Relationship between pre-treatment nutritional status, serum glutamine, arginine levels and clinicopathological features in Taiwan colorectal cancer patients

Asia Pac J Clin Nutr. 2015;24(4):598-604. doi: 10.6133/apjcn.2015.24.4.23.

Abstract

Background and objectives: To examine the relationship between malnutrition criteria, serum glutamine and arginine concentrations, and clinicopathological features in Taiwan colorectal cancer patients.

Methods and study design: Three malnutrition criteria (body weight loss>5% over past 6 months, body mass index (BMI)<18.5 kg/m2, and hypoalbuminemia) and serum levels of glutamine and arginine were measured in 164 colorectal patients. Malnutrition status and serum glutamine and arginine concentrations were tested for their association with each other, as well as with the clinicopathological variables.

Results: Of the 164 patients, 38 (23.5%) had body weight loss, 19 (11.9%) had low BMI, and 57 (35.8%) had hypoalbuminemia. The univariate analysis showed hypoalbuminemia was correlated with advanced tumour stage, lower concentrations of glutamine, higher C-reactive protein level, and progression-free survival rate. Univariate analysis also showed glutamine levels were lower in advanced tumour stage, but arginine levels were not associated with any clinicopathologic variables. Neither the nutrition criteria used in this study nor glutamine and arginine levels were correlated with hospital stay or progression-free survival rate in multivariate analysis.

Conclusions: Different nutrition assessment criteria produced different malnutrition rates in colorectal cancer patients; however, pre-treatment malnourished status and low serum glutamine and arginine concentrations were not correlated with hospital stay and progressionfree survival rate.

背景与目的:本研究的目的是探讨台湾地区大肠直肠癌病人治疗前营养不良情 形、血清谷氨酰胺与精氨酸值和临床病理特征之间的关系。方法与研究设计: 对164 位直肠癌病人运用三种营养不良诊断标准,包含六个月内体重下降超过 百分之五、身体质量指数小于18.5 kg/m2 及低蛋白血症,评估治疗前营养不良 状况,同时测量治疗前血清中谷氨酰胺与精氨酸浓度,来测试它们之间的关 系,及其与临床病理参数的关系。结果:164 位患者中,有38 位(23.5%)病 人体重下降、19 位(11.9%)病人有较低的身体质量指数及57 位(35.8%)病 人有低蛋白血症。单因素分析发现低蛋白血症与肿瘤前期、低谷氨酰胺浓度、 高C 反应蛋白值和无进展存活率有关。单因素分析还显示肿瘤前期时谷氨酰胺 浓度低,但没有发现精氨酸浓度与临床病理参数有关。在多变量分析中,无论 是营养不良诊断标准或是血清中谷氨酰胺与精氨酸浓度都与住院时间和无进展 存活率无关。结论:台湾地区大肠直肠癌病人治疗前营养不良发生率因不同营 养不良诊断标准而有所差异,但治疗前营养不良状况及低血清中谷氨酰胺与精 氨酸浓度与住院时间和无进展存活率无关。.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arginine / blood*
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Glutamine / blood*
  • Humans
  • Hypoalbuminemia
  • Length of Stay
  • Male
  • Malnutrition / blood
  • Malnutrition / complications*
  • Middle Aged
  • Neoplasm Staging
  • Nutrition Assessment
  • Nutritional Status*
  • Taiwan
  • Weight Loss

Substances

  • Glutamine
  • C-Reactive Protein
  • Arginine