Protein and micronutrient deficiencies in patients with radiation cystitis and outcome after hyperbaric oxygen therapy
| Autor: | Valérie Platzer, Michèle Genestal, Sylvie Caspar-Bauguil, Guillaume Perez, Anne Galinier, Béatrice Riu-Poulenc, Leslie Gonzalez, Eric Huyghe |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism 030232 urology & nephrology Nutritional Status Gastroenterology Radiation cystitis 03 medical and health sciences 0302 clinical medicine Hyperbaric oxygen Protein Deficiency Internal medicine Cystitis Prevalence medicine Humans Micronutrients Radiation Injuries Aged Retrospective Studies Aged 80 and over Hyperbaric Oxygenation Principal Component Analysis Nutrition and Dietetics Vitamin C business.industry Malnutrition Retrospective cohort study Middle Aged medicine.disease Micronutrient Surgery Exact test 030220 oncology & carcinogenesis Cohort Female Dietary Proteins business Follow-Up Studies |
| Zdroj: | Clinical Nutrition ESPEN. 23:141-147 |
| ISSN: | 2405-4577 |
| Popis: | Haemorrhagic radiation cystitis (HRC) is a late complication of pelvic radiotherapy. Severe cases are difficult to treat due to persistent or recurrent bleeding, despite urological and hyperbaric oxygen therapy (HBOT). However, wound healing requires a good nutritional status. In this respect, we aimed at analysing the nutritional status of patients with HRC prior to the onset of HBOT and at highlighting predictive nutritional factors of outcome.Data were retrospectively collected from a cohort of 179 patients with HRC (between 2011 and 2015). Haematuria was graded according to the Subjective, Objective, Management, Analytic scale (SOMA): grade-4 (n = 46) was compared with grade-3 (n = 56), and with grades 1 and 2 (n = 77). S-albumin, prealbumin, vitamins C, D and B6, zinc, selenium, and essential fatty acids were evaluated before HBOT. HBOT response was measured at 3 months according to the haematuria SOMA grade. The Mann-Whitney test, Fisher's exact test and principal-component analysis were used to compare groups.Patients with higher haematuria grades (3 and 4) harboured significant deficiencies in S-albumin, prealbumin, vitamins C, D and B6, zinc, selenium and essential fatty acids. Moreover, grade-4 patients without improvement after 3 months of HBOT had significant lower initial levels of S-albumin, vitamin C, selenium and linoleic acid. Vitamin C levels2.5 mg/L were strongly associated with HBOT non-response (OR 23.14, 95% CI 3.73-143.69, p = 0.002).Our analyses show serious nutritional deficiencies associated with higher grades of HRC and worse prognoses. Patients with haemorrhagic cystitis might benefit from an adequate dietary supplementation to support healing of their bladder mucosa. |
| Databáze: | OpenAIRE |
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