Abstract

Background: The objective assessment of phenotypic criteria for malnutrition requires tools which may be inaccessible to clinicians managing head and neck cancer (HNC) patients. The aim of this study was to measure the prevalence of malnutrition using Global Leadership Initiative on Malnutrition (GLIM) criteria, and evaluate the mid-upper arm circumference (MUAC) and quadriceps muscle layer thickness (QMLT) as a surrogate measure of fat free mass index (FFMI).

Methods: Fifty consecutive HNC patients were recruited in a cross-sectional study over a period of 18 months. QMLTwas measured at three points using linear mode ultrasound. FFMIwas determined using body impedance analysis. Blood samples were taken for serum albumin and C-reactive protein.

Results: The prevalence of malnutrition among HNC patients was 50.0%. MUAC was significantly correlated with FFMI, while QMLT significantly correlated with serum albumin (p < 0.05). The area under the curve of the MUAC measures obtained through the receiver operating characteristics was 0.9924, which was statistically significant (p < 0.001). Youden index revealed an optimal statistically derived MUAC cut-off of 23.5cm (YI = 0.78; specificity 96; sensitivity 72) for detecting an abnormally lowFFMI.

Conclusions: MUAC is superior to QMLT as a surrogate measure of FFMI. MUAC is a potentially useful phenotypic criteria for malnutrition in HNC.