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Previous issue date: 2016-11-10 / O c?ncer corresponde a um grupo de v?rias doen?as que t?m em comum a
prolifera??o descontrolada de c?lulas anormais e que pode ocorrer em qualquer local
do organismo. Os tumores mais frequentes na inf?ncia e na adolesc?ncia s?o as
Leucemias, e a Leucemia Linfobl?stica Aguda (LLA) ? a mais prevalente. A
desnutri??o evidenciada nesses pacientes est? relacionada ? s?ndrome da anorexiacaquexia
desencadeada pela doen?a, mas tamb?m nas altera??es do apetite, que
ocorrem durante o tratamento quimioter?pico e interferem no estado nutricional bem
como na resposta a terapia antineopl?sica. Embora seja reconhecida a poss?vel
influ?ncia dos horm?nios relacionados ao apetite sobre as altera??es no consumo
alimentar de pacientes com LLA durante o tratamento quimioter?pico, poucos estudos
na literatura investigaram as altera??es hormonais em pacientes com c?ncer infantojuvenil.
Diante disso, o objetivo desse estudo foi avaliar o estado nutricional e os n?veis
dos principais horm?nios relacionados ao apetite em crian?as e adolescentes
portadoras de LLA na fase de indu??o do tratamento quimioter?pico. Para atingir o
objetivo, foram acompanhadas 14 crian?as ou adolescentes com o diagn?stico de LLA
durante os 28 dias do ciclo de indu??o do tratamento quimioter?pico. No momento
basal (antes do in?cio da quimioterapia), na metade e ao final desse ciclo foram
realizadas avalia??es de estado nutricional antropom?trico, do consumo alimentar e
diet?tico sob a forma de registro alimentar pesado, e dos marcadores bioqu?micos e
hormonais. Foram avaliados os seguintes horm?nios relacionados ao apetite: leptina,
grelina, insulina e cortisol. A maioria dos pacientes apresentava eutrofia no in?cio do
tratamento, e este diagn?stico n?o foi alterado de forma significativa durante o ciclo
de indu??o. O consumo alimentar e diet?tico apresentou um aumento ao longo do
ciclo, especialmente em rela??o ao consumo de prote?nas e lip?deos do in?cio at? o
final do tratamento. Em rela??o aos par?metros bioqu?micos, observou-se aumento
significativo nos par?metros das plaquetas e na transaminase glut?mica pir?vica,
assim como redu??o significativa nas concentra??es de glicemia, creatinina e o s?dio.
Sobre os horm?nios relacionados ao apetite, registrou-se altera??o estatisticamente
significativa apenas na concentra??o de grelina, que apresentou um aumento entre
os momentos basal e meio do ciclo (p=0,027), mas n?o do meio para o final do ciclo.
Em conclus?o, o per?odo de indu??o do tratamento da LLA provocou um aumento no
consumo de energia e nutrientes, assim como um aumento na concentra??o de grelina, mas sem repercuss?o sobre o estado antropom?trico dos pacientes ou nos
outros horm?nios relacionados ao apetite. / Cancer is a group of several diseases that have in common an uncontrolled
proliferation of abnormal cells, and it can occur at anywhere in the body. The most
frequent tumors in childhood and adolescence are the leukemias, and the Acute
Lymphoblastic Leukemia (ALL) is the most prevalent. The evidenced malnutrition in
these patients is related to anorexia-cachexia syndrome triggered by the disease, but
also on changes in appetite, which occur during chemotherapy and interfere in the
nutritional status as well as in response to antineoplasic therapy. Although it
recognized a possible influence of hormones related to appetite on the changes in food
consumption of ALL patients during chemotherapy, few studies have investigated the
hormonal changes in patients with childhood cancers. Thus, the aim of this study was
to evaluate the nutritional status and levels of key hormones related to appetite in
children and adolescents with Acute Lymphoblastic Leukemia (ALL) in the induction
phase of chemotherapy. For this purpose, it was assessed 14 children/adolescents
diagnosed with ALL during the 28 days of induction chemotherapy cycle. At baseline
(prior to initiation of chemotherapy), in the middle and at the end of this cycle were
performed anthropometric measurement, weighted food record 24 hours and
biochemical and hormone levels were obtained. It were evaluated the following
hormones related to appetite: leptin, ghrelin, insulin and cortisol. Most patients had
normal weight at the beginning of treatment which did not change significantly during
the induction cycle. The dietary intake increased over the cycle, particularly in relation
to proteins and lipids intake from the beginning to the end of treatment. Platelet levels
and transaminase glutamic pyruvic significantly increased, and a significant reduction
in blood glucose, creatinine and sodium levels were observed. Regarding appetite
hormones, ghrelin significantly increased between the baseline and the half of the
cycle (p = 0.027), but not through the end. In conclusion, the ALL treatment induction
period caused an increase in energy and nutrients intake, as well as an increase in the
concentration of ghrelin, but no impact on the anthropometric status of patients or in
other hormones related to appetite.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/22481 |
| Date | 10 November 2016 |
| Creators | Gomes, Camila de Carvalho |
| Contributors | 95978887004, http://lattes.cnpq.br/0049770583345803, Friedman, Rog?rio, 29376920015, Lima, Severina Carla Vieira Cunha, 47473487434, http://lattes.cnpq.br/8818927353248941, Fayh, Ana Paula Trussardi |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM NUTRI??O, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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