Synergistic improvement effect of marine bioactive peptides on nutritional status in cancer patients during chemotherapy

Rui ZHOU; Yan LIU; Huiyi FENG; Xidi LIU; Chan LU; Wenying LIU; Xinxue ZHANG; Shaowei FU; Bing LIN; Yajing LIU; Jing YANG; Weiqian HU; Yongsheng ZHANG; Cuifeng ZHU

doi:10.16016/j.2097-0927.202304110

您当前的位置：

首页 >

文章列表页 >

Synergistic improvement effect of marine bioactive peptides on nutritional status in cancer patients during chemotherapy

Monographic Reports: Nutritional intervention for chronic diseases | 更新时间：2026-01-09

- Synergistic improvement effect of marine bioactive peptides on nutritional status in cancer patients during chemotherapy
- Journal of Army Medical University Vol. 45, Issue 15, Pages: 1627-1634(2023)
- 作者机构：
  
  1.518000 广东深圳，南方医科大学深圳医院临床营养科
  2.530000 南宁，广西医科大学第一附属医院营养科
  3.518000 广东深圳，南方医科大学深圳医院临床肿瘤科
  4.100015 北京，中国食品发酵工业研究院有限公司，北京市蛋白功能肽工程技术研究中心
- 作者简介：
- 基金信息：
  
  the National Key Research and Development Program of China(2016YFD0400604);the Special Fund of Clinical Research From Wu Jieping Medical Foundation of National Health Commission(320-6750 -2020.06.63);the Scientific Research Fund of Shenzhen Hospital of Southern Medical University(PY2020YM04)
- DOI：10.16016/j.2097-0927.202304110
  CLC： R459.3;R730.53;R977.6
- Received：28 April 2023，
  
  Revised：2023-06-14，
  
  Published：15 August 2023
- 稿件说明：
移动端阅览
Rui ZHOU, Yan LIU, Huiyi FENG, et al. Synergistic improvement effect of marine bioactive peptides on nutritional status in cancer patients during chemotherapy[J]. Journal of Army Medical University, 2023, 45(15): 1627-1634.
DOI：

Rui ZHOU, Yan LIU, Huiyi FENG, et al. Synergistic improvement effect of marine bioactive peptides on nutritional status in cancer patients during chemotherapy[J]. Journal of Army Medical University, 2023, 45(15): 1627-1634. DOI： 10.16016/j.2097-0927.202304110.

摘要

目的

探讨海洋生物活性肽联合常规口服营养补充(oral nutritional supplement，ONS)干预对恶性肿瘤患者营养状况的影响，评估营养支持方案。

方法

采用临床随机对照试验，纳入南方医科大学深圳医院和广西医科大学第一附属医院2021年9-11月确诊消化系统肿瘤患者共108例为研究对象。采用随机数字法将患者分为对照组、ONS组、ONS+活性肽组，3组均接受营养会诊及饮食指导，建议患者均衡膳食。ONS组接受加餐常规口服营养液，ONS+活性肽组在ONS基础上联合18 g/d海洋生物活性肽，比较3组患者入院时和8周的主要观察指标变化，包括NRS2002评分、PG-SGA评分、体质量、体质指数(body mass index，BMI)、肌肉量、脂肪量、上臂肌围、小腿围、握力，次要观察指标包括腰围、臀围、血清白细胞计数、红细胞计数、血红蛋白、白蛋白、总蛋白水平。

结果

对照组36例、ONS组33例和ONS+活性肽组30例最终完成临床随访。3组患者的一般临床资料具有可比性(

0.05)。随访8周后，对照组患者NRS2002评分和PG-SGA评分明显增高，体质量、BMI、体脂肪量、上臂肌围、小腿围、腰围、臀围、握力水平、白蛋白水平显著下降；ONS组和ONS+活性肽组患者体质量、BMI、肌肉量、体脂肪量、小腿围、腰围、臀围、握力水平、血清白蛋白、总蛋白水平明显高于入院时及对照组；ONS+活性肽组患者体质量、BMI、肌肉量、体脂肪量、血清白蛋白、总蛋白水平、小腿围较入院时有明显增长；与ONS组相比，ONS+活性肽组8周时患者蛋白质摄入明显增多，PG-SGA评分显著下降，差异均有统计学意义(

0.05)。

结论

肿瘤患者营养不良的风险较高，海洋生物活性肽联合常规ONS干预可能在改善肿瘤患者生活质量，延长生命中具有正面效应。

Abstract

Objective

To explore the effect of marine bioactive peptides (MBP) combined with routine oral nutritional supplementation (ONS) on nutritional status in cancer patients

and to evaluate the effectiveness of nutritional support therapy.

Methods

A clinical randomized controlled trial was conducted on 108 patients with digestive tumors admitted in Shenzhen Hospital of Southern Medical University and the First Affiliated Hospital of Guangxi Medical University from September to November 2021. They were randomly divided into control group

ONS group and ONS+MBP group. All patients from the 3 groups received nutrition consultation and diet guidance to suggest balanced diet. ONS alone or combined with 18 g/d MBP were given to the patients of the ONS group and ONS+MBP group. The main observation indexes at admission and 8 weeks after intervention included NRS2002 score

PG-SGA score

body weight

body mass index (BMI)

muscle mass

fat mass

upper arm muscle circumference

calf circumference

grip strength

and the secondary observation indexes included waist circumference

hip circumference

serum white blood cell count

red blood cell count

hemoglobin

albumin and total protein level.

Results

There were 36 patients from the control group

33 from the ONS group and 30 from the ONS+MBP group completing the follow-up. No statistical differences were observed in the general clinical data among the 3 groups (

0.05). After 8 weeks' follow-u

NRS2002 and PG-SGA scores were increased

but body weight

BMI

fat mass

upper arm muscle circumference

calf circumference

waist circumference

hip circumference

grip strength and albumin level were decreased in the control group. The body weight

BMI

muscle mass

fat mass

calf circumference

waist circumference

hip circumference

grip strength

serum albumin and total protein levels at 8 weeks after intervention were significantly increased in the ONS group and ONS+MBP group than the levels at admission and those of the control group after 8 weeks' follow-up. The ONS+MBP group also had obviously elevated body weight

BMI

muscle mass

fat mass

serum albumin and total protein levels and calf circumference when compared with those at admission. The patients of the ONS+MBP group showed significant increase in protein intake and notable decrease in PG-SGA score at 8 weeks (

0.05).

Conclusion

Cancer patients have a high risk for malnutrition

and intervention of ONS combined with MAP may have positive effects on improving their quality of life and extend their lives.

关键词

Keywords

references

SUNG H, FERLAY J, SIEGEL R L, et al . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J ] . CA A Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.

DA FONSECA G W P, SATO R, DE NAZARÉ NUNES ALVES M J, et al . Current advancements in pharmacotherapy for cancer cachexia[J ] . Expert Opin Pharmacother, 2023, 24(5): 629-639. DOI: 10.1080/14656566.2023.2194489.

ARENDS J, BACHMANN P, BARACOS V, et al . ESPEN guidelines on nutrition in cancer patients[J ] . Clin Nutr, 2017, 36(1): 11-48. DOI: 10.1016/j.clnu.2016.07.015.

MENG Q Y, TAN S J, JIANG Y, et al . Post-discharge oral nutritional supplements with dietary advice in patients at nutritional risk after surgery for gastric cancer: a randomized clin ical trial[J ] . Clin Nutr, 2021, 40(1): 40-46. DOI: 10.1016/j.clnu.2020.04.043.

CHAKNIRAMOL S, WIERSCHEM A, CHO M G, et al . Physiological and clinical aspects of bioactive peptides from marine animals[J ] . Antioxidants, 2022, 11(5): 1021. DOI: 10.3390/antiox11051021.

JAGER-WITTENAAR H, OTTERY F D. Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment[J]. Curr Opin Clin Nutr Metab Care, 2017, 20(5): 322-329. DOI: 10.1097/MCO.0000000000000389.

MARSHALL K M, LOELIGER J, NOLTE L, et al . Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points[J ] . Clin Nutr, 2019, 38(2): 644-651. DOI: 10.1016/j.clnu.2018.04.007.

ZHANG J, YU W Q, WEI T, et al . Effects of short-peptide-based enteral nutrition on the intestinal microcirculation and mucosal barrier in mice with severe acute pancreatitis[J ] . Mol Nutr Food Res, 2020, 64(5): 1901191. DOI: 10.1002/mnfr.201901191.

APOSTOLOPOULOS V, BOJARSKA J, CHAI T T, et al . A global review on short peptides: frontiers and perspectives[J ] . M olecules, 2021, 26(2): 430. DOI: 10.3390/molecules26020430.

XING H B, TONG M T, JIANG N Y, et al . Antitumour bioactive peptides isolated from marine organisms[J ] . Clin Exp Pharmacol Physiol, 2017, 44(11): 1077-1082. DOI: 10.1111/1440-1681.12808.

RUIZ-RUIZ F, MANCERA-ANDRADE E I, IQBAL H M N. Marine-derived bioactive peptides for biomedical sectors: a review[J]. Protein Pept Lett, 2017, 24(2): 109-117. DOI: 10.2174/0929866523666160802155347.

杨鑫, 朱明炜, 修典荣, 等. 口服营养补充疗法对结直肠癌术后辅助化疗患者营养状态及生活质量的影响: 一项多中心前瞻性随机对照研究[J]. 中华胃肠外科杂志, 2020, 23(6): 566-571. DOI: 10.3760/cma.j.cn.441530-20190724-00287.

YANG X, ZHU M W, XIU D R, et al . Effect of an oral nutritional supplementation on nutritional status and quality of life in patients with colorectal cancer and postoperative adjuvant chemotherapy: a multi-center prospective randomized control trial[J ] . Chin J Gastrointest Surg, 2020, 23(6): 566-571. DOI: 10.3760/cma.j.cn.441530-20190724-00287.

COMAS MARTÍNEZ M, FIDILIO MELI E, PALMAS CANDIA F, et al . Protein supplementation with short peptides prevents early muscle mass loss after roux-en-Y-gastric bypass[J ] . Nutrients, 2022, 14(23): 5095. DOI: 10.3390/nu14235095.

XU S S, LI S, XU H X, et al . Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer[J ] . World J Gastroenterol, 2020, 26(8): 828-838. DOI: 10.3748/wjg.v26.i8.828.

VISWESHWAR N, JAGLAL M, SOKOL L, et al . Chemotherapy-related anemia[J ] . Ann Hematol, 2018, 97(2): 375-376. DOI: 10.1007/s00277-017-3155-y.

SRINIVASARAGHAVAN N, VENKETESWARAN M V, BALAKRISHNAN K, et al . Comparison of nutrition screening tools and calf circumference in estimating the preoperative prevalence of malnutrition among patients with aerodigestive tract cancers—a prospective observational cohort study[J ] . Support Care Cancer, 2022, 30(8): 6603-6612. DOI: 10.1007/s00520-022-07092-5.

PAGOTTO V, DOS SANTOS K F, MALAQUIAS S G, et al . Calf circumference: clinical validation for evaluation of muscle mass in the elderly[J ] . Rev Bras Enferm, 2018, 71(2): 322-328. DOI: 10.1590/0034-7167-2017-0121.

JOCHEMS S H J, WOOD A M, HÄGGSTRÖM C, et al . Waist circumference and a body shape index and prostate cancer risk and mortality[J ] . Cancer Med, 2021, 10(8): 2885-2896. DOI: 10.1 002/cam4.3827.

STORCK L J, USTER A, GAFNER L, et al . Effect of combined therapies including nutrition and physical exercise in advanced cancer patients: a pooled analysis[J ] . Front Nutr, 2023, 10: 1063279. DOI: 10.3389/fnut.2023.1063279.

KIM Y J, HIRATSUKA Y, SUH S Y, et al . Performance of mid-upper arm circumference and other prognostic indices based on inflammation and nutrition in oncology outpatients: a tertiary cancer center study[J ] . Ann Palliat Med, 2022, 11(10): 3171-3180. DOI: 10.21037/apm-22-481.

ZHUANG C L, ZHANG F M, XU H X, et al . Reference values of low body mass index, mid-upper arm circumference, and calf circumference in cancer patients: a nationwide multicenter observational study[J ] . Nutrition, 2022, 99/100: 111688. DOI: 10.1016/j.nut.2022.111688.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Impact of compound nutritional preparations on clinical prognosis of patients undergoing cardiovascular surgery: A randomized controlled study

Effect of a compound nutrition preparation on wound healing after acute trauma in rats

Effects of low-gluten rice (W0868) feeding on nutritional status and renal function in mice

Synthesis of anti-CAⅨ proteoglycanlike region peptide and evaluation of its target binding ability

Risk management of nursing improves chemotherapy efficiency for diabetic patients with malignant tumor

Related Author

WANG Jian

MI Mantian

LIANG Xinyu

WANG Yong

NI Xiangmin

XIN Wenbin

BAI Qian

Related Institution

Department of Nutrition, Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

Department of Cardiovascular Surgery， Second Affiliated Hospital， Army Medical University （Third Military Medical University）， Chongqing, Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

Department of Military Nutrition and Food Hygiene, Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

Department of Nutrition， Second Affiliated Hospital， Army Medical University （Third Military Medical University）

Nutrition and Food Safety Research Center， Chongqing Medical Nutrition Research Center， Chongqing Key Laboratory of Nutrition and Health， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

⁰