Abstract:

Objective　To explore the effects of Mediterranean diet on the nutritional status, muscle mass and strength, and inflammatory factors in patients with cachexia induced by colorectal cancer. Methods　One hundred and sixty-five patients with cachexia induced by colorectal cancer treated at Lianyungang Second People's Hospital from January 2020 to June 2023 were selected for the randomized controlled trial, and were divided into a control group (83 cases) and an observation group (82 cases) by the random number table method. There were 48 males and 35 females in the control group; they were (62.87±5.56) years old. There were 45 males and 37 females in the observation group; they were (63.36±4.84) years old. The control group took conventional nutritional support, and the observation group Mediterranean diet, for 8 weeks. After the intervention, the muscle mass, grip strengths, body weights, upper arm muscle circumferences, skinfold thicknesses, levels of chloride ion (Cl^-), sodium (Na), potassium (K), prealbumin (PA), albumin (ALB), total protein (TP), C-reactive proteins (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and total response rates were compared between the two groups by t and χ² tests. Results　There was no statistical difference in the total response rate between the two groups (χ²=1.652, P=0.199). After the intervention, the electrolyte test indicators, nutritional indicators, inflammatory factors, muscle mass, grip strength, body weight, upper arm muscle circumference, and skinfold thickness were better than those before the intervention in both groups (all P<0.05). After the intervention, the total body fat mass, total body muscle mass, trunk muscle mass, and trunk fat mass in the observation group were (44.36±2.06) kg, (14.46±2.65) kg, (26.85±3.11) kg, and (12.32±3.62) kg, which were higher than those in the control group (t=2.317, 2.689, 2.787, and 2.337; all P<0.05); the grip strength, body weight, upper arm muscle circumference, skinfold thickness, and levels of Cl^-, Na, K, TP, ALB, PA, CRP, IL-6, and TNF-α in the observation group were (267.84±8.45) N, (65.58±4.65) kg, (24.58±3.32) cm, (14.87±2.33) mm, (102.63±5.51) mmol/L, (139.85±7.52) mmol/L, (0.48±0.13) mmol/L, (68.97±4.62) g/L, (38.89±4.63) g/L, (215.65±13.32) g/L, (18.75±3.31) mg/L, (15.65±2.31) ng/L, and (20.12±2.86) ng/L, which were better than those in the control group (t=4.327, 3.309, 2.559, 3.285, 8.404, 8.668, 2.870, 6.547, 5.566, 4.430, 15.173, 14.300, and 19.883; all P<0.05). Conclusion　Mediterranean diet for patients with cachexia caused by colorectal cancer is effective, and can maintain their body needs, improve their nutritional status and muscle strength and quality, and reduce the levels of inflammatory factors, so it is worthy of promotion.

Key words:

Mediterranean diet, Colorectal cancer, Cachexia, Nutritional status, Muscle mass, Strength, Inflammatory factors

摘要：

目的　探索地中海饮食对结直肠癌引起的恶病质患者的营养状况、肌肉质量和力量以及炎症因子的影响。方法　选取连云港市第二人民医院2020年1月至2023年6月收治的165例结直肠癌引起的恶病质患者进行随机对照试验。采用随机数字表法将其分为对照组83例和观察组82例。对照组男48例，女35例，年龄（62.87±5.56）岁。观察组男45例，女37例，年龄（63.36±4.84）岁。对照组采用常规营养支持，观察组采用地中海饮食。两组均干预8周。干预后，比较两组肌肉质量、握力、体质量、上臂肌围、皮褶厚度、氯离子（chloride ion，Cl^-）、钠（sodium，Na）、钾（potassium，K）、前蛋白（prealbumin，PA）、白蛋白（albumin，ALB）、总蛋白（total protein，TP）、C反应蛋白（C-reactive protein，CRP）、白细胞介素-6（interleukin-6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）以及总有效率。采用t检验和χ²检验。结果　两组总有效率比较，差异无统计学意义（χ²=1.652，P=0.199）。干预后，两组电解质检测指标、营养指标、炎症因子、肌肉质量、握力、体质量、上臂肌围、皮褶厚度均较同组治疗前有所改善（均P<0.05）。干预后，观察组全身脂肪量、全身肌肉量、躯干肌肉量、躯干脂肪量分别为（44.36±2.06）kg、（14.46±2.65）kg、（26.85±3.11）kg、（12.32±3.62）kg，均高于对照组（t=2.317、2.689、2.787、2.337，均P<0.05）；观察组握力、体质量、上臂肌围、皮褶厚度、Cl^-、Na、K、TP、ALB、PA、CRP、IL-6、TNF-α分别为（267.84±8.45）N、（65.58±4.65）kg、（24.58±3.32）cm、（14.87±2.33）mm、（102.63±5.51）mmol/L、（139.85±7.52）mmol/L、（0.48±0.13）mmol/L、（68.97±4.62）g/L、（38.89±4.63）g/L、（215.65±13.32）g/L、（18.75±3.31）mg/L、（15.65±2.31）ng/L、（20.12±2.86）ng/L，均优于对照组（t=4.327、3.309、2.559、3.285、8.404、8.668、2.870、6.547、5.566、4.430、15.173、14.300、19.883，均P<0.05）。结论　结直肠癌引起的恶病质患者进行地中海饮食效果显著，能够维持机体所需量，改善营养状态，提高肌肉力量和质量，降低炎症因子水平，值得推广。

关键词:

地中海饮食, 结直肠癌, 恶病质, 营养状况, 肌肉质量, 力量, 炎症因子