Usefulness of oral mucosal epithelial cell apoptosis rate in nutritional assessment.
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.
Luo
Xuelai
X
Molecular Centre and Department of Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Zhou
Yi
Y
Tao
Deding
D
Yu
Yuan
Y
Hu
Junbo
J
Qiu
Fazu
F
Kulkarni
Hrishikesh
H
Gong
Jianping
J
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
D015415:Biomarkers; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D012709:Serum Albumin