目的 探讨老年胃癌患者衰弱与人体成分的相关性,以评估人体成分对老年癌患者发生衰弱的预测价值.方法 选取 2021 年 9 月～2023 年 8 月期间在潍坊医学院附属医院经过病理明确诊断的老年胃癌患者 96 例为研究对象.根据Fried衰弱表型量表(frailty phenotype,FP)将其分为衰弱组和非衰弱组.收集两组患者包括年龄、性别、吸烟、饮酒、肿瘤部位和肿瘤分期等一般临床资料.测量患者的身高、体质量,应用人体成分分析仪对患者人体成分进行检查,包括体质量指数(body mass index,BMI)、体脂肪含量、体脂百分比资料,再根据人体成分中的去脂质量、肌肉质量、上肢肌肉质量、下肢肌肉质量分别计算去脂质量指数(fat free mass index,FFMI)、肌肉质量指数(muscle mass index,MMI)、上肢肌肉质量指数(upper limb muscle mass index,ULMMI)、下肢肌肉质量指数(lower limb muscle mass index,LLMMI).应用单因素Logistic回归分析,对其与老年癌患者衰弱之间的关联性进行分析;并进行多因素Logistic回归分析,了解其是否为老年胃癌患者衰弱的独立影响因素,并绘制ROC曲线,评估其对老年胃癌患者发生衰弱的预测价值.结果 ①96 例老年胃癌患者发生衰弱 38 例,发生率为 39.58%.②衰弱组胃癌患者年龄、肿瘤的临床分期均高于非衰弱组(均P<0.05);③衰弱组患者体脂肪含量和体脂百分比高于非衰弱组,FFMI、MMI、LLMMI明显低于非衰弱组(均P<0.05).④一般资料中年龄、肿瘤的分期Ⅲ期与Ⅳ期相对于分期Ⅰ期与老年胃癌患者发生衰弱存在着关联;人体成分中FFMI、MMI、LLMMI与老年胃癌患者衰弱呈负相关,体脂肪含量、体脂百分比与老年胃癌患者衰弱呈正相关.⑤校正年龄、肿瘤的临床分期后 FFMI、MMI、LLMMI、体脂肪含量、体脂百分比是老年胃癌患者发生衰弱的独立影响因素.⑥ROC曲线结果显示,FFMI、MMI、LLMMI、体脂肪含量、体脂百分比的曲线下面积AUC分别为 0.701、0.645、0.655、0.607、0.632.上述指标联合的曲线下面积AUC为 0.833.结论 老年胃癌患者中衰弱检出率较高.人体成分中的各独立组成部分联合诊断老年胃癌患者衰弱有一定的预测价值,能筛选出易发生衰弱的高危人群,为关注老年胃癌患者发生衰弱提供理论依据.
Correlation between frailty and body composition in elderly patients with gastric cancer
Objective To investigate the correlation between frailty and body composition among elderly patients with gastric cancer,so as to evaluate the efficacy of body composition metrics in forecasting frailty among this demographic.Methods Ninety-six elderly patients with gastric cancer underwent pathological diagnosis at the Affiliated Hospital of Weifang Medical University between September 2021 and August 2023.Utilizing the Fried frailty phenotype(FP),these patients were categorized into either the frailty group or the non-frailty group.Demographic data including age,sex,smoking history,alcohol consumption history,cancer location,cancer stage,body mass index(BMI),body fat content,and body fat percentage were collected for both groups of patients.The fat-free mass index(FFMI),muscle mass index(MMI),upper limb muscle mass index(ULMMI),and lower limb muscle mass index(LLMMI)were computed using the collected data.Univariate Logistic regression analysis was conducted to examine the relationship be-tween these indices and frailty among elderly cancer patients.Subsequently,multivariate Logistic regression analysis was employed to determine if these indices served as independent factors influencing frailty in elderly cancer patients.Addi-tionally,a ROC curve was constructed to assess the predictive capability of these indices for frailty in elderly patients with gastric cancer.Results ①A total of 96 elderly patients with gastric cancer were included.The incidence of frailty in elderly patients with gastric cancer was 39.58%.②The age and clinical stage of gastric cancer in the frailty group were higher than those of the non-fraity group(all P<0.05).③Body fat content and body fat percentage in the frailty group were higher than those in the non-frailty group,and FFMI,MMI,and LLMMI were significantly lower than those in the non-frailty group(all P<0.05).④Comparison of general data between the two groups revealed that age and clinical stages 3 and 4 of the tumor were associated with the occurrence of frailty in elderly patients with gastric cancer compared to clinical stage 1.Regarding the comparison of body composition between the two groups,FFMI,MMI,and LLMM were inversely correlated with frailty in elderly patients with gastric cancer,while body fat content and body fat percentage showed a positive correlation with frailty in this demographic.⑤After adjusting for age and cancer clinical stage,FFMI,MMI,LLMMI,body fat content,and body fat percentage emerged as independent predictors of frailty in elderly patients with gastric cancer.⑥The ROC curve analysis revealed that the AUC values for FFMI,MMI,LLMMI,body fat content,and body fat percentage were 0.701,0.645,0.655,0.607,and 0.632,respectively.The combined AUC for all these indicators was calculated to be 0.833.Conclusion The detection rate of frailty among elderly patients with gastric cancer is notably high.The amalgamation of independent components within the human body composition holds significant predictive value in diagnosing frailty in this demographic.This approach aids in identifying high-risk groups vulnerable to frailty,thereby offering a theoretical foundation for prioritizing attention to frailty among elderly patients with gastric cancer.
ElderlyGastric cancerFrailtyHuman body compositionRisk factor
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