Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients.

Katarina Papera Valente,Thailiny Ricati Lazzarini,Rafael Araújo Guedes De Moraes,Valdete Regina Guandalini,Thamirys De Souza Chaves Ribeiro,Taísa Sabrina Silva Pereira,Betullya Lucas Almeida,Vanusa Felício De Souza,Melissa M Markofski

doi:10.1371/journal.pone.0220334

Abstract

Background and aimMalnutrition is common in patients with cancer, and its early diagnosis can reduce or prevent further complications and improve the clinical and nutritional prognosis. Adductor Pollicis Muscle Thickness (APMT) and Handgrip Strength have been explored in this population to identify a reduction in strength and muscle mass prior to the use of conventional methods. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA).MethodsA cross-sectional study was conducted with 80 patients diagnosed with cancer who were candidates for surgery. Nutritional status was obtained from the PG-SGA. Conventional anthropometric measurements were taken, as well as APMT and Handgrip Strength. Pearson’s correlation analysis and multivariate linear regression were applied to detect the influence of variables on APMT and HGS. A significance level of 5.0% was considered.ResultsA high prevalence of malnutrition and the need for dietotherapic intervention was found, identified by the PG-SGA. Correlations between APMT and Handgrip Strength with anthropometric variables and with the PG-SGA score were observed. After regression adjustments, the variables that interacted with APMT were TSF and AC, and the PG-SGA score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength.ConclusionCorrelations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention.

Highlights

Malnutrition in patients with cancer is widely known as a negative prognosis factor with expressive consequences, such as a decreased response to treatment; an increased incidence of infections; increased morbidity, mortality, and length of hospitalization; decreased functional ability; and increased hospital costs [1,2,3,4], malnutrition affects 20% to 80% of the patients with cancer population [4,5,6].Among the main characteristics of malnutrition in these patients, the loss of strength and muscle activity and reserve are frequent and have a negative effect on treatment and clinical results [7]
The variables that interacted with Adductor Pollicis Muscle Thickness (APMT) were tricipital skinfold (TSF) and arm circumference (AC), and the Patient-Generated Subjective Global Assessment (PG-SGA) score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength
Correlations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention

Summary

Introduction

Among the main characteristics of malnutrition in these patients, the loss of strength and muscle activity and reserve are frequent and have a negative effect on treatment and clinical results [7]. To this end, a combination of objective and subjective methods enables greater sensitivity and specificity in diagnosis, which allows the evaluation and planning of more appropriate and individualized nutritional strategies [8,9]. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA)

Objectives

Results

Conclusion