Abstract
The monitoring of micronutrients and the relationship between dietary intake and micronutrient status prior to and after surgery in patients with histologically proven gastrointestinal adenocarcinoma, both weight-stable and weight-losing (> 7.5% of their pre-illness weight) has been studied and the results compared to controls. Plasma vitamin C and red blood cell thiamine levels were significantly lower in weight-losing cancer patients when compared to their weight-stable counterparts (P < 0.05 and P < 0.02 respectively). Weight-losing patients had a lower vitamin C (P < 0.05) and thiamine (P < 0.002) intake, and a higher elevation in plasma C-reactive protein and a lower prealbumin level (P < 0.02), when compared to both weight-stable cancer patients and controls. Plasma vitamin C, prealbumin and C-reactive protein levels remained unchanged after curative resections of the tumours compared to a preoperative value, and there was a highly significant correlation between plasma vitamin C and dietary intake of vitamin C. This study suggests that the lower vitamin C and thiamine status in weight-losing gastrointestinal cancer patients prior to surgery is due to a lower micronutrient intake and an acute phase response to their illness. Dietary intake of vitamin C appears to be the major factor in determining plasma vitamin C concentration following curative surgical resection.
Highlights
Forty-one consecutive patients admitted to the Surgical Unit at Royal London Hospital were recruited to the study. These comprised of thirty-one patients with histologically proven gastrointestinal adenocarcinoma and ten weight-stable patients of equal sex and age distribution, with benign gastrointestinal disease who acted as controls
Reference values given are derived from extensive studies of vitamin levels in normal individuals, including those in institutions and elderly at home (Newton et al, 1985; Schorah 'personal communication')
When all cancer patients irrespective of weight loss were compared to control patients, there was no significant difference between plasma levels of vitamin C or red blood cell thiamine levels
Summary
The aim of the present work was the monitoring of micronutrients in gastrointestinal cancer and to investigate the relationship between dietary intake and micronutrient status prior to and after surgery
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