亚洲恶病质工作组（AWGC）将于2023年提出第一份关于亚洲人恶病质诊断标准的共识报告。然而，目前的共识缺乏队列证据来验证其有效性和实用性。我们旨在通过对中国常见癌症营养状况及其临床结果调查（INSCOC）项目进行回顾性事后横断面分析，探讨 AWGC2023 标准对预测癌症患者预后和医疗负担的价值。进行 Cox 回归分析以评估恶病质与长期生存之间的独立关联。我们利用 C 反应蛋白 (CRP)、中性粒细胞与淋巴细胞比值 (NLR)、炎症负荷指数 (IBI)、白蛋白 (ALB) 和格拉斯哥预后评分 (GPS) 作为恶病质的诊断标志物，将其指定为基于 CRP 的指标分别是基于 NLR 的恶病质、基于 IBI 的恶病质、基于 ALB 的恶病质和基于 GPS 的恶病质。此外，我们分别使用体重指数 (BMI) 临界值 18.5、20、21 和 22 kg/m2 诊断恶病质，随后通过 Harrell 一致性指数（C 指数）比较其预后预测值。采用Logistic回归模型评估恶病质与医疗负担之间的关联。本研究共有5426名癌症患者入组。 Cox 回归分析证实，基于 AWGC2023 标准的恶病质是癌症患者长期生存的独立预测因子。恶病质患者的长期生存率明显低于无恶病质患者（66.4% vs. 49.7%，P < 0.001）。基于炎症生物标志物的恶病质是癌症患者预后的独立预测因子，基于炎症负荷指数（IBI）的恶病质表现出最佳的预后辨别能力。 C 指数表明，基于 BMI 截止值 18.5、20 和 22 kg/m2 的恶病质表现不如 BMI 截止值 21 kg/m2。逻辑回归模型显示，使用 AWGC2023 标准，与无恶病质患者相比，恶病质患者的长期住院风险高出 16.6%，高医疗费用风险高出 16.0%。 AWGC2023 标准是预测生存和医疗负担的宝贵工具中国癌症患者中。 AWGC2023 标准鼓励在其他亚洲人群中进行进一步验证。© 2024 作者。 《恶病质、肌肉减少症和肌肉杂志》由 Wiley periodicals LLC 出版。

The Asian Working Group for Cachexia (AWGC) proposed the first consensus report on diagnostic criteria for cachexia in Asians in 2023. However, the current consensus lacks cohort evidence to validate its effectiveness and practicality. We aimed to explore the value of the AWGC2023 criteria for predicting the prognosis and medical burden of patients with cancer through a retrospective post hoc cross-sectional analysis of the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC) project in China.Cox regression analyses were performed to assess the independent association between cachexia and long-term survival. We utilized C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), inflammatory burden index (IBI), albumin (ALB) and Glasgow prognostic score (GPS) as diagnostic markers for cachexia, designating them as CRP-based cachexia, NLR-based cachexia, IBI-based cachexia, ALB-based cachexia and GPS-based cachexia, respectively. Additionally, we diagnosed cachexia using body mass index (BMI) cutoff values of 18.5, 20, 21 and 22 kg/m2, respectively, and subsequently compared their prognostic predictive value through Harrell's concordance index (C-index). Logistic regression models were used to assess the association between cachexia and medical burden.A total of 5426 patients with cancer were enrolled in this study. Cox regression analysis confirmed that cachexia based on the AWGC2023 criteria was an independent predictor of long-term survival in patients with cancer. Patients with cachexia had significantly poorer long-term survival than patients without cachexia (66.4% vs. 49.7%, P < 0.001). Inflammatory biomarker-based cachexia was as an independent predictor of prognosis in patients with cancer, with inflammatory burden index (IBI)-based cachexia demonstrating the optimal prognostic discriminatory ability. The C-index indicated that cachexia based on BMI cutoff values of 18.5, 20, and 22 kg/m2 did not perform as well as a BMI cutoff value of 21 kg/m2. Logistic regression models revealed that using the AWGC2023 criteria, patients with cachexia had a 16.6% higher risk of prolonged hospitalization and a 16.0% higher risk of high medical expenses than patients without cachexia.The AWGC2023 criteria represent a valuable tool for predicting survival and medical burden among Chinese patients with cancer. Encouragement for further validation in other Asian populations is warranted for the AWGC2023 criteria.© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.