目的 探讨生物电阻抗相位角(PA)在结直肠癌新发病例营养评估中的应用价值,分析PA与营养风险、人体成分及营养生化指标的相关性。方法 选取2021年6月至2025年6月251例结直肠癌新发病例,按照性别分组,根据相位角值(男性PA < 5°,女性PA < 4.6°,)将其分为低PA组(n=23)和正常PA组(n=228)。比较两组患者的营养风险筛查2002(NRS 2002)评分、患者参与的主观全面评定(PG-SGA)评估、人体成分指标[如体质指数(BMI)、身体细胞量(BCM)、去脂体重(FFM)、骨骼肌质量(SMM)]及营养相关血清学指标(白蛋白、前白蛋白、血红蛋白等)。结果 与正常PA组相比,低PA组患者的营养风险发生率更高(P<0.05),重度营养不良发生率更高(P<0.05)。在血清学指标上,低PA组患者的前白蛋白、白蛋白、血红蛋白水平较正常PA组患者显著降低(P<0.05)。在人体成分方面,低PA组的BMI、BMC、FFM、SMM等指标均显著低于正常PA组(P<0.05)。多因素Logistic回归分析显示,年龄、NRS 2002评分,PG-SGA评分及前白蛋白及血红蛋白水平是相位角的独立影响因素(P<0.05)。结论 低PA与结直肠癌新发病例更高的营养风险、更严重的营养不良状况、显著的肌肉减少及更差的营养指标密切相关。PA可作为结直肠癌新发病例营养状况评估和临床预后预测的有效辅助工具。
Abstract
Objective To evaluate the application value of bioelectrical impedance phase angle in assessing nutritional status and to analyze the correlation between low phase angle and nutritional risk, body composition, and serum nutritional indicators in newly diagnosed colorectal cancer patients. Method A total of 251 newly diagnosed colorectal cancer patients were enrolled and stratified by gender. According to phase angle cutoff values (male < 5°, female < 4.6°), patients were divided into a low phase angle group (n=23) and a normal phase angle group (n=228). Nutritional risk screening 2002 (NRS 2002) score, patient-generated subjective global assessment (PG-SGA) score, body composition parameters (including body mass index, fat-free mass, skeletal muscle mass index, etc.), and serum nutritional indicators (albumin, prealbumin, hemoglobin, etc.) were collected and compared between the two groups. Result Compared with the normal phase angle group, the low phase angle group showed a significantly higher prevalence of nutritional risk (P < 0.05) and significantly elevated PG-SGA scores (P < 0.05). Regarding body composition, parameters such as body mass index, body cell mass, fat-free mass, and skeletal muscle mass were significantly lower in the low phase angle group (P < 0.05). Serum levels of prealbumin, albumin, and hemoglobin were also significantly reduced in the low phase angle group (P < 0.05). Logistic regression analysis showed that younger age, lower patient-generated subjective global assessment score, and higher levels of prealbumin and hemoglobin were protective factors for normal phase angle (P < 0.05). Conclusion Low phase angle is closely associated with higher nutritional risk, more severe malnutrition, significant muscle depletion, and poorer serum nutritional indicators in newly diagnosed colorectal cancer patients. Phase angle can serve as a useful, non-invasive, and objective adjunct tool for nutritional assessment and clinical prognosis prediction in this population.
关键词
结直肠癌 /
相位角 /
营养评估 /
营养不良 /
生物电阻抗 /
人体成分 /
新发病例 /
预后
Key words
Colorectal cancer /
Phase angle /
Nutritional assessment /
Malnutrition /
Bioelectrical impedance /
Body composition /
Newly diagnosed cases /
Prognosis
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