营养不良、肌肉减少症和虚弱虽然是相互关联的，但它们是与成人癌症患者不良结局相关的独特病症，但它们是否与影响高达 90% 癌症患者的多重发病率有关尚不清楚。这项研究调查了来自英国生物银行的成人癌症患者的多重发病率与营养不良、肌肉减少症和虚弱之间的关系。这是一项横断面研究，包括 4122 名癌症成人（平均 [SD] 年龄 59.8 [7.1] 岁，50.7% 女性） 。营养不良是使用全球营养不良领导力倡议标准来确定的。可能的肌肉减少症和肌肉减少症是使用欧洲老年人肌肉减少症工作组 2 标准定义的。使用 Fried 衰弱标准来确定（前）衰弱。多重发病被定义为≥2种长期病症，包括或不包括癌症诊断。根据多种疾病的存在情况，拟合逻辑回归模型来估计营养不良、肌肉减少症和虚弱的比值比 (OR)。泌尿生殖系统癌症 (28.9%) 和乳腺癌 (26.1%) 是最常见的癌症诊断。营养不良、（可能）肌肉减少症和（前期）虚弱的患病率分别为 11.1%、6.9% 和 51.2%。在 11.1% 的营养不良参与者中，大多数 (9%) 还患有（前期）虚弱，1.1% 还患有（可能的）肌肉减少症。在 51.2% 患有（前期）虚弱的参与者中，6.8% 还患有（可能）肌肉减少症。没有参与者仅患有（可能的）肌肉减少症，1.1% 的参与者患有营养不良、（可能的）肌肉减少症加上（前）虚弱。总共有 33% 和 65% 的参与者患有多种疾病，分别包括和排除癌症诊断。除癌症诊断外，最常见的长期疾病是高血压（32.5%）、骨关节炎或坐骨神经痛等疼痛性疾病（17.6%）和哮喘（10.4%）。总体而言，80% 的营养不良、74% 的（可能）肌肉减少症和 71.5% 的（前）虚弱参与者患有多种疾病。患有多种疾病（包括癌症诊断）的参与者营养不良（OR 1.72 [95% 置信区间，CI，1.31-2.30；P < 0.0005]）和（前）虚弱（OR 1.43 [95% CI 1.24-1.68]）的几率较高; P < 0.0005]）。除癌症诊断外，患有≥2种长期疾病的人的患病率进一步增加（营养不良，OR 2.41 [95% CI 1.85-3.14；P < 0.0005]；（前）虚弱，OR 2.03 [95% CI 1.73 -2.38；P<0.0005]）。几乎没有证据表明多重发病率与肌肉减少症存在关联。在患有癌症的成人中，多重发病率与营养不良和（预）衰弱的几率增加相关，但与（可能）肌肉减少症无关。这强调指出，多发病应被视为这些病症的风险因素，并在营养和功能筛查和评估期间进行评估，以支持临床实践中的风险分层。© 2024 作者。 《恶病质、肌肉减少症和肌肉杂志》由 Wiley periodicals LLC 出版。

Malnutrition, sarcopenia and frailty are distinct, albeit interrelated, conditions associated with adverse outcomes in adults with cancer, but whether they relate to multimorbidity, which affects up to 90% of people with cancer, is unknown. This study investigated the relationship between multimorbidity with malnutrition, sarcopenia and frailty in adults with cancer from the UK Biobank.This was a cross-sectional study including 4122 adults with cancer (mean [SD] age 59.8 [7.1] years, 50.7% female). Malnutrition was determined using the Global Leadership Initiative on Malnutrition criteria. Probable sarcopenia and sarcopenia were defined using the European Working Group on Sarcopenia in Older People 2 criteria. (Pre-)frailty was determined using the Fried frailty criteria. Multimorbidity was defined as ≥2 long-term conditions with and without the cancer diagnosis included. Logistic regression models were fitted to estimate the odds ratios (ORs) of malnutrition, sarcopenia and frailty according to the presence of multimorbidity.Genitourinary (28.9%) and breast (26.1%) cancers were the most common cancer diagnoses. The prevalence of malnutrition, (probable-)sarcopenia and (pre-)frailty was 11.1%, 6.9% and 51.2%, respectively. Of the 11.1% of participants with malnutrition, the majority (9%) also had (pre-)frailty, and 1.1% also had (probable-)sarcopenia. Of the 51.2% of participants with (pre-)frailty, 6.8% also had (probable-)sarcopenia. No participants had (probable-)sarcopenia alone, and 1.1% had malnutrition, (probable-)sarcopenia plus (pre-)frailty. In total, 33% and 65% of participants had multimorbidity, including and excluding the cancer diagnosis, respectively. The most common long-term conditions, excluding the cancer diagnosis, were hypertension (32.5%), painful conditions such as osteoarthritis or sciatica (17.6%) and asthma (10.4%). Overall, 80% of malnourished, 74% of (probable-)sarcopenia and 71.5% of (pre-)frail participants had multimorbidity. Participants with multimorbidity, including the cancer diagnosis, had higher odds of malnutrition (OR 1.72 [95% confidence interval, CI, 1.31-2.30; P < 0.0005]) and (pre-)frailty (OR 1.43 [95% CI 1.24-1.68; P < 0.0005]). The odds increased further in people with ≥2 long-term conditions in addition to their cancer diagnosis (malnutrition, OR 2.41 [95% CI 1.85-3.14; P < 0.0005]; (pre-)frailty, OR 2.03 [95% CI 1.73-2.38; P < 0.0005]). There was little evidence of an association of multimorbidity with sarcopenia.In adults with cancer, multimorbidity was associated with increased odds of having malnutrition and (pre-)frailty but not (probable-)sarcopenia. This highlights that multimorbidity should be considered a risk factor for these conditions and evaluated during nutrition and functional screening and assessment to support risk stratification within clinical practice.© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.