Handgrip Strength Measure Improves Malnutrition Diagnosis in CRC With Overweight 

A study published in the Journal of Gastroenterology and Hepatology found that the Global Leadership Initiative on Malnutrition (GLIM) criteria combined with handgrip strength (HGS) was effective at diagnosing malnutrition among patients with colorectal cancer (CRC) who were overweight.

GLIM criteria are commonly used to assess for malnutrition in hospitalized patients with malignant tumors; however, malnutrition is often overlooked in patients who are overweight, despite its frequent occurrence in those with CRC.

Therefore, researchers investigated whether combining the GLIM criteria with HGS (HGS-GLIM) was effective in assessing for malnutrition in hospitalized overweight patients with CRC after resection.

This retrospective study was part of a prospective study (ChiCTR Identifier: ChiCTR2200057818) conducted between 2015 and 2021 at 2 sites in China. 

Patients (N=850) who underwent radical surgery for CRC and had a BMI of 23 kg/m² or higher. The patients were median age 64 years, 65.6% were men, median BMI was 25.12 kg/m², 21.6% had a Charlson comorbidity index 2 or higher, and 58.2% had colon cancer. GLIM criteria were used to assess for malnutrition, skeletal muscle index was used to assess skeletal muscle mass, and HGS was used to assess skeletal muscle function.

A total of 105 patients screened positive for malnutrition using the GLIM criteria alone and 54 screened positive using GLIM criteria plus HGS.

Using the GLIM criteria alone, patients with malnutrition had more total complications, medical complications, laparoscopic operations, combined organ resections, and greater healthcare costs (all P ≤.016) but did not differ for survival outcomes compared with patients without malnutrition.

Using HGS-GLIM, the group with malnutrition had more total complications and medical complications (both P ≤.001) and worse overall (P =.028) and disease-free (P =.018) survival compared with patients without malnutrition.

In multivariate analyses, HGS-GLIM malnutrition was associated with total complications (odds ratio, 1.835; P =.046), overall survival (hazard ratio [HR], 1.552; P =.037), and disease-free survival (HR, 1.543; P =.047) outcomes.

Additional independent risk factors included age (65 years and older; P <.001), American Society of Anesthesiologists grade (III; P =.001) for total complications; and age and TNM stage (III or worse) for overall (P =.034) and disease-free (P =.016) survival.

The use of HGS in malnutrition assessments may be a limitation, as it does not indicate cause of malnutrition. However, “HGS measurement is a more sensitive indicator of malnutrition compared with other standardized physical performance tests. Furthermore, HGS test is useful for evaluating physical function and overall health in various populations, including overweight and obese individuals.”

The study authors concluded that combining the GLIM criteria with HGS improved the diagnosis of malnutrition in overweight patients with CRC hospitalized after surgical resection.