Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients

Abstract

BackgroundFew studies have assessed global nutritional assessment tools and body-composition measurements in gynecologic cancer patients. ObjectiveWe aimed to assess the convergent validity of different nutritional tools such as the scored Patient-Generated Subjective Global Assessment (PG-SGA), serum albumin, skinfold-thickness measurements, and total-body potassium (TBK) and body density measurements to identify gynecologic cancer patients at risk of malnutrition. DesignWe assessed the nutritional status of 194 patients with suspected or proven gynecologic cancer according to the SGA and the scored PG-SGA, and skinfold-thickness (n = 145), TBK (n = 51), and body density measurements (n = 42) before primary treatment. ResultsAccording to the SGA and the scored PG-SGA global rating, 24% of gynecologic cancer patients were classified as malnourished. The prevalence of malnutrition was highest in ovarian (67%) and lowest in endometrial (6%) cancer patients. The ability of the PG-SGA score (P < 0.001) and albumin (P < 0.001), triceps skinfold-thickness (P = 0.041), and TBK (P = 0.005) measurements to predict the SGA was significantly better than chance. TBK significantly correlated with measurements associated with protein depletion, including age (P < 0.001), arm muscle area (P < 0.001), fat-free mass (P < 0.001), and the PG-SGA score (P = 0.009). Multiple regression analysis showed that, together, the PG-SGA score and arm muscle area adjusted for age accounted for 66% of total TBK variance. ConclusionsThe PG-SGA is significantly associated with subjective and objective parameters and is a widely recognized, clinically relevant method of evaluating nutritional status. It therefore seems most appropriate for identifying malnourishment in gynecologic cancer patients.