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Fish Oil Decreases C-Reactive Protein/Albumin Ratio Improving Nutritional Prognosis and Plasma Fatty Acid Profile in Colorectal Cancer Patients

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Lipids

Abstract

Previous studies have shown that n-3 polyunsaturated fatty acids n-3 (n-3 PUFA) have several anticancer effects, especially attributed to their ability to modulate a variety of genomic and immune responses. In this context, this randomized, prospective, controlled clinical trial was conducted in order to check whether supplementation of 2 g/day of fish oil for 9 weeks alters the production of inflammatory markers, the plasma fatty acid profile and the nutritional status in patients with colorectal cancer (CRC). Eleven adults with CRC in chemotherapy were randomized into two groups: (a) supplemented (SG) daily with 2 g/day of encapsulated fish oil [providing 600 mg/day of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] for 9 weeks (n = 6), and (b) control (CG) (n = 5). All outcomes were evaluated on the day before the first chemotherapy session and 9 weeks later. Plasma TNF-α, IL-1β, IL-10 and IL-17A, the pro/anti-inflammatory balance (ratio TNF-α/IL-10 and IL-1β/IL10) and serum albumin, showed no significant changes between times and study groups (p > 0.05). C-reactive protein (CRP) and the CRP/albumin ratio showed opposite behavior in groups, significantly reducing their values in SG (p < 0.05). Plasma proportions of EPA and DHA increased 1.8 and 1.4 times, respectively, while the ARA reduced approximately 0.6 times with the supplementation (9 weeks vs baseline, p < 0.05). Patients from SG gained 1.2 kg (median) while the CG lost −0.5 kg (median) during the 9 weeks of chemotherapy (p = 0.72). These results demonstrate that 2 g/day of fish oil for 9 weeks of chemotherapy improves CRP values, CRP/albumin status, plasma fatty acid profile and potentially prevents weight loss during treatment.

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Abbreviations

ARA:

Arachidonic acid

BMI:

Body mass index

CG:

Control group

COX:

Cyclooxygenase

CRC:

Colorectal cancer

CRP:

C-Reactive protein

DHA:

Docosahexaenoic acid

ELISA:

Enzyme-linked immunosorbent assay

EPA:

Eicosapentaenoic acid

HPLC:

High pressure liquid chromatography

IL:

Interleukin

NF-κB:

Nuclear factor κB

PG:

Prostaglandin

PINI:

Prognostic inflammatory and nutritional index

PPAR:

Peroxisome proliferator-activated receptors

PUFA:

Polyunsaturated fatty acid

SC:

Santa Catarina

SG:

Supplemented group

TNF:

Tumor necrosis factor

TNM:

Tumor staging

VB:

Visual basic

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Acknowledgments

We are grateful to the Post-Graduate Program in Nutrition—Federal University of Santa Catarina, Brazil; the Fellowship Program Social Demand/Coordination of Improvement of Higher Education Personnel (CAPES) with a scholarship grant to the senior author; and to the Foundation that Supports Research and Innovation in the State of Santa Catarina (FAPESC) by financing evaluations of inflammatory markers. Thanks also to Phytomare for the donation of the dietary supplements.

Conflict of interest

The authors state that there was no conflict of interests in any step of this study.

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Authors and Affiliations

  1. Post-Graduate Program of Nutrition, Department of Nutrition, Federal University of Santa Catarina, Reitor João David Ferreira Lima Campus, Trindade, Florianópolis, SC, 88040-970, Brazil

    Michel Carlos Mocellin, Carolina de Quadros Camargo, Yara Maria Franco Moreno & Erasmo Benicio Santos de Moraes Trindade

  2. Ambulatory Care Clinic and Oncologic Research Center, Florianópolis, SC, Brazil

    Juliana de Aguiar Pastore e Silva, Maria Emília de Souza Fabre & Scheila Gevaerd

  3. Department of Physiology, Federal University of Paraná, Curitiba, PR, Brazil

    Katya Naliwaiko

  4. Post-Graduate Program of Nutrition, Multicenter Program of Post-Graduation in Physiological Sciences, Department of Physiology, Federal University of Santa Catarina, Florianópolis, SC, Brazil

    Everson Araújo Nunes

Authors
  1. Michel Carlos Mocellin
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  2. Juliana de Aguiar Pastore e Silva
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  3. Carolina de Quadros Camargo
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  4. Maria Emília de Souza Fabre
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  6. Katya Naliwaiko
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  8. Everson Araújo Nunes
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  9. Erasmo Benicio Santos de Moraes Trindade
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Correspondence to Michel Carlos Mocellin.

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Mocellin, M.C., Pastore e Silva, J.A., Camargo, C.Q. et al. Fish Oil Decreases C-Reactive Protein/Albumin Ratio Improving Nutritional Prognosis and Plasma Fatty Acid Profile in Colorectal Cancer Patients. Lipids 48, 879–888 (2013). https://doi.org/10.1007/s11745-013-3816-0

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  • DOI: https://doi.org/10.1007/s11745-013-3816-0

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