Marine Perrier1,2, Marie-Amelie Ordan3,4, Coralie Barbe5, Camille Mazza3, Damien Botsen3, Johanna Moreau3,4, Yohann Renard6, Mathilde Brasseur3,4, Barbara Tailliere7, Philippe Regnault8, Eric Bertin9, Olivier Bouche3,4. 1. Ambulatory Cancer Unit, Reims University Hospital, Reims, France. mperrier@chu-reims.fr. 2. Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France. mperrier@chu-reims.fr. 3. Ambulatory Cancer Unit, Reims University Hospital, Reims, France. 4. Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France. 5. Clinical Research Unit, Reims University Hospital, Reims, France. 6. Department of General and Digestive Surgery, Reims University Hospital, Reims, France. 7. Artificial Nutrition Unit, Reims University Hospital, Reims, France. 8. Mathematics Laboratory, UMR CNRS 9008, University of Reims Champagne Ardenne, Reims, France. 9. Department of Nutrition, Endocrinology, and Diabetology, Reims University Hospital, Reims, France.
Abstract
BACKGROUND: The FIGHTDIGO study determined the feasibility and acceptability of handgrip strength (HGS) measurement in digestive cancer outpatients. PURPOSE: To assess the relationship between muscle strength and markers of functional and nutritional status in this population. DESIGN: In this prospective study, a total of 201 patients were followed during 6 months and were asked to perform HGS measurement at each hospitalization. Anthropometric measurements, laboratory tests, and performance status (PS) evaluation were collected. The modified Glasgow Prognostic Score (mGPS) was calculated using CRP and albumin levels. Severe malnutrition was defined as body mass index (BMI) < 18 kg/m2 in patients > 70 years old, and BMI < 16 kg/m2 in those < 70 years old. Dynapenia was defined as HGS < 30 kg (men) and < 20 kg (women). Mixed logistic regressions and mixed linear regressions were performed to study factors associated with dynapenia and HGS value, respectively. RESULTS: A total of 879 HGS measurements were analyzed. Dynapenia occurred in 177 measurements (20.1%). BMI and HGS were significantly associated in univariate analysis (p = 0.001). In multivariate analysis, mGPS score (β = - 0.54 ± 0.31; p = 0.06) and severe malnutrition (β = - 2.8 ± 1.4; p = 0.08) tended to be associated with HGS. Dynapenia was only associated with functional status impairment in univariate analysis (n = 140/803, 17.4% in ECOG 0 and 1 versus n = 37/76, 58.7% in ECOG 2 and 3; p = 0.002). CONCLUSIONS: Identification of dynapenia using HGS measurement may be useful to predict nutritional vulnerability in digestive cancer outpatients undergoing chemotherapy. Patients could then benefit from nutritional support, adapted physical activity programs, and early therapeutic adjustments. Trial registration ClinicalTrials.gov, NCT02797197.
BACKGROUND: The FIGHTDIGO study determined the feasibility and acceptability of handgrip strength (HGS) measurement in digestive cancer outpatients. PURPOSE: To assess the relationship between muscle strength and markers of functional and nutritional status in this population. DESIGN: In this prospective study, a total of 201 patients were followed during 6 months and were asked to perform HGS measurement at each hospitalization. Anthropometric measurements, laboratory tests, and performance status (PS) evaluation were collected. The modified Glasgow Prognostic Score (mGPS) was calculated using CRP and albumin levels. Severe malnutrition was defined as body mass index (BMI) < 18 kg/m2 in patients > 70 years old, and BMI < 16 kg/m2 in those < 70 years old. Dynapenia was defined as HGS < 30 kg (men) and < 20 kg (women). Mixed logistic regressions and mixed linear regressions were performed to study factors associated with dynapenia and HGS value, respectively. RESULTS: A total of 879 HGS measurements were analyzed. Dynapenia occurred in 177 measurements (20.1%). BMI and HGS were significantly associated in univariate analysis (p = 0.001). In multivariate analysis, mGPS score (β = - 0.54 ± 0.31; p = 0.06) and severe malnutrition (β = - 2.8 ± 1.4; p = 0.08) tended to be associated with HGS. Dynapenia was only associated with functional status impairment in univariate analysis (n = 140/803, 17.4% in ECOG 0 and 1 versus n = 37/76, 58.7% in ECOG 2 and 3; p = 0.002). CONCLUSIONS: Identification of dynapenia using HGS measurement may be useful to predict nutritional vulnerability in digestive cancer outpatients undergoing chemotherapy. Patients could then benefit from nutritional support, adapted physical activity programs, and early therapeutic adjustments. Trial registration ClinicalTrials.gov, NCT02797197.
Authors: Alfonso J Cruz-Jentoft; Gülistan Bahat; Jürgen Bauer; Yves Boirie; Olivier Bruyère; Tommy Cederholm; Cyrus Cooper; Francesco Landi; Yves Rolland; Avan Aihie Sayer; Stéphane M Schneider; Cornel C Sieber; Eva Topinkova; Maurits Vandewoude; Marjolein Visser; Mauro Zamboni Journal: Age Ageing Date: 2019-01-01 Impact factor: 10.668