The feasibility of substituting handgrip strength for muscle mass as one of the constituent standards in the Global Leadership Initiative on Malnutrition to diagnose malnutrition in patients with gastrointestinal cancers

Abstract Purpose This study aims to determine the feasibility of substituting handgrip strength (HGS) for muscle mass as one of the constituents in the Global Leadership Initiative on Malnutrition (GLIM) to diagnose malnourished patients with gastrointestinal cancer. Methods A total of 2209 patients diagnosed with gastrointestinal cancer were included in our study from two centers. All patients were evaluated for nutritional risk using Nutritional Risk Screening 2002 (NRS 2002) within 24 hours of admission. The GLIM consensus was then used to diagnose malnourished patients. The evaluation of muscle mass as one of the constituents contained in GLIM consensus was measured by computed tomography presented as skeletal muscle index (SMI) and HGS respectively. Consistency test was carried out to evaluated the diagnostic value of SMI and HGS. Results There were 1042 (47.20%) cases of gastric cancer and 1167 (52.80%) cases of colorectal cancer. Among them including 768 (34.80%) patients at nutritional risk. Further, 603 (27.30%) patients and 593 (26.80%) patients were diagnosed with malnutrition in the GLIM (SMI) group and the GLIM (HGS) group, respectively, and 544 (24.60%) patients in the two groups overlapped. The consistency test results showed that the κ value in the GLIM(HGS) group compared with the GLIM(SMI) group was 0.881 (P Conclusion HGS can substitute muscle mass as one of the constituents in the diagnostic criteria of GLIM in patients with gastrointestinal cancer.