Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight

• Published in: European journal of clinical nutrition 1999-09, Vol.53 (9), p.740-745
• Main Authors: Korber, J, Pricelius, S, Heidrich, M, Muller, M.J
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Area Under Curve; Biological and medical sciences; Body Composition; Body mass index; Body size; Body Weight; Body weight loss; Cachexia; Cachexia - metabolism; Calorimetry; Calorimetry, Indirect; Cancer; Diet; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Emulsions; Fatty Acids, Nonesterified - blood; Female; Gastrointestinal diseases; Gastrointestinal Neoplasms - metabolism; Gastrointestinal Neoplasms - physiopathology; Glucose Clamp Technique; Half-Life; Humans; Intensive care medicine; Lipid Metabolism; Lipid peroxidation; Lipids; Male; Medical sciences; Metabolism; Middle Aged; neoplasms; Nutrition; nutritional status; Oils & fats; Oxidation; Oxidation rate; Oxygen Consumption; Patients; triacylglycerols; Triglycerides; Triglycerides - pharmacology; Weight control; weight gain; Weight Loss; weight losses
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1600843

Objective: Cachexia and weight loss are frequently seen in cancer patients. We investigated lipid metabolism to elucidate a metabolic basis for adequate nutrition of cancer patients. Design: Lipid metabolism was assessed by indirect calorimetry and triglyceride clearance rates after randomised injection of a lipid bolus (long-chain triglycerides (LCT) or medium-chain triglycerides (MCT) during an euglycemic clamp protocol in cancer patients. Setting: Rudolf-Virchow Krankenhaus, Berlin, Germany. Subjects: Eighteen patients were included. Twelve patients had upper gastrointestinal cancer: a weight stable cancer group (Caws, n = 6) with a body mass index (BMI) of 22.9 +/- 1.7 kg/m(2) and a weight losing cancer group (Cawl, n = 6) with a mean weight loss of 7.4 +/- 3.1 kg or 11% of the initial body weight during the previous three months (present BMI 21.8 +/- 0.8 kg/m(2)). The data were compared with six control patients with benign gastrointestinal diseases (BMI = 25.0 +/- 0.8 kg/m(2)). Main outcome: Cancer patients had an increased basal lipid oxidation rate that was more pronounced in Cawl (+92% vs +42% in Caws; P < 0.01 and 0.05 vs. controls, respectively). Utilisation of LCT was increased in cancer patients, this was most pronounced in Cawl (+150 vs +65% in Caws; P < 0.01 and 0.05, respectively). Metabolically, there were no differences in the utilisation of LCT and MCT/LCT containing lipid emulsions. Conclusions: Cancer patients have an increased lipid oxidation and an enhanced utilisation of exogeneous lipids. This is most pronounced in Cawl. To prevent further weight loss or to increase body weight, they should increase their fat intake. In contrast, fat-reduced or prudent diets seem to be inadequate for the nutrition of cancer patients.