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符合放疗条件的癌症患者的食物和营养不安全状况以及临床和人体测量指标

Food and nutrition insecurity and clinical and anthropometric indicators in individuals with cancer eligible for radiotherapy.

作者信息

de Andrade Panera Charnioski, de Oliveira Hinokuma Aniely Fernanda, Höfelmann Doroteia Aparecida

机构信息

Post-Graduate Program in Food and Nutrition, Federal University of Paraná, Curitiba, Brazil.

Department of Nutrition, Federal University of Paraná, Curitiba, PR, Brazil.

出版信息

Eur J Clin Nutr. 2025 Mar 5. doi: 10.1038/s41430-025-01593-2.

Abstract

OBJECTIVES

to analyze the association between food and nutrition insecurity (FNI) and sociodemographic, clinical, and anthropometric indicators in individuals with cancer eligible for curative radiotherapy.

METHODS

Study with the collection of sociodemographic and clinical data, and nutritional, anthropometric, and FNI assessment. Estimated Prevalence Ratio (PR) and 95% confidence intervals (95% CI) of FNI and exposure variables using the Poisson regression model with robust variance.

RESULTS

252 individuals were evaluated, 51.2% female, 60.7% elderly, 40.1% with breast or uterine cancer, 27.8% with urological cancer, 18.2% with head and neck cancer, and 7.5% with difficulty acquiring an enteral diet or nutritional supplement. The prevalence of FNI was 17.9%, 6.4% being moderate and 3.6% severe. FNI was less frequent in the high-income tertile (PR = 0,38; 95% CI: 0,18-0,79), and in individuals with urological tumors (PR = 0.12; 95% CI: 0.04-0.37), while higher prevalences were identified in non-white individuals (PR = 1,82; 95% CI: 1.01-3.28) among those with stage IV tumor (PR = 1.42; 95% CI: 1.03-1.95), with severe weight loss (PR = 2.99; 95% CI: 1.75-4.82), severely malnourished (PR = 2.58; 95% CI: 1.34-4.95) and bedridden (PR = 5.54; 95% CI: 2.72-11.29). Additionally, a higher prevalence of FNI associated with a reduction in usual food consumption (PR = 2.09; 95% CI: 1.24-3.54), the need to modify the consistency of the diet (PR = 3.45; 95% CI: 2.11-5.67), use of caloric supplements (PR = 2.07; 95% CI: 1.17-3.69) or enteral feeding (PR = 3.46; 95% CI: 2.01-5.94).

CONCLUSION

One in five individuals with cancer presented FNI associated with socioeconomic and nutritional vulnerability in the radiotherapy pre-treatment phase.

摘要

目的

分析适合根治性放疗的癌症患者中食物与营养不安全(FNI)与社会人口统计学、临床和人体测量学指标之间的关联。

方法

进行一项收集社会人口统计学和临床数据以及营养、人体测量和FNI评估的研究。使用具有稳健方差的泊松回归模型估计FNI及暴露变量的患病率比(PR)和95%置信区间(95%CI)。

结果

共评估了252名个体,其中51.2%为女性,60.7%为老年人,40.1%患有乳腺癌或子宫癌,27.8%患有泌尿系统癌症,18.2%患有头颈癌,7.5%在获取肠内饮食或营养补充剂方面存在困难。FNI的患病率为17.9%,其中中度为6.4%,重度为3.6%。FNI在高收入三分位数人群中较不常见(PR = 0.38;95%CI:0.18 - 0.79),在泌尿系统肿瘤患者中也较不常见(PR = 0.12;95%CI:0.04 - 0.37),而在非白人个体(PR = 1.82;95%CI:1.01 - 3.28)、IV期肿瘤患者(PR = 1.42;95%CI:1.03 - 1.95)、有严重体重减轻的患者(PR = 2.99;95%CI:1.75 - 4.82)、严重营养不良的患者(PR = 2.58;95%CI:1.34 - 4.95)和卧床不起的患者(PR = 5.54;95%CI:2.72 - 11.29)中患病率较高。此外,FNI患病率较高还与日常食物摄入量减少(PR = 2.09;95%CI:1.24 - 3.54)、需要改变饮食稠度(PR = 3.45;95%CI:2.11 - 5.67)、使用热量补充剂(PR = 2.07;95%CI:1.17 - 3.69)或肠内喂养(PR = 3.46;95%CI:2.01 - 5.94)有关。

结论

五分之一的癌症患者在放疗预处理阶段存在与社会经济和营养脆弱性相关的FNI。

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