Relationship between oropharyngeal dysphagia, nutritional status, antioxidant vitamins and the inflammatory response in adults and elderly: A cross-sectional study. (August 2020)

• Record Type: Journal Article
• Authors: Homem, Suellen Guesser; Moreira, Emilia Addison Machado; da Silva, Alice Freitas; Barni, Gabriela Cristofoli; da Rosa, Julia Salvan; Oliveira, Diane de Lima; Tomio, Camila; de Freitas, Maiara Brusco; Portari, Guilherme Vannucchi; Furkim, Ana Maria; Moreno, Yara Maria Franco; Fröde, Tânia Silvia
• Is Part Of: Clinical nutrition ESPEN. Volume 38(2020)
• Page Start: 211
• Page End: 217
• Publication Date: 2020-08
• Subjects: Deglutition disorders -- Nutritional status -- Antioxidants -- CRP -- MPO -- NOx; BMI Body Mass Index -- %BF Percentage of Body Fat -- CG Control Group -- ODG Oropharyngeal Dysphagia Group -- 95%CI 95% Confidence Interval -- DM Diabetes Mellitus -- FOIS Functional Oral Intake Scale -- IQR Interquartile Range -- OD Oropharyngeal Dysphagia -- OR Odds Ratio -- CRP C-Reactive Orotein -- MPO Myeloperoxidase -- NOx Nitric Oxide Metabolites -- TNF-alpha Tumor Necrosis Factor-α -- IL-1β Interleukin-1β -- IL-6 Interleukin-6 -- EI Energy Intake -- FFQ Food Frequency Questionnaire -- OF Oral Feeding; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2020.04.011
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background & aim: Oropharyngeal dysphagia (OD) can lead to a deficiency of antioxidant micronutrients. The aim of the present study was to investigate the relation between OD and nutritional status, antioxidant vitamins (β-carotene, vitamin E and C) and serum markers of the inflammatory response [C-reactive protein, myeloperoxidase (MPO), nitric oxide metabolites (NOx), tumor necrosis factor-α, interleukin (IL)-1β and IL-6] in adults and elderly. Methods: A cross-sectional study was conducted with 69 individuals: 22 in the control group (CG) and 47 in the OD group (ODG). The ODG was subdivided into ODG-mild = normal oral feeding (OF, n = 14), ODG-moderate (OF-modified, n = 22) and ODG-severe (OF-suspended, n = 11). Associations were investigated using multiple linear regression. Results: The body mass index (BMI) was higher in the ODG compared to the CG (p = 0.008), independently of sex, age, energy intake (EI) and score on the Functional Independence Measure. BMI was significantly lower in the ODG-severe compared to the ODG-mild (p = 0.012). OD was associated with lower concentrations of β-carotene (p < 0.001) and vitamin C (p < 0.001), independently of sex, age and EI, and higher concentrations of MPO (p = 0.008) and NOx (p = 0.011), independently of sex, age and the presence of comorbidities. Conclusion: Adults and elderly with OD have lower levels of antioxidant vitamins (β-carotene and vitamin C) and a high inflammatory response (MPO and NOx). The evaluation of antioxidant vitamins could be incorporated in nutritional status assessment in this population. Highlights: Functional capacity is diminished in oropharyngeal dysphagia (OD). Overweight and obesity were more prevalent than malnutrition. Lower median body mass index and body fat were found in the severe OD. Nutritional status is prejudiced when oral feeding was suspended.