Relationship between nutritional status and sarcopenia incidence in patients with primary liver cancer

Abstract

Abstract: Objective: To study the relationship between nutritional status and the incidence of sarcopenia in patients with primary liver cancer, so as to provide reference for the prevention and treatment of sarcopenia in patients with liver cancer.
Methods: A total of 207 patients with primary liver cancer who were admitted to The First Affiliated Hospital of Hebei North University from January 2017 to December 2021 were selected and divided into sarcopenia group (n=59) and non-sarcopenia group (n=148) according to the occurrence of sarcopenia. Their clinical datas were collected. The differences in demographic data, physical examination, laboratory examination, and daily living ability scores were compared between the two groups. The influencing factors of the patients with primary liver cancer for sarcopenia were screened by multivariate Logistic regression analysis.
Results: The age of sarcopenia group was higher than that of non-sarcopenia group, and the body weight and body mass index (BMI) were lower than those of non-sarcopenia group; fasting blood glucose, urinary albumin-to-creatinine ratio (UACR), lipoproteina (Lpa), high-sensitivity C-reactive protein (hs-CRP) were higher than those in the non-sarcopenia group (P<0.05). The red blood cell count and albumin in the sarcopenia group were lower than those in the non-sarcopenia group (P<0.05). Upper arm muscle circumference, lean body mass, skeletal muscle mass index (SMI), 4m walking speed (GS), maximal grip strength, activity of daily living (ADL) score, instrumental activity of daily living (IADL), and mini-nutrition assessment (MNA) scores of sarcopenia group were lower than those of the non-sarcopenic group (P<0.05), and the fat mass was higher than that of the non-sarcopenic group (P<0.05). Sarcopenia group (P<0.05), with the decrease of MNA score, sarcopenia patients had lower arm circumference, upper arm muscle circumference, lean body mass, SMI, 4m GS, maximal grip strength value, and increased fat mass. Comparison of indicators in patients with different MNA grades, the difference was statistically significant (P<0.05); age, BMI, fasting blood glucose, albumin, hs-CRP, upper arm muscle circumference, SMI, 4m GS, maximum grip strength, ADL score, IADL score and MNA score were all different from the original score. The incidence of sarcopenia in patients with hepatocellular carcinoma was related to the occurrence of sarcopenia (P<0.05).
Conclusion: Older age, low BMI, high fasting blood glucose, high hs-CRP level, low albumin, low upper arm muscle circumference, poor nutritional status, and low activity level in primary liver cancer patients have higher incidence of sarcopenia risk. Nutritional status is closely related to the development of sarcopenia especially.

Key words: Primary liver cancer, Nutritional status, Sarcopenia, Influencing factors

Sun Dibo, Ma Haiyan, Guo Fei, Wu Xueliang. Relationship between nutritional status and sarcopenia incidence in patients with primary liver cancer[J]. Electronic Journal of Liver Tumor, 2023, 10(1): 25-30.

References

[1] TAKADA H, KUROSAKI M, NAKANISHI H, et al.Impact of pre-sarcopenia in sorafenib treatment for advanced hepatocellular carcinoma[J]. PLoS One, 2018, 13(6): e0198812.
[2] 黄小江, 骆天炯. 肌少症危险因素及发病机制的研究进展[J]. 实用老年医学, 2020, 34(1): 81-85.
[3] 何莉, 陈林, 张颖君, 等. 亚洲地区维持性血液透析患者肌少症患病率及影响因素的Meta分析[J]. 中国血液净化, 2021, 20(7): 455-459.
[4] 周健国, 黄彪, 范文川, 等. 肝癌患者围手术期营养风险和营养支持状况的研究[J]. 中国医师进修杂志, 2021, 44(9): 838-841.
[5] 方亮, 熊晓云, 方路, 等. 基于ESPEN标准探讨四种营养筛查工具对肝细胞肝癌患者的营养评估及预后价值[J]. 实用医学杂志, 2020, 36(20): 2792-2796, 2801.
[6] 向谦, 陈丽, 付丹, 等. 肌肉减少症对接受TACE治疗原发性肝癌患者生存期的影响[J]. 现代消化及介入诊疗, 2021, 26(2): 202-207.
[7] 贾淑利, 董碧蓉. 2018国际肌少症临床实践指南解读及管理肌少症对预防老年人失能的意义[J]. 中华老年医学杂志, 2019, 38(10): 1107-1110.
[8] GARROD R, BESTALL J C, PAUL E A, et al.Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living scale (LCADL)[J]. Respir Med, 2000, 94(6): 589-596.
[9] BAUMGARTNER R N, WAYNE S J, WATERS D L, et al.Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly[J]. Obes Res, 2012, 12(12): 1995-2004.
[10] 袁华财, 张甜甜, 郭冬梅, 等. 微型营养评价量表在社区老年人群中的信效度评价[J]. 山东大学学报(医学版), 2018, 56(9): 77-82.
[11] FU R D, LI J Y, ZHANG X H, et al.Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient[J]. Case Rep Gastroenterol, 2020, 14(1): 91-97.
[12] SUCANDY I, GIOVANNETTI A, ROSS S, et al.Institutional First 100 Case Experience and Outcomes of Robotic Hepatectomy for Liver Tumors[J]. Am Surg, 2020, 86(3): 200-207.
[13] 钱多, 沈静慧, 王玫玲. 临床护理路径在我国肝癌介入治疗术后患者中应用效果的Meta分析[J]. 中国全科医学, 2014, 17(35): 43-48.
[14] 张阳, 颜萍, 赵萍, 等. 原发性肝癌患者肌少症发生情况及影响因素[J]. 华南预防医学, 2020, 46(2): 175-177.
[15] 刘建营, 常静. 肌少症与肝细胞癌的临床研究进展[J]. 中国肿瘤临床, 2020, 47(17): 897-901.
[16] 王燕, 孟秀凤, 常清, 等. 中年2型糖尿病病人肌少症患病情况及其对再入院的影响[J]. 护理研究, 2020, 34(3): 532-535.
[17] 李娟, 任美欣, 王忠英, 等. HBV相关肝癌和肝硬化患者能量代谢差异比较[J]. 中西医结合肝病杂志, 2021, 31(5): 391-393, 397.
[18] 孟欣宇, 赵文静, 张金华, 等. 社区老年人身体活动与罹患肌少症的关联[J]. 中华疾病控制杂志, 2020, 24(8): 914-918.
[19] 王欢, 张磊, 谭志强, 等. 老年肌少症的综合干预研究进展[J]. 成都医学院学报, 2020, 15(3): 405-408.
[20] SKRINJAR I, BRAILO V, VIDOVIC-JURAS D, et al.Evaluation of pretreatment serum interleukin-6 and tumour necrosis factor alpha as a potential biomarker for recurrence in patients with oral squamous cell carcinoma[J]. Med Oral Patol Oral Cir Bucal, 2015, 20(4): e402-e407.