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Objective:To observe the changes of nutrition impact symptoms (NIS) and fat-free mass and analyze the relationship between them in patients with head and neck cancer (HNC) during radiotherapy.Methods:A convenient sampling method was adopted to select HNC patients who received radiotherapy in the outpatient clinic of department of radiotherapy for head and neck cancer in a cancer hospital in Beijing from March 2017 to January 2020. The nutrition impact symptoms (NIS) were assessed by a nutrition impact symptoms checklist and the fat free mass was assessed by bioelectrical impedance analysis at three time points: before radiotherapy (T1), during radiotherapy (T2) and at the end of radiotherapy (T3). The Generalized Estimating Equations (GEE) was used to analyze the relationship between them.Results:A total of 542 HNC patients were included in the analysis. During radiotherapy, the patients' NIS number and score presented an increasing trend, reaching the highest level and peaked at the end of radiotherapy. The change of fat-free mass showed a decreasing trend and reached the minimum at the end of radiotherapy. Patients with higher NIS scores had more percentage loss of fat-free mass.Conclusions:During radiotherapy, patients with HNC showed an increase in NIS score and lost fat-free mass. Patients with higher NIS score lost more percentage of fat-free mass, which suggested that clinical medical staff should pay attention to NIS management and take comprehensive intervention measures in time to reduce the loss of fat-free mass.
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Objective To describe the characteristics of dysphagia in patients with head and neck cancer during radiotherapy,and analyze the cause of dysphagia and the relationship between dysphagia and weight change.Methods Patients with head and neck cancer treated with radiotherapy in Beijing Cancer Hospital from November 2017 to June 2018 were recruited.The M.D.Anderson Dysphagia Inventory (MDADI) was used to assess the dysphagia of patients before (T1),during (T2) and at the end (T3) of the radiotherapy.Meanwhile,the weight,dietary intake and radiation adverse effects were investigated.Generalized estimating equations were used to analyze the impact factors of dysphagia and the relationship among dysphagia,dietary intake and weight change.Results Ninety-six patients were completely investigated and the incidence of dysphagia were 6.3％ (6/ 96),80.2％ (77/96) and 85.4％ (82/96) in T1,T2 and T3.With the progress of radiotherapy,the total score and the scores of 4 dimensions of MDADI dropped and the dietary intake declined.The average weight loss was (5.09±3.31) kg,and 76.1％ of the patients had weight loss over 5％ at the end of radiotherapy.The occurrence of dysphagia was associated with the radiotherapy-related oral and laryngeal mucositis and the weight loss was closely associated with the site of radiation,dysphagia,and dietary intake decline.Conclusions The dysphagia of patients with head and neck cancer is affected by radiation adverse effects,and is most severe at the end of radiotherapy.Dysphagia might result in dietary intake decline and weight loss.Clinicians should pay close attention to the swallowing function of the patients and take measures earlier accordingly.
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Objective To describe the characteristics of radiation induced mucositis in patients withhead and neck cancer ( HNC) during radiotherapy, and analyze the effect of radiation induced mucositis on diet patterns and weight change and the influencing factors for radiation induced mucositis. Methods Patients with HNC treated with radiotherapy in one cancer hospital were recruited. Data were collected before, during and at the end of the radiotherapy, which included radiation induced oral and pharyngeal mucositis, pain during eat-ing, diet patterns and weight. Results Two hundred and two patients were completely investigated and 43.5％and 34. 2％ of the patients suffered from moderate to severe (≥grade 2) oral mucositis and pharyngeal mucosi-tis, respectively during the radiotherapy. At the end of radiotherapy, 53. 5％ and 51. 5％ of the patients suffered from moderate to severe oral mucositis and pharyngeal mucositis (≥grade 2 ) , respectively. Oral and pharyngeal mucositis were significantly correlated with pain during eating, diet patterns and weight ( P<0. 05) . Tumor site was the main reason that affected the severity of mucositis ( Wald χ2 =26. 033, 14. 216;P<0.001). Conclusion Radiation induced mucositis was gradually aggravated with radiotherapy progress, which is closely related to pain during eating, change of diet patterns and weight loss. The severity of mucositis is re-lated to the tumor site. Measures should be taken to strengthen the management of adverse reactions and nutri-tional status of patients.
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Objective To explore the relationship between dietary patterns and non alcoholic fatty liver disease (NAFLD) in Karamay adults.Methods A total of 2377 subjects aged 20-75 years old who took health check-up during April and June 2011 were included in this investigation.Body mass index (BMI),waist to hip ratio (WHR),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST) and serum uric acid (SUA)were measured.Food intake patterns and life style of the participants were accessed by using food frequency questionnaire (FFQ).Main component analysis and multivariate logistic regression model were used to explore the association of dietary patterns with NAFLD.Results Five dietary patterns were identified,including condiment dietary pattern, western dietary pattern, conventional healthy dietary pattern,snacks and bean pattern,and high protein dietary pattern.Subjects of condiment dietary pattern,western dietary pattern or conventional healthy dietary pattern showed significantly different prevalence of NAFLD (x2 values were 149.873,8.247 and 18.766,respectively; all P ＜ 0.05).In condiment dietary pattern,age,BMI,WHR,SUA and TG were significantly different in Q4 group (F values were 8.42,5.64,12.78,10.72 and 9.63,respectively; all P ＜0.05).For those with western dietary pattern,age,WHR,SBP,SUA,TC and TG showed significant different trend (F values were 9.84,6.87,6.11,10.61,6.87 and 8.13,respectively; all P ＜ 0.05).However,subjects with conventional healthy dietary pattern showed a significant different trend of age,BMI,WHR,SBP,SUA and AST (F values were 19.13,11.09,13.89,6.11,15.12,6.19,respectively ; all P ＜ 0.05).After age,BMI,WHR,SBP,SUA,AST,TC and TG were adjusted,the risk of NAFLD of those with condiment pattern or western pattern were significantly increased (odds ratio (OR) were 1.33 (95％ confidence interval (CI) 0.95-1.87) and 1.36 (95％ CI 0.979-1.902),respectively).Conclusion Dietary pattern may be associated with NAFLD.People need to learn healthy dietary habit to prevent NAFLD.