Avaliação da massa muscular em pacientes com câncer avançado com base nos critérios GLIM: o papel das medidas antropométricas

Abstract

Malnutrition is highly prevalent among cancer patients, especially those in advanced stages of the disease. It is estimated that between 10% and 20% of deaths in this population are directly attributable to malnutrition rather than cancer progression itself. Additionally, malnutrition is associated with several complications, such as sarcopenia and cancer cachexia, which contribute to a poorer prognosis. To standardize its diagnosis, the Global Leadership Initiative on Malnutrition (GLIM) criteria were proposed, requiring the identification of at least one phenotypic and one etiologic criterion following nutritional risk screening. Reduced muscle mass is one of the phenotypic criteria and is commonly assessed using body composition methods such as bioelectrical impedance analysis, magnetic resonance imaging, or computed tomography. Although accurate, these techniques are costly and often inaccessible in clinical practice. In this context, the present study aimed to compare simple anthropometric measures, such as Calf Circumference (CC) and Mid-Upper Arm Muscle Circumference (MUAMC), as estimates of muscle mass in cancer patients, with the Appendicular Skeletal Muscle Mass Index (ASMI) in terms of their ability to diagnose malnutrition based on the GLIM criteria. The study included 76 patients with advanced cancer receiving outpatient care at the Hospital de Clínicas of the Federal University of Uberlândia. The results showed high agreement between the anthropometric measures and ASMI, with kappa values of κ = 1.000 for MUAMC and κ = 0.877 for CC. These findings suggest that such simple measures are accessible and effective alternatives for diagnosing malnutrition associated with muscle mass loss.