Nutritional status disorders in women with lichen sclerosus of the vulva

Authors

  • V.V. Dunaievska National Cancer Institute; SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-2949-7623
  • E.H. Manzhalii О.О. Bogomolets National Medical University; Ukrainian Liver Foundation; Global Longevity Institute; Medical center “Verum Expert Clinic”, Kyiv, Ukraine https://orcid.org/0000-0003-0920-4627

DOI:

https://doi.org/10.18370/2309-4117.2021.62.75-79

Keywords:

lichen sclerosus, vulva, nutritional status, nutrients, vitamins, coprological study, microflora

Abstract

Research objective: to determine the characteristics of nutritional status (NS) in women of reproductive age with typical clinical signs of lichen sclerosus of the vulva (LSV) using key NS parameters.
Materials and methods. The study included 75 women with average age 31.3 ± 1.3 years. 50 women were diagnosed with LSV and NS disorders (main group), and 25 women were practically healthy (control group). Information about all patients was collected through direct interviews, clinical examination and study of medical records. The presence of anogenital pruritus, soreness or burning, dryness, dyspareunia, urinary disturbances, perianal and/or intestinal symptoms, inflammatory bowel disease, thyroid dysfunction and tenderness, and other comorbidities were recorded. NS evaluated using anthropometric, laboratory and clinical studies. Body mass index, index of nutritional risk (nutritional deficiency), vitamins, micro- and macroelements value, scatological parameters were determined in all patients, and the intestinal microflora was examined.
Results. The results of the study showed a disorder of NS in most patients with LSV by all studied parameters in comparison with the control group. Thus, it was found that 60% of patients with LSV had abnormal body mass index as well as NS was observed in 72% of patients. In addition, patients with LSV also had a higher deficiency of vitamins D and B12, and some important micro- and macronutrients. The results of the coprological study showed the neutral fats in feces, unchanged muscle fibers, extracellular and intracellular starch, decreased levels of bifidobacteria and lactobacilli in 68–74% of patients and opportunistic bacteria and fungi in 30–46% of women in the main group.
Conclusions. Thus, the results of this study indicate the association between the abnormal NS and LSV. However, further research is needed to assess the course of the underlying disease and to analyze the metabolic pathways that lead to disorders of lipid, carbohydrate and protein metabolism in target patients, to select of the correct nutrients and alternative treatments.

Author Biographies

V.V. Dunaievska, National Cancer Institute; SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Kyiv

PhD, gynecologist-oncologist;
Endocrine Gynecology Department

E.H. Manzhalii, О.О. Bogomolets National Medical University; Ukrainian Liver Foundation; Global Longevity Institute; Medical center “Verum Expert Clinic”, Kyiv

Associate professor, Department of Propedeutics of Internal Medicine;
President of the Ukrainian Liver Foundation;
CEO of Global Longevity Institute;
Chief of Hepatology Department

References

  1. Nair, P.А. “Vulvar lichen sclerosus et atrophicus.” Journal of Mid-life Health 8.2 (2017): 55–62. DOI: 10.4103/jmh.JMH_13_17
  2. Balbinotti, R.R., Grossi, F.S., Perez, A.V., et al. “Nonablative radiofrequency in the treatment of refractory vulvar lichen sclerosus: A case series.” JAAD Case Reports 17 (2021): 122–5. DOI: 10.1016/j.jdcr.2021.09.028
  3. Belotto, R.A., Chavantes, M.C., Tardivo, J.P., et al. “Therapeutic comparison between treatments for vulvar lichen sclerosus: study protocol of a randomized prospective and controlled trial.” BMC Womens Health 17.1 (2017): 61. DOI: 10.1186/s12905-017-0414-y
  4. Corazza, M., Schettini, N., Zedde, P., et al. “Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects.” Biomedicines 9 (2021): 950. DOI: 10.3390/biomedicines9080950
  5. Pounds, S.T., Dawson, C., Woodman, C., et al. “A survey on the use of topical steroids in patients treated for lichen sclerosus-associated vulval squamous cell carcinoma.” J Obstet Gynaecol 38.2 (2018): 265–9. DOI: 10.1080/01443615.2017.1352572
  6. Lee, A., Fischer, G. “Diagnosis and treatment of vulvar lichen sclerosus: an update for dermatologists.” Am J Clin Dermatol 19.5 (2018): 695–706. DOI: 10.1007/s40257-018-0364-7
  7. Bleeker, M.C., Visser, P.J., Overbeek, L.I., et al. “Lichen Sclerosus: Incidence and Risk of Vulvar Squamous Cell Carcinoma.” Cancer Epidemiol Biomark Prev 25 (2016): 1224–30. DOI: 10.1158/1055-9965.EPI-16-0019
  8. Corazza, M., Borghi, A., Gafà, R., et al. “Risk of vulvar carcinoma in women affected with lichen sclerosus: Results of a cohort study.” J Dtsch Dermatol Ges 17 (2019): 1069–71. DOI: 10.1111/ddg.13961
  9. Chattopadhyay, S., Arnold, J.D., Malayil, L., et al. “Potential role of the skin and gut microbiota in premenarchal vulvar lichen sclerosus: A pilot case-control study.” PloS One 16.1 (2021): e0245243. DOI: 10.1371/journal.pone.0245243
  10. Felmingham, C., Chan, L., Doyle, L.W., et al. “The Vulval Disease Quality of Life Index in women with vulval lichen sclerosus correlates with clinician and symptom scores.” Australas J Dermatol 16.2 (2020): 110–8. DOI: 10.1111/ajd.13197
  11. Sadownik, L.A., Koert, E., Maher, C., et al. “A Qualitative Exploration of Women’s Experiences of Living with Chronic Vulvar Dermatoses.” J Sex Med 17.9 (2020): 1740–50. DOI: 10.1016/j.jsxm.2020.06.016
  12. Kirtschig, G., Becker, K.L., Gunthert, A.R., et al. “Evidence-based (S3) Guideline on (anogenital) Lichen sclerosus.” J Eur Acad Dermatol Venereol 29.10 (2015): e1–43.
  13. Trietsch, M.D., Nooij, L.S., Gaarenstroom, K., et al. “Genetic and epigenetic changes in vulvar squamous cell carcinoma and its precursor lesions: A review of the current literature.” Gynecol Oncol 136 (2015): 143–57. DOI: 10.1016/j.ygyno.2014.11.002
  14. Tran, D.A., Tan, X., Macri, C.J., et al. “Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets.” Int J Biol Sci 15.7 (2019): 1429–39. DOI: 10.7150/ijbs.34613
  15. Dzhangishieva, A.K., Uvarova, E.V., Batyrova, Z.K. “Lichen sclerosus: modern view on clinical manifestations, diagnosis and treatment methods (analytical review).” Pediatric and Adolescent Reproductive Health 14.3 (2018): 34–50.
  16. Andreescu, N., Puiu, M., Niculescu, M. “Effects of Dietary Nutrients on Epigenetic Changes in Cancer.” Methods Mol Biol 1856 (2018): 121–39. DOI: 10.1007/978-1-4939-8751-1_7
  17. Dolinoy, C.D., Weidman, J.R., Jirtle, R.L. “Epigenetic gene regulation: Linking early developmental environment to adult disease.” Reprod Toxicol 23 (2007): 297–307. DOI: 10.1016/j.reprotox.2006.08.012
  18. Ciebiera, M., Esfandyari, S., Siblini, H., et al. “Nutrition in Gynecological Diseases: Current Perspectives.” Nutrients 13.4 (2021): 1178. DOI: 10.3390/nu13041178
  19. Crujeiras, A.B., Casanueva, F.F. “Obesity and the reproductive system disorders: epigenetics as a potential bridge.” Human Reproduction Update 21.2 (2015): 249–61. DOI: 10.1093/humupd/dmu060
  20. Swenson, C.W., Schimpf, M.O., Menees, S.B., et al. “Comparison of Serum Vitamin D Levels in Relation to Bowel and Bladder Symptoms in Women with Vulvar Diseases.” Int J Vitam Nutr Res 90.3 (2020): 266–72. DOI: 10.1024/0300-9831/a000527
  21. Bharadwaj, S., Ginoya, S., Tandon, P., et al. “Malnutrition: laboratory markers vs nutritional assessment.” Gastroenterol Rep (Oxf) 4.4 (2016): 272–80. DOI: 10.1093/gastro/gow013
  22. Bhattacharya, A., Pal, B., Mukherjee, S., et al. “Assessment of nutritional status using anthropometric variables by multivariate analysis.” BMC Public Health 19 (2019): 1045. DOI: 10.1186/s12889-019-7372-2
  23. Keller, U. “Nutritional Laboratory Markers in Malnutrition.” J Clin Med 8.6 (2019): 775. DOI: 10.3390/jcm8060775
  24. Sun, M., Wu, W., Chen, L., et al. “Microbiota-derived short-chain fatty acids promote Th1 cell IL-10 production to maintain intestinal homeostasis.” Nat Commun 9.1 (2018): 3555. DOI: 10.1038/s41467-018-05901-2
  25. Sun, M., Wu, W., Liu, Z., et al. “Microbiota metabolite short chain fatty acids, GPCR, and inflammatory bowel diseases.” J Gastroenterol 25.1 (2017): 1–8. DOI: 10.1007/s00535-016-1242-9

Published

2021-12-29

How to Cite

Dunaievska, V., & Manzhalii, E. (2021). Nutritional status disorders in women with lichen sclerosus of the vulva. REPRODUCTIVE ENDOCRINOLOGY, (62), 75–79. https://doi.org/10.18370/2309-4117.2021.62.75-79

Issue

Section

Gynecology

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