Resumos
A perda de peso é comum em uma grande variedade de doenças, particularmente entre as neoplasias. O objetivo deste estudo foi o de comparar a composição corporal de pacientes desnutridos portadores de câncer ou doenças benignas do aparelho digestivo, através da impedância bioelétrica. Foram avaliados 35 pacientes desnutridos (Indice de massa corporal < 18,5), de 22 a 70 anos, 26 (74,3%) do sexo masculino e nove (25,7%) do sexo feminino, sendo 17 (48,6%) portadores de neoplasias e 18 (51,4%) com doenças benignas. O grupo com neoplasia apresentou idade superior ao de doenças benignas (55,5±10,4 vs 39,8±9,9; p<0,05). O percentual de perda de peso e os valores de albumina sérica não foram diferentes entre os grupos. O percentual de gordura corporal, de massa magra e de água corporal também não diferiu significantemente. Conclui-se que a variação da composição corporal não é diferente em pacientes desnutridos portadores de doença neoplásica ou benigna do aparelho digestivo, quando eliminada a interferência causada por diferentes graus de perda ponderal.
Desnutrição; Composição corporal; Aparelho digestivo; Câncer; Impedância bioelétrica
The loss of weight is a common feature in a large number of diseases, particularly in malignancies. There are some controverses in the literature concerning body composition in malnourished patients with cancer that may differ from patients without cancel: The aim of this study was to compare the body composition of malnourished patients with benign and malignant diseases of the digestive system by bioelectric impedance. Thirty five malnourished patients (body mass index < I 8.5) were evaluated. The age ranged from 22 to 70 years; 26 (74.3%) were male and 09 (25.7%) were female. Seventeen of them (48.6%) had neoplasies and 18 (51.4% ) had benign conditions of the digestive tract. The neoplasic group was older than the non-neoplasic group (55.5±10.4 vs 39.8±9.9; p<0.05). The body fat, lean mass and body water percents did not differ between the groups. Albumin levels (benign 2.6±0.6 mg/dl vs cancer 2.9±0.6 mg/d/,. p>0.05) and the percentual of loss of weight (benign 24.0±9.8 vs cancer 24.1± I4.7) were similar in both groups. It was concluded that the body composition in malnourished patients is similar in benign and malignant conditions of the digestive tract provided that interferencies due to different degrees of loss of weight are eliminated.
Malnutrition; Body composition; Digestive system; Cancer; Bioelectric impedance
ARTIGOS ORIGINAIS
Composição corporal na desnutrição causada por câncer e doenças benignas do aparelho digestivo
Body composition in malnutrition due to cancer and benign digestive diseases
Shirley Ferreira PereiraI; José Eduardo de Aguilar-Nascimento, TCBC-MTII
IProfessora Assistente, Mestre em Saúde e Ambiente, Departamento de Nutrição da FEN-UFMT
IIProfessor Adjunto, Doutor em Medicina, Chefe do Departamento de Cirurgia da FCM-UFMT
Endereço para correspondência Endereço para correspondência: Dr. José Eduardo de Aguillar-Nascimento Rua Estevão de Mendonça, 81/801 78045-200 - Cuiabá-MT
RESUMO
A perda de peso é comum em uma grande variedade de doenças, particularmente entre as neoplasias. O objetivo deste estudo foi o de comparar a composição corporal de pacientes desnutridos portadores de câncer ou doenças benignas do aparelho digestivo, através da impedância bioelétrica. Foram avaliados 35 pacientes desnutridos (Indice de massa corporal < 18,5), de 22 a 70 anos, 26 (74,3%) do sexo masculino e nove (25,7%) do sexo feminino, sendo 17 (48,6%) portadores de neoplasias e 18 (51,4%) com doenças benignas. O grupo com neoplasia apresentou idade superior ao de doenças benignas (55,5±10,4 vs 39,8±9,9; p<0,05). O percentual de perda de peso e os valores de albumina sérica não foram diferentes entre os grupos. O percentual de gordura corporal, de massa magra e de água corporal também não diferiu significantemente. Conclui-se que a variação da composição corporal não é diferente em pacientes desnutridos portadores de doença neoplásica ou benigna do aparelho digestivo, quando eliminada a interferência causada por diferentes graus de perda ponderal.
Unitermos: Desnutrição; Composição corporal; Aparelho digestivo; Câncer; Impedância bioelétrica.
ABSTRACT
The loss of weight is a common feature in a large number of diseases, particularly in malignancies. There are some controverses in the literature concerning body composition in malnourished patients with cancer that may differ from patients without cancel: The aim of this study was to compare the body composition of malnourished patients with benign and malignant diseases of the digestive system by bioelectric impedance. Thirty five malnourished patients (body mass index < I 8.5) were evaluated. The age ranged from 22 to 70 years; 26 (74.3%) were male and 09 (25.7%) were female. Seventeen of them (48.6%) had neoplasies and 18 (51.4% ) had benign conditions of the digestive tract. The neoplasic group was older than the non-neoplasic group (55.5±10.4 vs 39.8±9.9; p<0.05). The body fat, lean mass and body water percents did not differ between the groups. Albumin levels (benign 2.6±0.6 mg/dl vs cancer 2.9±0.6 mg/d/,. p>0.05) and the percentual of loss of weight (benign 24.0±9.8 vs cancer 24.1± I4.7) were similar in both groups. It was concluded that the body composition in malnourished patients is similar in benign and malignant conditions of the digestive tract provided that interferencies due to different degrees of loss of weight are eliminated.
Key words: Malnutrition; Body composition; Digestive system; Cancer; Bioelectric impedance.
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REFERÊNCIAS
1. Studlet HO - Percentage of weight loss. A basic index of surgical risk in patients with chronic peptic ulcer. J Am Med Assoc 1936;106: 458-465.
2. Kamath SK, Lawler M, Smith AE, et al- Hospital malnutrition: a 33- hospital screening study. J Am Diet Assoc 1986;86:203-206.
3. Lansey S, Waslien C, Mulvihill M, et al- The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly. Gerontol 1993;39:346-353.
4. Mc Whirter JP, Pennington CR - Incidence and recognition of malnutrition in hospital. Br Med J 1994;308:945-948.
5. Gallagher-Allred CR, Voss. AC, Finn SC, et al- Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 1996;96:361-366.
6. Aguilar-Nascimento JE, Caporossi C, Serra MC, et al - Implicações da desnutrição em cirurgia. Rev Col Bras Cir 1991;23:193-196.
7.. Shizgal HM - Body composition of patients with malnutrition and cancer Cancer 1985;55:250-253.
8. Tisdale MJ - Cancer cachexia: metabolic alterations and clinical manifestations. Nutrition 1997;13:1-7.
9. Gurski RR, Pereira da Rosa AR, Santos WG,et al Avaliação nutricional pré-operatória do paciente cirúrgico. Rev Col Bras Cir 1997;24: 185-189.
10. Robert S, Zarowitz B1, Hyzy R, et al - Bioelectrical impedance assessment of nutritional status in critically ill patients. Am J Clin Nutr 1993;57:840-844.
11. Gagnon R, Gagner M, Duplessis S - Variations de la composition corporelle par impédancemétrie bioélectrique aprés chirurgie majeure. Ann Chir 1994;48:708-716.
12. Holt TL, Cui C, Thomas B1, et al - Clinical applicability of bioelectric impedance to measure body composition in health and disease. Nutrition 1994;10:221-224.
13. Madden AM, Morgan MY - The potential role of dual-energy X-ray absortiometry in the assessment of body composition in cirrhotic patients. Nutrition 1997;13:40-45.
14. Cohn SH, Gartenhaus W, Sawitsky A - Compartimental body composition of cancer patients with measurements of total nitrogen, potassium and water. Metabol 1981 ;30:222-1.28.
15. Lindmark L, Bennegard K, Eden E, et al- Resting energy expenditure in malnourished patients with and without cancer. Gastroenterol 1984;87:402-408.
16. Heymsfield SB, Stevens V, Noel R, et al - Biochemical composition of muscle in normal and semistarved human subjects: relevance to anthropometric measurements. Am J Clin Nutr 1982; 36:131-142.
17. Ferro-Luzzi A, Sette S, Franklin M, et al- A simplified approach of assessing adult chronic energy deficiency. Eur J Clin Nutr 1992; 46:173-186.
18. Pereira SF, Martins MAS, Aguilar-Nascimento JE- Estudo comparativo da estimação da gordura corporal através da antropometria e da impedância bioelétrica. J Bras Med (aceito para publicação)
19. Guedes DP - Composição corporal: princípios, técnicas e aplicações. Londrina: APEF, 1994.
20. Falconer JS, Fearon KCH, Plester CE, et al - Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg 1994;4:325-331.
21. Strassmann G, Fong M, Kenney JS, et al- Evidence for the involvement of interleukin 6 in experimental cancer cachexia. J Clin Invest 1992; 1681-1684.
22. Yoneda T, Alsina MA, Chavez JB, et al - Evidence that tumor necrosis factor plays a pathogenic role in the paraneoplasic syndromes of cachexia, hypercalcemia, and leukocytosis in a human tumor in nude mice. J Clin Invest 1991;87:977-985.
23. Kralovic RC, Zepp EA, Cenedella RJ - Studies of the mechanism of carcass fat depletion in experimental cancer. Eur J Cancer 1977; 13:1.071-1.079.
24. Dumin, JVGA - Energy requeriments: general principles. Eur J Clin Nutr 1996; 50:S2-S10.
25. Moreira Jr JC - Repercussões clínicas da desnutrição. Desnutrição e avaliação nutricional. GANEP, SPNPE. 1996
26. Shetty PS - Physiological mechanisms in the adaptative response of metabolic rales to energy restriction. Nutr Res Rev 1990;3:49-74.
27. Soares MJ, Shetty PS - Basal metabolic rates and metabolic economy in chronic undernutrition. Eur J Clin Nutr 1991; 5:363-373.
28. Bemstein L, Pleban W - Prealbumin in nutrition evaluation. Nutrition 1996; 12:255-259.
Recebido em 23/1/98
Aceito para publicação em 26/10/98
Trabalho realizado no Departamento de Cirurgia do Hospital Universitário Júlio Müller, da Universidade Federal de Mato Grosso - UFMT.
- 1. Studlet HO - Percentage of weight loss. A basic index of surgical risk in patients with chronic peptic ulcer. J Am Med Assoc 1936;106: 458-465.
- 2. Kamath SK, Lawler M, Smith AE, et al- Hospital malnutrition: a 33- hospital screening study. J Am Diet Assoc 1986;86:203-206.
- 3. Lansey S, Waslien C, Mulvihill M, et al- The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly. Gerontol 1993;39:346-353.
- 4. Mc Whirter JP, Pennington CR - Incidence and recognition of malnutrition in hospital. Br Med J 1994;308:945-948.
- 5. Gallagher-Allred CR, Voss. AC, Finn SC, et al- Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 1996;96:361-366.
- 6. Aguilar-Nascimento JE, Caporossi C, Serra MC, et al - Implicaçőes da desnutriçăo em cirurgia. Rev Col Bras Cir 1991;23:193-196.
- 7.. Shizgal HM - Body composition of patients with malnutrition and cancer Cancer 1985;55:250-253.
- 8. Tisdale MJ - Cancer cachexia: metabolic alterations and clinical manifestations. Nutrition 1997;13:1-7.
- 9. Gurski RR, Pereira da Rosa AR, Santos WG,et al Avaliaçăo nutricional pré-operatória do paciente cirúrgico. Rev Col Bras Cir 1997;24: 185-189.
- 10. Robert S, Zarowitz B1, Hyzy R, et al - Bioelectrical impedance assessment of nutritional status in critically ill patients. Am J Clin Nutr 1993;57:840-844.
- 11. Gagnon R, Gagner M, Duplessis S - Variations de la composition corporelle par impédancemétrie bioélectrique aprés chirurgie majeure. Ann Chir 1994;48:708-716.
- 12. Holt TL, Cui C, Thomas B1, et al - Clinical applicability of bioelectric impedance to measure body composition in health and disease. Nutrition 1994;10:221-224.
- 13. Madden AM, Morgan MY - The potential role of dual-energy X-ray absortiometry in the assessment of body composition in cirrhotic patients. Nutrition 1997;13:40-45.
- 14. Cohn SH, Gartenhaus W, Sawitsky A - Compartimental body composition of cancer patients with measurements of total nitrogen, potassium and water. Metabol 1981 ;30:222-1.28.
- 15. Lindmark L, Bennegard K, Eden E, et al- Resting energy expenditure in malnourished patients with and without cancer. Gastroenterol 1984;87:402-408.
- 16. Heymsfield SB, Stevens V, Noel R, et al - Biochemical composition of muscle in normal and semistarved human subjects: relevance to anthropometric measurements. Am J Clin Nutr 1982; 36:131-142.
- 17. Ferro-Luzzi A, Sette S, Franklin M, et al- A simplified approach of assessing adult chronic energy deficiency. Eur J Clin Nutr 1992; 46:173-186.
- 18. Pereira SF, Martins MAS, Aguilar-Nascimento JE- Estudo comparativo da estimaçăo da gordura corporal através da antropometria e da impedância bioelétrica. J Bras Med (aceito para publicaçăo)
- 19. Guedes DP - Composiçăo corporal: princípios, técnicas e aplicaçőes. Londrina: APEF, 1994.
- 20. Falconer JS, Fearon KCH, Plester CE, et al - Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg 1994;4:325-331.
- 21. Strassmann G, Fong M, Kenney JS, et al- Evidence for the involvement of interleukin 6 in experimental cancer cachexia. J Clin Invest 1992; 1681-1684.
- 22. Yoneda T, Alsina MA, Chavez JB, et al - Evidence that tumor necrosis factor plays a pathogenic role in the paraneoplasic syndromes of cachexia, hypercalcemia, and leukocytosis in a human tumor in nude mice. J Clin Invest 1991;87:977-985.
- 23. Kralovic RC, Zepp EA, Cenedella RJ - Studies of the mechanism of carcass fat depletion in experimental cancer. Eur J Cancer 1977; 13:1.071-1.079.
- 24. Dumin, JVGA - Energy requeriments: general principles. Eur J Clin Nutr 1996; 50:S2-S10.
- 25. Moreira Jr JC - Repercussőes clínicas da desnutriçăo. Desnutriçăo e avaliaçăo nutricional. GANEP, SPNPE. 1996
- 26. Shetty PS - Physiological mechanisms in the adaptative response of metabolic rales to energy restriction. Nutr Res Rev 1990;3:49-74.
- 27. Soares MJ, Shetty PS - Basal metabolic rates and metabolic economy in chronic undernutrition. Eur J Clin Nutr 1991; 5:363-373.
- 28. Bemstein L, Pleban W - Prealbumin in nutrition evaluation. Nutrition 1996; 12:255-259.
Endereço para correspondência:
Datas de Publicação
-
Publicação nesta coleção
25 Fev 2010 -
Data do Fascículo
Fev 1999
Histórico
-
Aceito
26 Out 1998 -
Recebido
23 Jan 1998
