Grip-Strength-Lean-Mass Index (GSLMI) as a valuable tool for sarcopenia diagnosis and survival prognosis in cancer patients: a nationwide multicenter cohort study

J Nutr Health Aging. 2025 Jan;29(1):100409. doi: 10.1016/j.jnha.2024.100409. Epub 2024 Nov 11.

Abstract

Objectives: To identify whether the Grip-Strength-Lean-Mass Index (GSLMI) can precisely diagnose sarcopenia and predict prognosis for cancer patients in clinical settings.

Design: A nationwide multicenter cohort study.

Setting and participants: 8,831 inpatients aged 18 years and older, histologically diagnosed with cancer and receiving anti-cancer therapy.

Measurements: The GSLMI is the ratio of hand grip strength (HGS) divided by lean mass (LM), calculated by the formula: GSLMI = HGS (kg) / LM (kg). Kaplan-Meier curves and Cox models were used to estimate the association between the GSLMI and survival.

Results: A total of 3,071 (48.40%) male and 3,274 (51.60%) female patients were enrolled in the study. The prevalence of GLIS-defined sarcopenia was 2,646 (41.70%). The optimal sex-specific thresholds with the best diagnostic performance to identify a low GSLMI were determined to be <0.61 for males and <0.47 for females based on the ROC curves. According to Kaplan-Meier curves, patients with a high GSLMI exhibited better overall survival than those with a low GSLMI (HR = 0.664, 95%CI = 0.604-0.729, log-rank P < 0.001). Multivariable survival analysis revealed that the GSLMI showed an independent association with a lower hazard of death as a continuous variable (HR = 0.70, 95% CI = 0.51-0.96).

Conclusions: The GSLMI may serve as a novel diagnostic tool for identifying sarcopenia and may have prognostic value for cancer patients. Using the GSLMI represents a feasible and promising option for better managing the health of patients with cancer.

Keywords: Cancer; Hand grip strength; Lean mass; Mortality; Sarcopenia.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Body Composition
  • Body Mass Index
  • Cohort Studies
  • Female
  • Hand Strength*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms* / complications
  • Neoplasms* / mortality
  • Prevalence
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Sarcopenia* / diagnosis
  • Sarcopenia* / mortality