RESUMO
Patients with colorectal cancer (CRC) often exhibit changes in body composition (BC) which are associated with poorer clinical outcomes. Many studies group colon and rectal cancers together, irrespective of staging, potentially affecting assessment and treatment strategies. Our study aimed to compare BC in patients with CRC focusing on tumor location and metastasis presence. A total of 635 individuals were evaluated, with a mean age of 61.8 ± 12.4 years and 50.2% female. The majority had rectal cancer as the primary cancer site (51.0%), and 23.6% had metastatic disease. The first regression model showed tumor site and metastasis as independent factors influencing skeletal muscle (SM), skeletal muscle index (SMI), and visceral adipose tissue variability (all p values < 0.05). The second model, adjusted for BMI, indicated tumor site as the primary factor affecting SMI variations (adjusted R2 = 0.50 p < 0.001), with colon tumors inversely associated with SM (standardized ß - 2.15(- 3.3; - 0.9) p < 0.001). A third model, considering all the confounders from the directed acyclic graphs, was constructed and the found association remained independent. Our findings highlight significant BC variations in patients with CRC, influenced by tumor location and metastases presence, underscoring the need for location-specific assessment in CRC management.
Assuntos
Composição Corporal , Neoplasias Colorretais , Estadiamento de Neoplasias , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias Colorretais/patologia , Idoso , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Gordura Intra-Abdominal , Índice de Massa CorporalRESUMO
Introduction: Myopenia is a significant problem in oncology patients and the use of reliable instruments for its identification in clinical practice is necessary.Objective: To evaluate the association between the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and skeletal muscle (SM) measured by computed tomography (CT) in patients with cervical cancer.Methods: This is an observational, cross-sectional study which enrolled women with cervical cancer, over 20 years, who started treatment between January 2015 and September 2018. The ones who presented PG-SGA and imaging of CT with a maximum interval of 45 days between them were included. The SM index (SMI) was used to classify myopenia and a significance level of 5% was adopted.Results: According to the PG-SGA, malnutrition was found in 56% patients and 23% were classified with myopenia by CT. The PG-SGA parameters were significantly associated with the SMI. The cutoff points that best discriminated myopenia were the PG-SGA total score ≥ 10, muscle depletion ≥ 2.0, and physical examination score ≥ 2.0.Conclusion: The PG-SGA showed to be a useful and viable method that shows good association and correlation with the SMI.
Assuntos
Músculo Esquelético/patologia , Estado Nutricional , Tomografia Computadorizada por Raios X/métodos , Neoplasias do Colo do Útero/metabolismo , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Avaliação NutricionalRESUMO
Hepatic vitamin A stores should be the best early indicator of vitamin A status because more than 90% of total body vitamin A is stored in the liver. The objective of the present study was to evaluate the hepatic vitamin A stores in all stages of chronic liver disease (CLD), including chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). One hundred forty-four patients (age 55.34 ± 9.38 years) were evaluated in a cross-sectional study. Vitamin A nutrition status was analyzed by serum retinol levels and relative dose-response (RDR) method. Patients with cholestasis were excluded from the sample group. Biochemical, clinical, and anthropometric evaluations were performed. Vitamin A deficiency (VAD) was detected in 51.4% of all patients. Patients with adequate levels of serum retinol presented adequate liver vitamin A reserves; in contrast, nearly half the patients with low serum retinol levels presented adequate levels of retinol in the liver, although none of the patients with hepatitis had this condition. Therefore, the effectiveness of the RDR method for evaluating vitamin A nutrition status was limited in patients with cirrhosis and HCC, perhaps due to the advanced age of these patients, since those in the chronic hepatitis group, who were younger, responded adequately to the test. Thus, the RDR method should be modified when applied to later stages of CLD, considering the time and dose of retinyl palmitate supplementation, as VAD may be a risk factor for the progression of the disease.
Assuntos
Hepatopatias/sangue , Fígado/efeitos dos fármacos , Vitamina A/sangue , Adulto , Idoso , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/complicações , Doença Crônica , Estudos Transversais , Relação Dose-Resposta a Droga , Feminino , Humanos , Fígado/fisiopatologia , Cirrose Hepática/sangue , Cirrose Hepática/complicações , Hepatopatias/complicações , Hepatopatias/fisiopatologia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estudos Prospectivos , Espécies Reativas de Oxigênio , Vitamina A/administração & dosagem , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/complicaçõesRESUMO
OBJECTIVE: to evaluate retinol and ß-carotene serum levels and their relationship with risk factors for cardiovascular disease in individuals with morbid obesity, resident in Rio de Janeiro. METHODOLOGY: blood serum concentrations of retinol and ß-carotene of 189 morbidly obese individuals were assessed. The metabolic syndrome was identified according to the criteria of the National Cholesterol Education Program (NCEP) and World Health Organization (WHO). Lipid profile, insulin resistance, basal insulin, glycemia, blood pressure, and anthropometry and their correlation with retinol and ß-carotene serum levels were evaluated. RESULTS: metabolic syndrome diagnosis was observed in 49.0% of the sample. Within this percentage the levels of ß-carotene were significantly lower when body mass index increased. Serum retinol didn't show this behavior. Serum retinol inadequacy in patients with metabolic syndrome (61.3%), according to WHO criterion, was higher (15.8%) than when the whole sample was considered (12.7%). When metabolic syndrome was diagnosed by NCEP criterion, ß-carotene inadequacy was higher (42.8%) when compared to the total sample (37.5%). There was a significant difference between average ß-carotene values of patients with and without metabolic syndrome (p=0.048) according to the classification of the NCEP. Lower values were found in patients with metabolic syndrome. CONCLUSION: considering the vitamin A contribution in antioxidant protection, especially when risk factors for cardiovascular disease are present, it is suggested that great attention be given to morbidly obese. This could aid in prevention and treatment of cardiovascular disease, which affects a significant part of the population.
Assuntos
Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Obesidade Mórbida/sangue , Vitamina A/sangue , beta Caroteno/sangue , Adulto , Idoso , Envelhecimento , Índice de Massa Corporal , Brasil/epidemiologia , LDL-Colesterol/sangue , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Saúde da População Urbana , Deficiência de Vitamina A/epidemiologia , Adulto Jovem , beta Caroteno/deficiênciaRESUMO
BACKGROUND: The objective of the present study was to investigate vitamin A nutritional status in individuals with class III obesity through a biochemical indicator (retinol and beta-carotene serum levels), correlating these findings with non-alcoholic fatty liver disease (NAFLD) presence and its risk factors. METHODS: The studied population was composed of 145 patients with morbid obesity [body mass index, BMI > or = 40 kg/m(2)) of both sexes. Retinol and beta-carotene serum levels were assessed by high performance liquid chromatography. The cutoff values used for serum retinol and beta-carotene inadequacy were <1.05 micromol/l and < or =40 microg/dl, respectively. Insulin resistance (IR) was assessed through homeostasis model assessment index (HOMA) method. Biochemical parameters of liver enzymes, lipid profile, and glycemia were analyzed. Anthropometric measurements were conducted. NAFLD diagnosis was performed through magnetic resonance. RESULTS: NAFLD prevalence in the group was 71%. An inadequacy of 11.3 and 41.7% of retinol and beta-carotene serum levels, respectively, was found when NAFLD was present. A significant correlation of serum retinol with albumin liver and total bilirubin was found. As regards beta-carotene, a positive correlation for HDL-c variable and a negative correlation for the HOMA-IR, weight, and BMI variables were observed. There was a significant association between IR presence and retinol and beta-carotene inadequacy. CONCLUSION: The high inadequacy of retinol and beta-carotene nutritional status in the sample, with a higher inadequacy in those with NAFLD, suggests an increase in the utilization of vitamin A in this group related to the fight against the oxidative stress to what they are exposed to. The significant association between retinol and beta-carotene with IR supports the hypothesis that vitamin A may have a protector effect on IR pathogenesis.