Introduction: Since 2019 the Global Leadership Into Malnutrition (GLIM) criteria exist for diagnosing malnutrition. Patients with gastoenteropancreatic (GEP) neuroendocrine tumours (NETs) using somatostatin analogues (SSAs) are at risk of malnutrition. Deficiencies in fat-soluble vitamins, minerals and trace elements are not part of the GLIM criteria but frequently reported in patients with GEP-NETs using SSAs. The relationship between malnutrition and these deficiencies has not been explored before.
The aim: To describe the prevalence of deficiencies in fat-soluble vitamins, minerals and trace elements and explore the relation these of deficiencies with malnutrition in patients with GEP-NETs using SSAs.
Methods: A cross-sectional study was performed screening single-time patients with GEP-NETs using SSAs for deficiencies in fat-soluble vitamins (A, D), minerals (Magnesium, Iron), trace elements (Zinc) and for malnutrition using GLIM criteria. This included screening for weight, weight loss, body mass index (BMI) and sarcopenia using body composition analysis. Logistic regression was performed to explore the relationship between deficiencies and the presence of malnutrition.
Results: A total of 118 patients, 55 males (47%) with a median age 67 (IQR 56.8 75) year were included. Primary tumours were located in the small intestine n=91 (77%) and pancreas n=25 (21%). The median period on somatostatin analogue was 23 months (IQR 5.5 59 months). The prevalence of deficiencies was 75% (n=81) for iron, 55% (n=57) for iron saturation, 54% (n=64) for vitamin D, 25% (n=29) for vitamin A, 51% (n=54) for zinc and 19% (n=22) for magnesium. Malnutrition was present in 88 patients (75%). There was no relationship between any of the deficiencies and the presence of malnutrition.
Conclusion: Patients with GEP-NETs using SSAs demonstrate a high prevalence of deficiencies in fat-soluble vitamins, minerals and trace elements and are frequently malnourished but a relationship between specific deficiencies and the presence of malnutrition could not be identified. Patients with GEP-NETs using SSAs should be screened annually for malnutrition (using GLIM criteria) and fat-soluble vitamins, minerals and trace elements. If deficiencies are found supplementation is recommended. Future research should focus on early identification of deficiencies and the benefits of supplementation.