Nutritional status disorders in women with lichen sclerosus of the vulva
DOI:
https://doi.org/10.18370/2309-4117.2021.62.75-79Keywords:
lichen sclerosus, vulva, nutritional status, nutrients, vitamins, coprological study, microfloraAbstract
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.
References
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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.
- 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
- 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
- Ciebiera, M., Esfandyari, S., Siblini, H., et al. “Nutrition in Gynecological Diseases: Current Perspectives.” Nutrients 13.4 (2021): 1178. DOI: 10.3390/nu13041178
- 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
- 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
- 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
- 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
- Keller, U. “Nutritional Laboratory Markers in Malnutrition.” J Clin Med 8.6 (2019): 775. DOI: 10.3390/jcm8060775
- 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
- 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
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 В.В. Дунаєвська, Е.Г. Манжалій
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.