Clinical Nutrition: 绝对和相对握力可以用来预测癌症预后

2022-06-28 xuyihan MedSci原创

握力主要是测试上肢肌肉群的发达程度,测试受试者前臂和手部肌肉力量,反映人体上肢力量的发展水平的一种指标。

癌症仍然是影响人们生活和健康的主要疾病负担之一。2020年,全世界估计有1930万新发癌症病例和近1000万癌症死亡病例。癌症相关性肌肉减少症是影响癌症患者预后和生活质量的不良因素。由于肿瘤的慢性消瘦特征、缺乏体力活动、食物摄入减少以及各种抗癌治疗的副作用等因素,癌症患者处于过度分解代谢和低合成状态,导致肌肉功能状态发生剧烈变化。肌肉减少症的临床评估需要评估包括肌肉质量、肌肉力量和身体功能等多方面指标,较为繁琐和复杂。而肌力测量简单方便;因此,它更适合在临床场景中实施。握力 (HGS) 是临床和研究环境中最简单和最常见的肌肉力量测量方法。由于其操作简单、无创、成本低等优点,HGS在癌症患者的临床护理和预后中的重要性越来越受到关注。此外,研究人员发现HGS与癌症预后之间关系的证据主要限于绝对 HGS。目前,HGS在癌症患者预后评估中的具体标准尚未达成共识。目前尚不清楚绝对或相对 HGS 是否更适合癌症的预后评估。因此,本研究旨在比较绝对和相对 HGS 在癌症患者中的预后、预测能力。

 

 

为此,研究人员对16150名癌症患者进行了一项多中心前瞻性队列研究。暴露变量是绝对和相对HGS值。相对 HGS 根据身高、体重、体重指数 (BMI) 和中臂围 (MAC) 进行标准化。Cox比例风险回归模型用于确定 HGS 相关指数与生存率之间的关系。逻辑回归分析用于评估 HGS 相关指数与 90 天癌症相关结果之间的关联。

 

 

研究结果发现绝对和相对 HGS 都是癌症的独立预后因素。所有HGS相关指标均适用于肺癌结直肠癌。绝对值和 MAC调整的 HGS 均适用于乳腺癌。对于肝胆和泌尿系统癌症的预后评估,只有一部分HGS 是适用的。与绝对 HGS 相比,高度调整的 HGS 具有更好的预测性能(P <0.001),尤其是在肺癌和结直肠癌中。然而,体重/BMI/MAC 调整的 HGS 的预测性能比绝对 HGS 的预测性能差 (P <0.001)。低绝对和相对 HGS 与癌症患者 90 天不良预后显着相关。在预测 90 天结果方面,高度调整的 HGS 优于绝对 HGS。

 

 

本项研究证实在HGS相关指标中,经过身高调整后的 HGS 在预测癌症患者,尤其是肺癌患者的短期和长期生存率方面具有最佳价值。

 

 

 

原始出处:HailunXie. Et al. Comparison of absolute and relative handgrip strength to predict cancer prognosis: A prospective multicenter cohort study. Clinical Nutrition.2022.

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    2023-02-06 syscxl
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    2022-06-27 zll0628

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