Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer-A cross-sectional pilot study
Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer-A cross-sectional pilot study
复制标题
DOI：
10.1016/j.clnesp.2020.03.001
复制
发表时间：
2020-06-01
影响因子：
3
通讯作者：
Johnson, Egil
中科院分区：
文献类型：
--
作者：
Gharagozlian, Sedegheh;Mala, Tom;Johnson, Egil
背景与目的：胃切除术后常见的后遗症是胃肠道症状、吸收不良、进食减少和体重减轻。这可能导致营养不良，随后恢复时间延长，身体功能下降，生活质量（QoL）恶化。很少有研究调查胃癌长期生存者GI症状、生活质量和营养不良之间的关系。因此，我们评估了恶性肿瘤胃切除术后2-5年的营养状况、GI症状和生活质量。方法：对2012年至2016年期间在奥斯陆大学医院接受全胃切除术或次全胃切除术的患者进行了一项横断面初步研究，这些患者没有经历疾病复发。排除85岁以上的受试者。患者的营养状况根据主观全面评估（SGA）评分分为三组-A、B和C。肌肉质量通过生物电阻抗分析的身体组成和肌肉力量通过握力（HGS）测量。通过重复24小时饮食回忆评估饮食摄入量。采用GI症状评定量表（GSRS）和SF-36问卷对21例患者进行GI症状和生活质量评定。从术前状态到随访，平均（SD）体重减轻12.8%（11.6）。全胃切除术后的体重减轻百分比大于胃次全切除术（17.9%（12.3）vs. 6.6%（7.1）（p = 0.03））。据报道，与北欧一般人口的饮食建议和全国饮食调查中的摄入量相比，能量和蛋白质的平均摄入量较低。所有患者均被归类为肌肉减少症前期，5%为肌肉减少症。在45%的受试者中观察到持续体重减轻>10%，这些受试者有营养不良的风险。营养不良的受试者有较高的GSRS评分的腹痛综合征（p = 0.042）和较低的SF-36评分的身体疼痛（p = 0.01）和活力（p = 0.02）相比，那些没有营养不良。SGA评估的营养不良与更多GI症状和QoL评分降低相关。需要更多参与者的进一步研究来验证我们的发现。(C)2020作者（S）由Elsevier Ltd代表欧洲临床营养与代谢学会发布。
Background and aims: Gastrointestinal (GI) symptoms, malabsorption, reduced food intake and weight loss are common sequela of gastrectomy. This can result in malnutrition with a subsequent prolonged recovery, reduced physical functioning and deteriorated quality of life (QoL). Few studies have investigated the relationship between GI-symptoms, QoL and malnutrition in long-term survivors of gastric cancer. Therefore, we assess nutritional status, GI-symptoms and QoL 2-5 years after gastrectomy for malignancy.Methods: A cross-sectional, pilot study was carried out in patients who underwent total or subtotal gastrectomy at Oslo University Hospital between 2012 and 2016, who had not experienced disease recurrence. Subjects above 85 years were excluded. The nutritional status of the patients fell into three groups by a score of subjective global assessment (SGA)-A, B, and C. Muscle mass was measured by body composition by bioelectrical impedance analysis and muscle strength was measured by handgrip strength (HGS). Dietary intake was assessed by repeated 24-h dietary recalls. GI-symptoms and QoL were assessed using GI-Symptom Rating Scale (GSRS) and the SF-36 questionnaire.Results: 21 patients were included. Mean (SD) weight loss was 12.8% (11.6) from preoperative status to follow up. Percentage weight loss was larger after total gastrectomy compared with subtotal gastrectomy (17.9% (12.3) vs. 6.6% (7.1) (p = 0.03)). A low mean intake of energy and protein was reported compared to dietary recommendations for the general Nordic population and intake in a national dietary survey. All of the patients were classified as pre-sarcopenic, and 5% as sarcopenic. Persistent weight loss >10% was observed in 45% of the subjects and these were in risk of malnutrition. Subjects with malnutrition had higher GSRS score for the abdominal pain syndrome (p = 0.042) and lower SF-36 scores for bodily pain (p = 0.01) and vitality (p = 0.02) compared with those without malnutrition.Conclusions: A high prevalence of weight loss, and pre-sarcopenia was observed. Malnutrition as assessed by SGA was associated with more GI-Symptoms and reduced QoL scores. Further studies with larger number of participants are needed to verify our findings. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.