Sex differences in the scored Patient-Generated Subjective Global Assessment in 19,528 cancer patients

• Published in: Journal of nutritional oncology Vol. 8; no. 1; pp. 38 - 46
• Main Authors: Wang, Yan-Li, Wu, Tian-Tian, Fu, Zhen-Ming, Guo, Zeng-Qing, Lin, Yuan, Shi, Ying-Ying, Hu, Wen, Ba, Yi, Li, Su-Yi, Li, Zeng-Ning, Wang, Kun-Hua, Wu, Jing, He, Ying, Yang, Jia-Jun, Xie, Cong-Hua, Zhou, Fu-Xiang, Song, Xin-Xia, Chen, Gong-Yan, Ma, Wen-Jun, Luo, Su-Xia, Chen, Zi-Hua, Cong, Ming-Hua, Ma, Hu, Zhou, Chun-Ling, Wang, Wei, Luo, Qi, Shi, Yong-Mei, Qi, Yu-Mei, Jiang, Hai-Ping, Guan, Wen-Xian, Chen, Jun-Qiang, Chen, Jia-Xin, Fang, Yu, Zhou, Lan, Feng, Yong-Dong, Tan, Rong-Shao, Li, Tao, Ou, Jun-Wen, Zhao, Qing-Chuan, Wu, Jian-Xiong, Lin, Xin, Yang, Liu-Qing, Zhang, Qi, Jia, Ping-Ping, Li, Wei, Xu, Hong-Xia, Shi, Han-Ping, Song, Chun-Hua
• Format: Journal Article
• Language: English
• Published: Lippincott Williams & Wilkins 01.03.2023; Department of Epidemiology and Statistics,College of Public Health,Zhengzhou University,Zhengzhou,Henan,China%Cancer Center,Renmin Hospital of Wuhan University,Wuhan,Hubei China%Department of Medical Oncology,Fujian Cancer Hospital,Fujian Medical University Cancer Hospital Fuzhou,Fujian,China%Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Guangxi Medical University,Nanning,Guangxi,China%Department of Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,China%Department of Clinical Nutriton,West China Hospital of Sichuan University,Chengdu,Sichuan,China%Department of Gastrointestinal Oncology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin,China%Department of Nutrition and Metabolism of Oncology,Affiliated Provincial Hospital of Anhui Medical University,Hefev,Anhui,China%Department of Clinical Nutrition,The First Hospital of Hebei Medical University,Shijiazhuang,Hebei,China%Department of Gastrointestinal Surgery,Institute of Gastroenterology,The First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan,China%Zhongshan Chenxnghai Hospital(Affiliated Zhongshan Chenxinghai Hospital of Guangdong Medical University),Zhongshan,Guangdong,China; Department of Clinical Nutrition,The First People's Hospital of Kashi,Kashi,Xinjiang,China%Department of Clinical Nutrition,Chongqing General Hospital,Chongqing,China%Department of Colorectal and Anal Surgery,Huizhou Municipal Central Hospital,Huizhou,Guangdong,China%Department of Radiation and Medical Oncology,Zhongnan Hospital of Wuhan University,Wuhan,Hubei,China%Department of Oncology,Xingtai People's Hospital,HebeiMedical University,Xingtai,Hebei China%The First Department of the Tumor Hospital of Harbin Medical University,Harbin,Heilongfang,China%Department of Nutrition,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,China%Department of Oncology,Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital,Zhengzhou,Henan,China%Department of General Surgery,Xiangya Hospital,Central South University,Changsha,Hunan,China%Comprehensive Oncology Department,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing,China%Department of Oncology,Affiliiated Hospital of Zunyi Medical University,Zunyi,Guizhou,China%The Fourth Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,China%Cancer center,The First People's Hospital of Foshan,Foshan,Guangdong,China%Department of Gastrointestinal Tumor Surgery,The First Affiliated Hospital,Xiamen University,Xiamen,Fujian,China%Department of Nutrition,Rujin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China%Department of Nutrition,Tianjin Third Central Hospital,Tianjin,China%Department of Surgery,The First Affiliated Hospital of Jinan University,Guangzhou,Guangdong,China%Department of General Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,China%Department of Gastrointestinal Surgery,First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China%Department of Radiation and Medical Oncology,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi China%Department of Clinical Nutrition,Peking University Cancer Hospital and Institute,Beijing,China%Department of Nutrition,Third Affiliated Hospital of Kunming Medical College,Tumor Hospital of Yunnan Province,Kunming,Yunnan,China%Department of Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,China%Department of Nutrition,Guangzhou Red Cross Hospital,Guangzhou,Guangdong,China%Department of Radiotherapy,Sichuan Cancer Hospital and Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan,China%Department of Clinical Nutrition,Clifford Hospital,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong,China%Department of Digestive Diseases,Xijing Hospital,Fourth Military Medical University,Xi'an,Shanxi,China%Department of Hepatobiliary Surgery,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China%Department of Clinical Nutrition,Daping Hospital Army Medical University,Chongqing,China%Department of Gastrointestinal Surgery/Clinical Nutrition,Beijing Shijitan Hospital,Capital Medical University,Beijing,China%Cancer Center of the First Hospital of Jilin University,Changchun,Jilin,China
• Subjects: Sex differences; Cancer patients; TCGA database; Malnutrition; PG-SGA
• ISSN: 2096-2746; 2834-5371
• DOI: 10.1097/JN9.0000000000000002

Abstract Background The scored Patient-Generated Subjective Global Assessment (PG-SGA) has been widely used to assess the nutritional status of cancer patients. The purpose of this study is to compare the differences in PG-SGA scores and the 7 domain scores of the PG-SGA in male and female cancer patients. Methods This study was conducted at 72 hospitals from July 2013 to December 2018, a part of the Investigation on Nutritional Status and its Clinical Outcomes of Common Cancers. The PG-SGA was recorded to evaluate the nutritional status of patients. A total of 19,528 patients with 13 common malignancies were included in this study. Student t test and the χ2 test were applied to analyze the sex differences in the 7 domain scores. The Cancer Genome Atlas (TCGA) database was used to analyze the expression levels of symptom-related genes. Results There were significant sex differences in the PG-SGA (P = 0.032), notably in patients with gastric cancer (male vs female: 9.09 ± 4.86 vs 9.58 ± 5.07, P = 0.005) and esophageal cancer (9.64 ± 4.90 vs 10.46 ± 4.96, P = 0.011) and the average total PG-SGA of female patients was slightly higher than that of male patients (7.64 ± 4.98 vs 7.77 ± 5.14). The differences were mainly related to the weight, eating, symptom, as well as activity and physical function scores in the stratified analysis. Possible causes of the sex differences were the rates of nausea, vomiting, dry mouth, and other symptoms, in both gastric and esophageal cancer patients. Analysis of the TCGA database suggested that most of the related genes were sex neutral, except for genes related to dysphagia in gastric cancer (VEGFC was higher in female patients, VEGFA and VEGFB higher in male patients). Conclusions There are sex differences in the PG-SGA scores in patients with various tumor types (female patients generally had higher scores than male patients), with differences mainly in the weight, eating, symptom, as well as activity and physical function scores. The sex differences in PG-SGA scores might be due to the differences in the clinical manifestations of the disease, and further studies should be carried out to investigate other factors influencing the PG-SGA scores in cancer patients. This study provides basic data supporting the individualized nutritional treatment of cancer patients in clinical practice.