical stage,and body mass index(BMI)subgroups revealed that m PG-SGA showed strong consistency for good/mild malnutrition,moderate malnutrition and seve
作者
廖欣
苏文意
姜祺澜
韩明
吕沐瀚
汪敏
Liao Xin;Su Wenyi;Jiang Qilan;Han Ming;Lyu Muhan;Wang Min(Depurtment of Clinical Nutrition The Affiliated Hospital of Southuest Medical University Luzhou 646000 Sichuan China;Department of Gastroenterology The Affiliated Hopital of Southuest Medical Unitersity Luzhou 646000 Sichuan China)
出处
《肿瘤代谢与营养电子杂志》
2024年第3期353-359,共7页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
四川省科技计划项目基金(2021JDTD0003)。
关键词
结直肠癌
肌肉减少症
上臂围
小腿围
Colorectal cancer
Sarcopenia
Mid-upper amn circumference
Calf circumference
