Abstract
Objective: To assess the influence of malnutrition in patients with pancreatic carcinoma (PC) on the oxidative stress and antioxidant system. Design: Observation, matched case-control study.
Settings: This study was conducted at the 4th Department of Internal Medicine of General University Hospital in Prague, U Nemocnice 2, 128 01 Prague 2, Czech Republic Material and methods: In to our study 68 patients (M/F = 36/32) with PC were included and divided according to the nutrition risk index into two groups - patients with moderate or severe malnutrition (PC-MAL) and mild or no malnutrition (PCNOR). In both groups there were 34 patients (M/F = 18/16) with no difference in age between both groups.
Furthermore, group of 34 sex- and age-matched healthy controls (CON) were enrolled into the study. The samplings were taken after overnight fast and apart from basic clinical and biochemical parameters markers of oxidative stress (level of conjugated dienes in precipitated LDL, CD/LDL and oxidized LDL, ox-LDL/LDL), activities of antioxidant enzymes and concentration of reduced glutathione (GSH) were assessed.
For all statistical analysis the statistical program STATISTICA (Stat Soft, CZ) was used. Results: In our study we confirmed increased oxidative stress in PC, with higher levels of ox-LDL/LDL and CD/LDL compared to CON (p < 0.01).
Significantly higher levels of these markers were in patients with malnutrition then without malnutrition. We observed also changes in antioxidant system of PC patients - these patients had decreased activity of catalase (CAT, p < 0.01), glutathione peroxidase (p < 0.01), arylesterase (PON-A) and also lactonase activity (PON-L) of paraoxonase (p < 0.01) and concentration of GSH (p < 0.001) and higher levels of serum amyloid A (SAA, p < 0.001).
The changes in CAT, PON-A, PON-L and SAA levels were significantly higher in PC patients with malnutrition then without. Conclusion: In this study we proved the deepening of oxidative stress and the strongly impaired function of antioxidant system in PC patients due to malnutrition.