Stobäus Nicole, Müller Manfred J, Küpferling Susanne, Schulzke Jörg-Dieter, Norman Kristina
a Department of Gastroenterology , Infectiology and Rheumatology (Section Nutritional Medicine), Charité-University Medicine Berlin , Berlin , Germany.
Nutr Cancer. 2015;67(5):818-24. doi: 10.1080/01635581.2015.1040520. Epub 2015 May 21.
Cancer patients, in general, suffer from anorexia hence diminished nutritional intake. In a prospective observational study, we investigated the impact of recent energy and protein intake on cancer-related fatigue and 6-month mortality in patients undergoing chemotherapy. Recent protein and energy intake was assessed by 24-h recall in 285 patients. Cancer-related fatigue was determined by Brief Fatigue Inventory, and fat free mass index (FFMI) was assessed with bioelectrical impedance analysis. Symptoms with the validated German version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (30 questions) and 6-month mortality was documented. Risk factors of cancer-related fatigue and predictors of mortality were investigated with logistic regression analysis and stepwise Cox regression analysis, respectively. Low protein intake (<1 g/kg body weight) was found in 66% of patients, who were characterized by higher age, weight, and body mass index. Recent protein intake emerged as the strongest contributor to cancer-related fatigue followed by nausea/vomiting, insomnia, and age. Reduced protein intake, male sex, number of comorbidities, and FFMI were identified as significant predictors for increased 6-month mortality. In conclusion, a low recent protein intake assessed by 24-h recall is associated with a more than twofold higher risk of cancer-related fatigue and 6-month mortality. Every effort should be taken to assess and guarantee proper nutritional intake in patients undergoing chemotherapy.
一般来说，癌症患者会出现厌食症状，因此营养摄入量会减少。在一项前瞻性观察研究中，我们调查了近期能量和蛋白质摄入量对接受化疗患者的癌症相关疲劳及6个月死亡率的影响。通过24小时回顾法评估了285例患者近期的蛋白质和能量摄入量。采用简明疲劳量表测定癌症相关疲劳，并通过生物电阻抗分析评估去脂体重指数（FFMI）。使用经过验证的德语版欧洲癌症研究与治疗组织生活质量核心问卷（30个问题）记录症状，并记录6个月死亡率。分别采用逻辑回归分析和逐步Cox回归分析研究癌症相关疲劳的危险因素和死亡率的预测因素。66%的患者蛋白质摄入量低（<1克/千克体重），这些患者的特点是年龄、体重和体重指数较高。近期蛋白质摄入量是导致癌症相关疲劳的最主要因素，其次是恶心/呕吐、失眠和年龄。蛋白质摄入量减少、男性、合并症数量和FFMI被确定为6个月死亡率增加的显著预测因素。总之，通过24小时回顾法评估发现，近期蛋白质摄入量低与癌症相关疲劳风险增加两倍多以及6个月死亡率相关。应尽一切努力评估并确保接受化疗患者的营养摄入适当。
