相位角对肿瘤患者营养不良的影响及其预测价值

The effect of phase angle on malnutrition in patients with cancer and the predictive value

目的:研究相位角与肿瘤患者营养不良的关系,探讨相位角对肿瘤患者营养不良的预测价值。方法:选取2022年1月至2023年3月在成都市某三甲医院肿瘤科的622例住院肿瘤患者为研究对象,于入院后48小时内测量其人体成分,采用患者主观整体评估量表(PG-SGA)评估患者营养不良。使用t检验或卡方检验比较营养不良组和营养良好组基本信息和营养指标的差异,采用二分类Logistic回归方法分析相位角与营养不良的关系,受试者工作特征曲线法探讨相位角预测肿瘤患者营养不良的截断值。结果:研究对象平均相位角为(5.04±1.00)°,61.4%(382/622)的肿瘤患者为营养不良。营养不良组相位角、体质量指数、白蛋白、前白蛋白、去脂体重、基础代谢率均低于营养良好组,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示相位角是肿瘤患者患营养不良的保护因素(OR=0.471,95%CI:0.359~0.619)。以PG-SGA≥2分作为营养不良的金标准作受试者工作特征曲线图,结果表明相位角预测营养不良的截断值是4.75°。结论:相位角与肿瘤患者营养不良发生风险有关,可作为营养不良的客观预测指标。相位角低于4.75°的肿瘤患者发生营养不良的风险更高。

Objective:To evaluate the association between phase angle and the malnutrition in patients with cancer and explore the predictive value.Methods:A total of 622 patients with cancer in the oncology department of a grade A tertiary hospital in Chengdu were selected from January 2022 to March 2023.Body composition was measured within 48 hours after admission.Patient Generated Subjective Global Assessment(PG-SGA)was used to evaluate the malnutrition of patients.The t test andχ^(2) test were used to compare the difference of basic information and nutritional indicators between the malnutrition group and well-nourished group.Logistic regression model was used to analyze the association between phase angle and the malnutrition in patients with cancer.Receiver operating characteristic curves were estimated to determine the optimal cut-off level of phase angle for predicting malnutrition in patients with cancer.Results:The average phase angle was(5.04±1.00)°,and 61.4%(382/622)patients were malnourished.The phase angle,body mass index,albumin,prealbumin,fat free mass and basal metabolic rate in malnutrition group were lower than those in well-nourished group,and the differences were statistically significant(P<0.05).Logistic regression analysis results showed that phase angle was a protective factor for malnutrition in patients with cancer(OR=0.471,95%CI:0.359~0.619).Using PG-SGA≥2 scores as the gold standard of malnutrition,the receiver operating characteristic curve showed that the cut-off value of phase angle for predicting malnutrition was 4.75°.Conclusion:The phase angle is related to the risk of malnutrition in patients with cancer and it can be used as an objective predictor of malnutrition.Patients with phase angle lower than 4.75°have a higher risk of malnutrition.