Kitagawa Moeko, Haji Seiji, Amagai Teruyoshi
Department of Food Sciences and Nutrition, School of Environmental Sciences, Mukogawa Women's University, Nishinomiya, Japan.
Department of General Surgery, Takatsuki Hospital, Osaka, Japan.
In Vivo. 2017 Sep-Oct;31(5):1003-1009. doi: 10.21873/invivo.11161.
In recent years, the number of cancer patients has increased. Cancer patients are prone to sarcopenia as a result of the decrease in muscle mass and muscle weakness which occurs in cancer cachexia. Attention has been given on the effects of fatty acid administration on cancer patients.
We conducted a retrospective chart-review study of consecutive patients with unresectable advanced GI cancer (stage IV) (n=46) receiving chemotherapy treatment in an outpatient or in-hospital setting between December 2012 and September 2015 at our Institution. The collected data were characteristics, psoas muscle area as measured by computed tomography (CT), and biochemical blood test and serum fatty acid profiles. Three methods of analysis were evaluated: (i) Comparison of biomarkers between two groups: psoas muscle index change rate (ΔPMI) decrease group vs. ΔPMI increase group. (ii) Correlation between ΔPMI and biomarkers. (iii) Multiple regression of ΔPMI and biomarkers Results: In the ΔPMI decrease group, n-6/n-3 ratio and AA/EPA ratio in the decrease group were significantly higher than those in the increase group. Among all parameters, serum EPA was positively and significantly related to ΔPMI (CC=0.443, p=0.039). In contrast, serum CRP, AA/EPA ratio and n-6/n-3 ratio were negatively related to ΔPMI (CC=-0.566, CC=-0.501, CC=-0.476, p=0.006, p=0.018, p=0.025, respectively). On multiple regression analysis, serum CRP value was strongly related to ΔPMI (r=0.421, β=-0.670, p=0.001).
Higher n-6/n-3 and AA/EPA ratios were associated with a decrease in psoas muscle area, that lead to diagnosis of sarcopenia. Higher CRP was also associated with a decrease in psoas muscle area, suggesting that this might be an indicator of cachexic skeletal muscle depletion in cachexic patients with advanced gastro-intestinal cancers.
近年来，癌症患者数量有所增加。癌症患者由于癌症恶病质导致肌肉量减少和肌肉无力，容易出现肌肉减少症。脂肪酸给药对癌症患者的影响已受到关注。
我们对2012年12月至2015年9月期间在我院门诊或住院接受化疗的连续不可切除的晚期胃肠道癌（IV期）患者（n = 46）进行了一项回顾性图表审查研究。收集的数据包括患者特征、通过计算机断层扫描（CT）测量的腰大肌面积、生化血液检测和血清脂肪酸谱。评估了三种分析方法：（i）两组生物标志物的比较：腰大肌指数变化率（ΔPMI）降低组与ΔPMI升高组。（ii）ΔPMI与生物标志物之间的相关性。（iii）ΔPMI与生物标志物的多元回归分析。结果：在ΔPMI降低组中，降低组的n-6/n-3比值和AA/EPA比值显著高于升高组。在所有参数中，血清EPA与ΔPMI呈显著正相关（CC = 0.443，p = 0.039）。相反，血清CRP、AA/EPA比值和n-6/n-3比值与ΔPMI呈负相关（CC分别为-0.566、-0.501、-0.476，p = 0.006、p = 0.018、p = 0.025）。多元回归分析显示，血清CRP值与ΔPMI密切相关（r = 0.421，β = -0.670，p = 0.001）。
较高的n-6/n-3和AA/EPA比值与腰大肌面积减少有关，这导致了肌肉减少症的诊断。较高的CRP也与腰大肌面积减少有关，这表明这可能是晚期胃肠道癌恶病质患者恶病质骨骼肌消耗的一个指标。
