Does KRAS status influence the association between dietary total antioxidant capacity, nutritional status, and inflammation in metastatic colorectal cancer? A case-control study

Nutritional factors and systemic inflammation are known as potential modulators of metastatic colorectal cancer (mCRC) progression, while KRAS mutation status is a critical molecular determinant. This study aimed to assess the relationship between dietary total antioxidant capacity (DTAC), nutritional status indices (PNI, CONUT), and systemic inflammatory markers, and their association with KRAS mutation status in patients with mCRC. In a case-control study, 90 patients with mCRC (45 with KRAS mutation and 45 with wild-type KRAS) were enrolled. Dietary intake was assessed using a validated food frequency questionnaire. Nutritional indices (PNI and CONUT) were assessed. Inflammatory indices including Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and biochemical factors (Albumin, Cholesterol) were measured. Independent samples t-test was used to compare variables between the two groups, and linear and logistic regression models adjusted for potential confounding factors were employed to examine associations. Comparisons of inflammatory markers (NLR, PLR, MLR, ESR, and CRP) and nutritional variables between the groups showed no significant variations. Analysis of the odds ratio associations between KRAS mutation status and the studied variables—including inflammatory marker levels and nutritional indices—did not reveal any significant relationships. Similarly, linear regression analysis indicated no statistically significant associations between dietary index and inflammatory markers. In this cohort of patients with mCRC, no statistically significant associations were found between DTAC, nutritional indices, inflammatory markers, and KRAS mutation status. These findings should be interpreted with caution because the study was conducted exclusively in patients with metastatic disease and had a limited sample size.