Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis
Objectives: Low skeletal muscle index (SMI) and radiodensity (SMD) are established prognostic indicators in cancer. This study investigated risk factors for low and decreasing SMI and low SMD in upper gastrointestinal cancer and examined the influence of malnutrition risk on the association between...
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Elsevier
2025-09-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770725001484 |
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| author | Lauren Hanna Kay Nguo Judi Porter Daniel Croagh Catherine E Huggins |
| author_facet | Lauren Hanna Kay Nguo Judi Porter Daniel Croagh Catherine E Huggins |
| author_sort | Lauren Hanna |
| collection | DOAJ |
| description | Objectives: Low skeletal muscle index (SMI) and radiodensity (SMD) are established prognostic indicators in cancer. This study investigated risk factors for low and decreasing SMI and low SMD in upper gastrointestinal cancer and examined the influence of malnutrition risk on the association between SMI and health-related quality of life (HRQOL). Design: Longitudinal analysis of randomised controlled trial outcome data. Setting: Three health services in Victoria, Australia. Participants: Adults newly diagnosed with oesophageal, gastric or pancreatic cancer. Measurements: Outcomes assessed at diagnosis, and three- and six-month follow-up. SMI and SMD were assessed via computed tomography imaging analysis, with low values determined using established sex-specific thresholds. Malnutrition risk was assessed using the Patient Generated Subjective Global Assessment (Short Form), and HRQOL with the EORTC QLQ-C30. Multiple logistic regression identified risk factors for low SMI and low SMD at baseline, and SMI decline (≥5%) from baseline to 3 months. Associations between SMI and HRQOL were examined using multiple linear regression, adjusting for malnutrition risk. Results: Among 105 participants (43% oesophageal, 20% gastric, 37% pancreatic cancer), older age predicted low SMI and low SMD. Low SMI risk was higher in females and lower with higher BMI. At three months, 57% (37/65) experienced ≥5% SMI loss, associated with higher malnutrition risk, higher baseline SMI, and post-diagnosis weight loss. Malnutrition risk was a strong independent predictor of poorer HRQOL score at all timepoints. Lower or decreasing SMI (≥5%) was also independently associated with poorer HRQOL on some scales. Conclusion: Malnutrition risk independently predicted lower HRQOL and muscle loss, and may confound the relationship between SMI and HRQOL. As a modifiable factor, addressing malnutrition risk could improve HROQL and preserve muscle in upper gastrointestinal cancer. Trial registration: Australian New Zealand Clinical Trials Registry, 27 January 2017 (12617000152325). |
| format | Article |
| id | doaj-art-f5ad92cc2cc34f50a8712c46c78e41e9 |
| institution | Matheson Library |
| issn | 1760-4788 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-f5ad92cc2cc34f50a8712c46c78e41e92025-07-03T04:39:36ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-09-01299100623Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysisLauren Hanna0Kay Nguo1Judi Porter2Daniel Croagh3Catherine E Huggins4Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia; Department of Nutrition and Dietetics, Monash Health, Monash Medical Centre, Clayton, Victoria, Australia; Corresponding author.Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, AustraliaDepartment of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, AustraliaDepartment of Surgery, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia; Department of Upper Gastrointestinal Surgery, Monash Health, Clayton, Victoria, AustraliaDepartment of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia; Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Clayton, Victoria, AustraliaObjectives: Low skeletal muscle index (SMI) and radiodensity (SMD) are established prognostic indicators in cancer. This study investigated risk factors for low and decreasing SMI and low SMD in upper gastrointestinal cancer and examined the influence of malnutrition risk on the association between SMI and health-related quality of life (HRQOL). Design: Longitudinal analysis of randomised controlled trial outcome data. Setting: Three health services in Victoria, Australia. Participants: Adults newly diagnosed with oesophageal, gastric or pancreatic cancer. Measurements: Outcomes assessed at diagnosis, and three- and six-month follow-up. SMI and SMD were assessed via computed tomography imaging analysis, with low values determined using established sex-specific thresholds. Malnutrition risk was assessed using the Patient Generated Subjective Global Assessment (Short Form), and HRQOL with the EORTC QLQ-C30. Multiple logistic regression identified risk factors for low SMI and low SMD at baseline, and SMI decline (≥5%) from baseline to 3 months. Associations between SMI and HRQOL were examined using multiple linear regression, adjusting for malnutrition risk. Results: Among 105 participants (43% oesophageal, 20% gastric, 37% pancreatic cancer), older age predicted low SMI and low SMD. Low SMI risk was higher in females and lower with higher BMI. At three months, 57% (37/65) experienced ≥5% SMI loss, associated with higher malnutrition risk, higher baseline SMI, and post-diagnosis weight loss. Malnutrition risk was a strong independent predictor of poorer HRQOL score at all timepoints. Lower or decreasing SMI (≥5%) was also independently associated with poorer HRQOL on some scales. Conclusion: Malnutrition risk independently predicted lower HRQOL and muscle loss, and may confound the relationship between SMI and HRQOL. As a modifiable factor, addressing malnutrition risk could improve HROQL and preserve muscle in upper gastrointestinal cancer. Trial registration: Australian New Zealand Clinical Trials Registry, 27 January 2017 (12617000152325).http://www.sciencedirect.com/science/article/pii/S1279770725001484Skeletal muscle indexLow muscle massSarcopeniaHealth-related quality of lifeEORTC QLQ-C30PG-SGA |
| spellingShingle | Lauren Hanna Kay Nguo Judi Porter Daniel Croagh Catherine E Huggins Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis The Journal of Nutrition, Health and Aging Skeletal muscle index Low muscle mass Sarcopenia Health-related quality of life EORTC QLQ-C30 PG-SGA |
| title | Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis |
| title_full | Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis |
| title_fullStr | Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis |
| title_full_unstemmed | Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis |
| title_short | Malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis: A longitudinal analysis |
| title_sort | malnutrition risk as a predictor of quality of life and skeletal muscle depletion following upper gastrointestinal cancer diagnosis a longitudinal analysis |
| topic | Skeletal muscle index Low muscle mass Sarcopenia Health-related quality of life EORTC QLQ-C30 PG-SGA |
| url | http://www.sciencedirect.com/science/article/pii/S1279770725001484 |
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