Prognostic value of anthropometric- and Biochemistry-based nutrition status indices on blood chemistry panel levels during cancer treatment

Body weight, body mass index (BMI), nutrition risk screening 2002 (NRS2002) and prognostic nutritional index (PNI) are among vital nutrition status indices employed during cancer treatment. These have also been associated with the levels of blood chemistry panels (BCPs), which are touted as significant indicators of disease prognosis. However, it remains unclear which nutrition status index better predict future trends in specific BCPs. Using records of 407 cancer patients, we retrospectively examined the potential of nutritional status indices at baseline for predicting changes in specific BCPs over a 6-week period. Generally, both serum biochemical parameters and nutrition status indices among the study participants fluctuated over the study period. PNI was often linearly associated with blood cell counts (WBC and hemoglobin) compared to anthropometric-based nutrition status indices. Increases in weight was protective against having abnormal lymphocyte levels at 6 weeks (OR: 0.960 - 0.974, CI: 0.935 - 0.997, P < 0.05) while increases in baseline PNI was associated with 0.865 - 0.941 and 0.675 - 0.915 odds of having future abnormal WBC and lymphocyte levels, respectively. Increases in PNI was also protective against (0.734 - 0.886 times) having future abnormal albumin levels and 8.5 - 12.5% decreases in the odds of having abnormal C-reactive protein level in subsequent visits. Changes in NRS2002 tended to predict the odds of having future abnormal blood glucose levels. In conclusion, serum biochemistry-derived nutrition status index PNI, is a more consistent measure as an early indicator to track the trend of future changes in BCPs among cancer patients. This implies that PNI could be targeted as an early warning measure with relevant preventive interventions for patients at risk of malnutrition.