Grip-Strength-Lean-Mass Index (GSLMI) as a valuable tool for sarcopenia diagnosis and survival prognosis in cancer patients: a nationwide multicenter cohort study - 30/10/24

Doi : 10.1016/j.jnha.2024.100409

Zhenyu Huo ^a,^b, Feifei Chong ^a,^b, Siyu Luo ^a,^b, Na Li ^a,^b, Ning Tong ^a,^b, Zongliang Lu ^a,^b, Jing Guo ^a,^b, Ling Zhang ^a,^b, Xin Lin ^a,^b, Mengyuan Zhang ^a,^b, Hongmei Zhang ^a,^b, Muli Shi ^a,^b, Xiumei He ^a,^b, Jie Liu ^c, Chunhua Song ^d, Hanping Shi ^e,^f,⁎ , Xu Hongxia ^a,^b,⁎
^a Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
^b Chongqing Municipal Health Commission Key Laboratory of Intelligent Clinical Nutrition and Transformation, Chongqing, 400042, China
^c Department of Clinical Nutrition, the Thirteenth People's Hospital of Chongqing, 400053, China
^d Department of Epidemiology, College of Public Health, Zhengzhou University, Henan 450001, China
^e Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
^f Key Laboratory of Cancer FSMP for State Market Regulation, Beijing 100038, China

^⁎Corresponding authors.

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Abstract

Objectives

To identify whether the Grip-Strength-Lean-Mass Index (GSLMI) can precisely diagnose sarcopenia and predict prognosis for cancer patients in clinical settings.

Design

A nationwide multicenter cohort study.

Setting and participants

8831 patients aged 18 years and older, diagnosed with cancer and/or receiving inpatient anti-cancer therapy.

Measurements

The GSLMI is the ratio of hand grip strength (HGS) divided by lean mass (LM), calculated by the formula: GSLMI = HGS (kg) / LM (kg). Kaplan-Meier curves and Cox models were used to estimate the association between the GSLMI and survival.

Results

A total of 3,071 (48.40%) male and 3,274 (51.60%) female patients were enrolled in the study. The prevalence of GLIS-defined sarcopenia was 2,646 (41.70%). The optimal sex-specific thresholds with the best diagnostic performance to identify a low GSLMI were determined to be < 0.61 for males and < 0.47 for females based on the ROC curves. According to Kaplan-Meier curves, patients with a high GSLMI exhibited better overall survival than those with a low GSLMI (HR = 0.664, 95%CI = 0.604 - 0.729, log-rank P < 0.001). Multivariable survival analysis revealed that the GSLMI showed an independent association with a lower hazard of death as a continuous variable (HR = 0.70, 95% CI = 0.51 - 0.96).

Conclusions

The GSLMI may serve as a novel diagnostic tool for identifying sarcopenia and may have prognostic value for cancer patients. Using the GSLMI represents a feasible and promising option for better managing the health of patients with cancer.

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Keywords : Cancer, Sarcopenia, Hand grip strength, Lean mass, Mortality