Abstract
Assessment tools and body-composition measurements are useful in diagnosing malnutrition. Which one is better for lung disease patients is unclear. The objectives of the present study are: to assess relationships between different methods of nutritional measurements in lung diseases patients; to determine which one is better in diagnosing malnutrition for lung disease patients; and to determine whether lung cancer patients can be differentiated from benign lung disease patients using different measurements. A total of 96 newly diagnosed primary lung cancer patients in stage IIIB/IV and 52 benign lung disease patients nutritional status were assessed according to the SGA, the scored PG-SGA, and serum albumin, prealbumin, transferrin, hemoglobin, total lymphocyte count, body mass index (BMI), and weight. A total of 40% of lung cancer patients were severely malnourished, with men or elder having a higher rate of malnutrition. Significantly lower values of weight, BMI, total lymphocyte count, transferrin, prealbumin and serum albumin were found for them. Age, sex, weight, weight half year ago and prealbumin are in the regression equation to predict them. For benign lung disease patients, 21.2% were severely malnourished with significantly lower values of weight and transferrin. Age and prealbumin are in the equation to predict severely malnourished benign lung disease patients. The highest receiver operation characteristic area under the curve was found for the PG-SGA score, BMI and weight. PG-SGA global rating, age and iron-transferring protein are in the equation for predicting disease status. The SGA and PG-SGA are appropriate for identifying malnutrition in lung disease patients. Lung cancer patients can be differentiated from benign conditions by PG-SGA.
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Inui A. Cancer anorexia-cachexia syndrome: current issues in research and management. CA Cancer J Clin. 2002;52(2):72–91.
MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE. Understanding and managing cancer cachexia. J Am Coll Surg. 2003;197(1):143–61.
Songür N, Kuru B, Kalkan F, Ozdilekcan C, Cakmak H, Hizel N. Serum interleukin-6 levels correlate with malnutrition, survival in patients with advanced non-small cell lung cancer. Tumori. 2004;90(2):196–200.
Heber D, Byerly LO, Chlebowski RT. Metabolic abnormalities in the cancer patient. Cancer. 1985;55(1 Suppl):225–9.
Jagoe RT, Goodship TH, Gibson GJ. Nutritional status of patients undergoing lung cancer operations. Ann Thorac Surg. 2001;71(3):929–35.
Naber TH, Schermer T, de Bree A, Nusteling K, Eggink L, Kruimel JW, et al. Prevalence of malnutrition in nonsurgical hospitalized patients, its association with disease complications. Am J Clin Nutr. 1997;66(5):1232–9.
Delbecque-Boussard L, Gottrand F, Ategbo S, Nelken B, Mazingue F, Vic P, et al. Nutritional status of children with acute lymphoblastic leukemia: a longitudinal study. Am J Clin Nutr. 1997;65(1):95–100.
Guo CB, Ma DQ, Zhang KH. Nutritional status of patients with oral, maxillofacial malignancies. J Oral Maxillofac Surg. 1994;52(6):559–62.
Geisler JP, Linnemeier GC, Thomas AJ, Manahan KJ. Nutritional assessment using prealbumin as an objective criterion to determine whom should not undergo primary radical cytoreductive surgery for ovarian cancer. Gynecol Oncol. 2007;106:128–31. [Epub 2007 Apr 26].
Unsal D, Mentes B, Akmansu M, Uner A, Oguz M, Pak Y. Evaluation of nutritional status in cancer patients receiving radiotherapy: a prospective study. Am J Clin Oncol. 2006;29(2):183–8.
Read JA, Crockett N, Volker DH, MacLennan P, Choy ST, Beale P, et al. Nutritional assessment in cancer: comparing the Mini- Nutritional Assessment (MNA) with the scored Patient-Generated Subjective Global Assessment (PGSGA). Nutr Cancer. 2005;53(1):51–6.
Laky B, Janda M, Cleghorn G, Obermair A. Comparison of different nutritional assessments, body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr. 2008;87(6):1678–85.
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8–13.
Santoso JT, Cannada T, O’Farrel B, Alladi K, Coleman RL. Subjective versus objective nutritional assessment study in women with gynecological cancer: a prospective cohort trial. Int J Gynecol Cancer. 2004;14:220–3.
Girón R, Matesanz C, García-Río F, de Santiago E, Mancha A, Rodríguez-Salvanés F, et al. Nutritional state during COPD exacerbation: clinical and prognostic implications. Ann Nutr Metab. 2009;54(1):52–8.
Budweiser S, Meyer K, Jörres RA, Heinemann F, Wild PJ, Pfeifer M. Nutritional depletion, its relationship to respiratory impairment in patients with chronic respiratory failure due to COPD or restrictive thoracic diseases. Eur J Clin Nutr. 2008;62(3):436–43.
Yoon SH, Choi NW, Yun SR. Pulmonary dysfunction is possibly a marker of malnutrition and inflammation but not mortality in patients with end-stage renal disease. Nephron Clin Pract. 2009;111(1):c1–6.
Phairin T, Kwanjaroensub V. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc. 2000;100(11):1316–22.
ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002; 26:1SA–138SA.
Weimann A, Braga M, Harsanyi L, Laviano A, Ljungqvist O, Soeters P, et al. ESPEN guidelines on enteral nutrition: surgery including organ transplantation. Clin Nutr. 2006;25:224–44.
McCallum PD, Polisena CG. The clinical guide to oncology nutrition. Chicago, IL: The American Dietetic Association; 2000.
Segura A, Pardo J, Jara C, Zugazabeitia L, Carulla J, de Las Peñas R, et al. An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer. Clin Nutr. 2005;24(5):801–14.
Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894:1–253.
Desbrow B, Bauer J, Blum C, Kandasamy A, McDonald A, Montgomery K. Assessment of nutritional status in hemodialysis patients using patient-generated subjective global assessment. J Ren Nutr. 2005;15:211–6.
Isenring E, Cross G, Daniels L, Kellett E, Koczwara B. Validity of the malnutrition screening tool as an effective predictor of nutritional risk in oncology outpatients receiving chemotherapy. Support Care Cancer. 2006;14:1152–6.
Foster NR, Mandrekar SJ, Schild SE, Nelson GD, Rowland KM Jr, Deming RL, et al. Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central Cancer Treatment Group trials. Cancer. 2009;115(12):2721–31.
Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr. 2005;82(4):784–91.
Nourissat A, Mille D, Delaroche G, Jacquin JP, Vergnon JM, Fournel P, et al. Estimation of the risk for nutritional state degradation in patients with cancer: development of a screening tool based on results from a cross-sectional survey. Ann Oncol. 2007;18(11):1882–6.
Chang JW, Asamura H, Kawachi R, Watanabe S. Gender difference in survival of resected non-small cell lung cancer: histology-related phenomenon? J Thorac Cardiovasc Surg. 2009;137(4):807–12.
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We would like to thank the patients for participating in this study. Science and Education Division of Shanghai Chest Hospital approved the present nutrition study (subject number: Y206-19) and provided funding.
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Li, R., Wu, J., Ma, M. et al. Comparison of PG-SGA, SGA and body-composition measurement in detecting malnutrition among newly diagnosed lung cancer patients in stage IIIB/IV and benign conditions. Med Oncol 28, 689–696 (2011). https://doi.org/10.1007/s12032-010-9534-z
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DOI: https://doi.org/10.1007/s12032-010-9534-z