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

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.

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

“…CRP is an acute phase protein regulated by IL-6, tumor necrosis factor and other inflammatory factors (35). Therefore, CRP may indicate inflammation.…”

Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review

“…In the Silva et al (2012) study that included only colorectal cancer patients, no change in body weight and body mass index was observed for the patients that received fish oil (P > 0.05), while both indicators decreased for the patients that did not receive fish oil (P ¼ 0.01 and P ¼ 0.03, respectively) [22]. In the Mocellin et al (2013) study, no significant changes in body weight or body mass index were observed by the end of the study period [23]. For the remaining chemotherapy studies, the duration and administration form of supplement varied.…”

“…Moreover, these patients were compared with those that did not receive a nutritional supplement [20,22,23]. In the Bonatto et al (2012) study, the oncologic patients that received fish oil gained an average of 1.7 kg (P ¼ 0.002), while the control group lost an average of 2.5 kg [20].…”

Expand+In Vivoiv.iiarjournals.orgIn Vivo September-October 2017 vol. 31 no. 5 1003-1009 Elevated Serum AA/EPA Ratio as a Predictor of Skeletal Muscle Depletion in Cachexic Patients with Advanced Gastro-intestinal Cancers

“…There have been reports that inflammation and nutritional status improved by intervention with fish oil administration. (7,21,22). As fish oil is rich in EPA and DHA, we therefore considered that an improved CRP and decreased serum AA/EPA ratio, or n-6/n-3 ratio could be reached by eating a diet with n-3 fatty acid, such as EPA and DHA.…”