Abstract
IntroductionMalnutrition is a frequently diagnosed condition in head and neck cancer (HNC) patients after radiation therapy (RTH). Malnutrition causes adipose tissue dysfunction associated with intensified lipolysis and disruption of the activity of mechanisms that protect adipose tissue against this process, which include the protective function of perilipin.Material and methodsThe purpose of this study was the evaluation of the predictive value of 13041A>G PLIN1 polymorphism in the development of malnutrition related to adipose tissue loss in a group of 80 patients with locally advanced HNC treated by means of radical radiation therapy.ResultsAfter the completion of RTH, men with AA genotype had significantly lower fat mass (FM compared to men with G haplotype; FM: 13.84 ± 6.36 kg and 19.06 ± 6.30 kg (p = 0.009). In consequence of RTH, the AA genotype carriers lost an average of 37.01% adipose tissue mass and patients with GA and GG genotypes lost 12.82 and 0.31% (p = 0.035), respectively. AA genotype was also associated with higher chance of ≥ 10%, ≥ 20% and ≥ 30% FM loss in the course of RTH (OR = 13.78; 5.78; 2.28).ConclusionsThe evaluation of such molecular factors as SNP 13041A>G may have higher predictive value in the development of malnutrition associated with severe loss of fat mass than the subjective scales, e.g., SGA and NRS-2002. The presence of AA genotype on men with HNC before RTH may facilitate earlier nutritional intervention and supportive treatment aimed at limiting or preventing body mass and fat mass loss during the applied treatment.
Highlights
Malnutrition is a frequently diagnosed condition in head and neck cancer (HNC) patients after radiation therapy (RTH)
The distribution of single nucleotide polymorphisms (SNPs) genotypes did not depend on the clinical-demographic features of HNC patients, such as age, gender, disease stage and anatomical location of the tumour or the treatment applied before RTH
The presence of malnutrition is associated with unfavourable prognosis of the disease, higher mortality and deterioration of the quality of life; it is necessary to identify the patients with high risk of malnutrition and cachexia [18]
Summary
Malnutrition is a frequently diagnosed condition in head and neck cancer (HNC) patients after radiation therapy (RTH). The negative influence of the therapy on the nutritional status of HNC patients is confirmed by a high incidence of malnutrition (44–88%) observed after the treatment completion in this group of patients and the toxicity of the therapy leading to digestive disorders such as vomiting, diarrhoea, xerostomia, oral mucositis, taste disorder and loss of appetite [2, 5, 6] These side effects of the treatment lead to a significant reduction in the supply of food and energy. Its main task in the state of energy balance of the body is to protect fat drops with triglycerides (TG) stored inside them from the access of HSL and ATGL lipases, and regulating the process of fat storage and decomposition This function can be modulated depending on the energy needs, i.e. in states of satiation and energy surplus, the lipase access to TG is inhibited; while in states of starvation and catabolism, perilipin supports TG breakdown by lipases [13,14,15]. Among SNPs, rs2304795 (13041A>G) located in the 3′ region of the PLIN1 gene seems to have a significant role in the regulation of perilipin function and adipose tissue turnover in the body, as its close association with BMI, body weight and obesity risk has been reported [17]
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