The Effect of Adherence to Mediterranean Diet on Inflammation and Recurrence in Cancer Patients

Öz

Systemic inflammation and oxidative stress are known to have an effect on the development and progression of cancer. Although there are some studies showing that the effect of the Mediterranean diet on cancer is through these parameters, this relationship has still not been clearly determined. Therefore, the aim of this study was to reveal the relationship between adherence to the Mediterranean diet and systemic inflammation markers in cancer patients and to examine its effect on relapse or progression in these patients. For this purpose, 102 cancer patients who applied to University of Health Sciences Antalya Education and Resarch Hospital Medical Oncology Department outpatient clinic for follow-up and treatment between March 2021 and May 2021 were evaluated. Patients were divided according to whether they received active oncological treatment or not. Adaptation to the Mediterranean diet; Evaluated by the Mediterranean diet adherence scale ([Mediterranean Diet Adherence Screener (MEDAS)] questionnaire. Systemic inflammation index and HALP score were used to evaluate the inflammation status of the patients. In addition, Charlson Comorbidity index, which may affect the results of inflammation and recurrence, was also evaluated in patients. It was detected that the mean MEDAS score (7.4±2.41) of the individuals in the untreated group was significantly higher than the MEDAS score average (6.3±1.78) of the individuals in the treated group (p<0.05). In the analysis on inflammation markers, it was detected that individuals who did not adharence to the Mediterranean diet had higher CRP levels and SII scores, and lower HALP scores than those who did adharence to the Mediterranean diet (p<0.05). As a result of univariate and multivariate analyzes, CRP (OR 0.97, 95% CI 0.95-0.99, p=0.006) and presence of relapse (OR 0.07, 95% CI 0.01-0.45, p=0.005) were found to be associated with the Mediterranean diet, independent of other factors. In conclusion, our study showed that adherence to the Mediterranean diet was inversely related to CRP, an inflammation marker, and ultimately to the recurrence or progression of the disease. As a result of univariate and multivariate analyzes, CRP (OR 0.97, 95% CI 0.95-0.99, p=0.006) and presence of recurrence or progression (OR 0.07, 95% CI 0.01-0.45, p=0.005) were associated with adherence to the Mediterranean diet, regardless of other factors. found to be related. In conclusion, our study showed that adherence to the Mediterranean diet was inversely related to CRP, an inflammation marker, and ultimately to the recurrence or progression of the disease.

Anahtar Kelimeler

• Mediterranean diet
• inflammation
• cancer
• recurrence

Kanser Hastalarında Akdeniz Diyetine Uyumun İnflamasyon ve Nüks Üzerine Olan Etkisi

Öz

Sistemik inflamasyon ve oksidatif stresin kanserin gelişimi ve ilerlemesi üzerine etkisi olduğu bilinmektedir. Akdeniz diyetinin kanser üzerine olan etkisinin bu parametreler üzerinden olduğunu gösteren bazı çalışmışalar bulunsa da bu ilişki hale net olarak belirlenememiştir. Bu nedenle bu çalışmanın amacı, kanser hastalarında Akdeniz diyetine uyum ile sistemik İnflamasyon belirteçleriyle olan ilişkiyi ortaya koymak ve bu hastalardaki nüks veya progresyon üzerine olan etkisini incelemekti. Bu amaçla Mart 2021 ile Mayıs 2021 tarihleri arasında takip ve tedavi Sağlık Bilimleri Üniversitesi Antalya Eğitim Araştırma Hastanesi Tıbbi Onkoloji Bilim Dalı polikliniğine başvuran 102 kanser hastası değerlendirilmiştir. Hastalar aktif onkolojik tedavi alıp almamasına göre ayrılmıştır. Akdeniz diyetine uyum; Akdeniz diyeti bağlılık ölçeği ([Mediterranean Diet Adherence Screener (MEDAS)] anketi ile değerlendirilmiştir. Hastaların inflamasyon durumlarının değerlendirilmesinde ise sistemik inflamasyon indeksi ve HALP skoru kullanılmıştır. Ayrıca inflamasyon ve nüks sonuçlarına etki edebilecek Charlson Komorbidite indeksi de hastalarda değerlendirilmiştir. Hastalarda tedavi almayan gruptaki bireylerin MEDAS skor ortalamasının (7.4±2.41) tedavi alan gruptaki bireylerin MEDAS skor ortalamasına (6.3±1.78) göre anlamlı düzeyde yüksek olduğu saptanmıştır (p<0.05). İnflamasyon belirteçler üzerine yapılan analizde ise Akdeniz diyetine uyum sağlamayan bireylerin Akdeniz diyetine uyum sağlayan bireylere göre C-reaktif protein (CRP) düzeyleri ve Sİİ skorları daha yüksek, HALP skorlarının ise daha düşük olduğu saptanmıştır (p<0.05). Yapılan univariate ve multivariate analizler sonucunca CRP (OR 0.97, %95 CI 0.95-0.99, p=0.006) ve nüks varlığı (OR 0.07, %95 CI 0.01-0.45, p=0.005) diğer faktörlerden bağımsız olarak Akdeniz diyetiyle ilişkili olarak saptanmıştır. Sonuç olarak çalışmamızda Akdeniz diyetine uyumun bir inflamasyon belirteci olan CRP ile ve nihayetinde hastalığın nüks veya progresyonu ile ters ilişki olduğu gösterilmiştir.

Anahtar Kelimeler

• Akdeniz diyeti
• İnflamasyon
• Kanser
• Nüks

Kaynakça

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