title: Usefulness of oral mucosal epithelial cell apoptosis rate in nutritional assessment.
abstract: OBJECTIVE
  This preliminary study was designed to explore a new method for nutritional assessment by measuring oral mucosal cell apoptosis or proliferation.
  
  
  METHODS
  Forty-two consecutive patients with gastrointestinal malignant tumors were hospitalized on the surgical wards and studied prospectively. Patient-Generated Subjective Global Assessment was used to identify malnourished patients. Anthropometric measurements including weight, body mass index, triceps skinfold thickness, and midarm muscle circumference were recorded. The serum proteins measured were retinol-binding protein (RBP), transferrin, prealbumin (PA), and albumin. Simultaneously, the rates of oral epithelial cell apoptosis and proliferation were measured by flow cytometry. Of the 20 malnourished patients, 14 were followed up in a serial study with a 3-d nutritional support therapy. Nutritional indices and oral epithelial cell apoptosis rate were measured after 3 d of nutritional support.
  
  
  RESULTS
  Malnutrition was diagnosed in 20 of 42 patients (47.6%). Oral epithelial apoptosis and proliferation rates were significantly decreased (P < 0.01 and P < 0.05, respectively) in malnourished compared with non-malnourished patients, although there were no significant differences between their anthropometric data. Malnourished patients had lower serum levels of RBP, albumin, and PA and rates of oral epithelial cell apoptosis and proliferation. The rate of oral epithelial cell apoptosis positively correlated with serum RBP (R = 0.32, P < 0.05) and PA (R = 0.33, P < 0.05). The rate of oral epithelial cell apoptosis and serum RBP and PA increased significantly in the malnourished patients who received nutritional support for 3 days.
  
  
  CONCLUSIONS
  Measuring the rate of oral epithelial cell apoptosis may be another non-invasive technique to determine nutritional assessment and is worthy of further exploration.
authors.affiliation: Molecular Centre and Department of Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
authors.forename: Xuelai
authors.initials: X
authors.lastname: Luo
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhou
authors.forename: Deding
authors.initials: D
authors.lastname: Tao
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yu
authors.forename: Junbo
authors.initials: J
authors.lastname: Hu
authors.forename: Fazu
authors.initials: F
authors.lastname: Qiu
authors.forename: Hrishikesh
authors.initials: H
authors.lastname: Kulkarni
authors.forename: Jianping
authors.initials: J
authors.lastname: Gong
mesh_terms: D017209:Apoptosis; D015415:Biomarkers; D002455:Cell Division; D004847:Epithelial Cells; D005260:Female; D005434:Flow Cytometry; D005770:Gastrointestinal Neoplasms; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D009061:Mouth Mucosa / Q000166:cytology* / Q000473:pathology; D015596:Nutrition Assessment; D011228:Prealbumin / Q000378:metabolism; D011446:Prospective Studies; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D015415:Biomarkers; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D012709:Serum Albumin