Nutrition (Burbank, Los Angeles County, Calif.) · 2025
Association between baseline inflammation and the effectiveness of nutritional support among terminally ill patients with cancer: A secondary analysis of a multicenter prospective cohort study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Amano Koji, Okamura Satomi, Mori Naoharu, Sakaguchi Tatsuma, Miura Tomofumi, Uneno Yu, Ishiki Hiroto, Hiratsuka Yusuke, Yokomichi Naosuke, Hamano Jun, Mori Masanori, Morita Tatsuya
Аннотация
OBJECTIVES: Inflammatory status may influence the response to nutritional support. We aimed to determine associations between calorie intake and survival considering serum C-reactive protein (CRP) levels among advanced cancer patients.
METHODS: Data on characteristics and CRP levels were obtained at baseline. The nutritional administration method and calorie intake during the first week were recorded. Patients were divided into three CRP groups: Low (<1 mg/dL), moderate (1-10 mg/dL), or high (≥10 mg/dL). Patients in each group were divided into two categories: low-calorie (<250 kcal/d) or high-calorie (≥250 kcal/d). We assessed survival using the Kaplan-Meier method and calculated multivariate-adjusted hazard ratios (HR) with 95% confidence intervals (CI) using Cox proportional hazard models.
RESULTS: A total of 1233 patients were divided into three CRP groups: Low (n = 223), moderate (n = 718), and high (n = 292). Significant differences were observed in survival rates between the high- and low-calorie categories in all groups (all log-rank P < 0.001). Significantly lower risks of mortality were observed in the Cox proportional hazard model for the high-calorie category than for the low-calorie category in all CRP groups (adjusted HR 0.37, 95% CI 0.26-0.52 in the low group; adjusted HR 0.38, 95% CI 0.32-0.45 in the moderate group; adjusted HR 0.44, 95% CI 0.34-0.56 in the high group). The lower the CRP level, the lower the risk of death in the high-calorie category.
CONCLUSIONS: Nutritional support had beneficial effects on patient outcomes regardless of CRP levels.
METHODS: Data on characteristics and CRP levels were obtained at baseline. The nutritional administration method and calorie intake during the first week were recorded. Patients were divided into three CRP groups: Low (<1 mg/dL), moderate (1-10 mg/dL), or high (≥10 mg/dL). Patients in each group were divided into two categories: low-calorie (<250 kcal/d) or high-calorie (≥250 kcal/d). We assessed survival using the Kaplan-Meier method and calculated multivariate-adjusted hazard ratios (HR) with 95% confidence intervals (CI) using Cox proportional hazard models.
RESULTS: A total of 1233 patients were divided into three CRP groups: Low (n = 223), moderate (n = 718), and high (n = 292). Significant differences were observed in survival rates between the high- and low-calorie categories in all groups (all log-rank P < 0.001). Significantly lower risks of mortality were observed in the Cox proportional hazard model for the high-calorie category than for the low-calorie category in all CRP groups (adjusted HR 0.37, 95% CI 0.26-0.52 in the low group; adjusted HR 0.38, 95% CI 0.32-0.45 in the moderate group; adjusted HR 0.44, 95% CI 0.34-0.56 in the high group). The lower the CRP level, the lower the risk of death in the high-calorie category.
CONCLUSIONS: Nutritional support had beneficial effects on patient outcomes regardless of CRP levels.