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. 2025 Jan 23:15:1428214.
doi: 10.3389/fonc.2025.1428214. eCollection 2025.

Association between dietary antioxidants, serum albumin/globulin ratio and quality of life in esophageal squamous cell carcinoma patients: a 7-year follow-up study

Juwei Zhang  1 , Jinsong Zhou  1 , Siting Chen  1 , Yue Huang  1 , Zheng Lin  1 , Yuan Deng  1 , Minglian Qiu  2 , Zhisheng Xiang  3 , Zhijian Hu  1   4
Affiliations

Association between dietary antioxidants, serum albumin/globulin ratio and quality of life in esophageal squamous cell carcinoma patients: a 7-year follow-up study

Juwei Zhang et al. Front Oncol. .

Abstract

Objective: This study aimed to explore the association between dietary antioxidant index (DAI) combined with serum albumin-to-globulin ratio (AGR) and postoperative Health-related quality of life (HRQOL) in patients with esophageal squamous cell carcinoma (ESCC).

Methods: All patients were newly diagnosed with ESCC and underwent radical esophagectomy. Dietary data and routine blood tests were collected preoperatively to compute DAI and AGR. HRQOL was assessed over 7 years post-surgery via telephone follow-up and analyzed longitudinally using a time to deterioration (TTD) model. The deterioration times were compared using the log-rank test, and the association of the combined DAI and AGR index with postoperative quality of life in ESCC patients was examined through Cox regression models.

Results: A total of 238 ESCC patients were included in the study. The results indicate that compared to the low DAI-AGR group, the high DAI-AGR group had a lower rate of deterioration events, and the time to deterioration in emotional functioning (p=0.014), dysphagia (p=0.042), and speech problems (p=0.023) were significantly delayed. Cox proportional hazard model revealed that preoperative high DAI-AGR was associated with improvement in emotional functioning (HR=0.575, 95% CI: 0.368-0.898) and speech problems (HR=0.525, 95% CI: 0.298-0.925) in ESCC patients postoperatively, which remained significant even after adjusting for covariates. The stratified analysis revealed that this improvement was associated with demographic and clinical characteristics.

Conclusions: Our findings suggest that high preoperative DAI-AGR is linked to enhanced postoperative HRQOL in ESCC patients, offering crucial insights for patients, practitioners, and researchers.

Keywords: albumin-to-globulin ratio; dietary antioxidant index; esophageal squamous cell carcinoma; health-related quality of life; time to deterioration model.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Baseline characteristics stratified analysis of forest map. P-value based on multivariate Cox regression analyses, adjusting for all variables except the stratification variables. P-value less than 0.05 was considered significant.
See this image and copyright information in PMC

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