Influence of whole body protein turnover rate on resting energy expenditure in patients with cancer

Department of Medical Oncology, University of Glasgow, United Kingdom.
Cancer Research (Impact Factor: 9.33). 06/1988; 48(9):2590-5.
Source: PubMed


Whole body protein turnover and resting energy expenditure are measured simultaneously in weight stable and weight losing patients with lung (n = 22) or colorectal cancer (n = 38). These results were compared with those from weight stable and weight losing non-cancer controls (n = 22). Rates of whole body protein turnover were calculated from the plateau isotopic enrichment of urinary ammonia and urea following a primed, continuous, 24-h infusion of [15N]glycine. Resting energy expenditure was measured by indirect calorimetry. All groups of cancer patients had significantly elevated rates of whole body protein turnover (P less than 0.05) and synthesized, on average, 1.9 g/kg/day more protein compared with weight stable non-cancer controls. In contrast, the resting energy expenditure of cancer patients and controls was similar. Moreover, there was no correlation between individual rates of whole body protein turnover. Thus, although cancer patients had rates of whole body protein turnover which were 50-70% greater than controls, this did not result in a measurable increase in resting energy expenditure. The assumption that elevation of whole body protein turnover or resting energy expenditure causes weight loss in cancer patients must be an oversimplification. An acute phase protein response was observed in the majority of cancer patients. Although the presence of such an inflammatory response did not correlate with the rate of whole body protein turnover, the role of inflammatory mediators in the pathogenesis of disturbed protein metabolism in cancer patients merits further investigation.

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    • "This has been well documented in cachectic15 and non-cachectic cancer patients.16 The decrease in protein synthesis17 and the increase in muscle protein degradation in cancer patients18 imply that tumors are able to mobilize muscle proteins. Indeed, several studies demonstrated a direct relationship between tumor growth and host protein metabolism. "
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    • "n et al . ( 1985 ) ; 18 , Stein et al . ( 1991 ) ; 19 , Glass et al . ( 1983 ) ; 20 , Stein et al . ( 1990 ) ; 21 , Yoshida et al . ( 1996 ) ; 22 , Ma & Jiang ( 1990 ) ; 23 , Taggart et al . ( 1991 ) ; 24 , Powell - Tuck et al . ( 1984 ) ; 25 , Jeevanandam et al . ( 1991a ) ; 26 , Glynn et al . ( 1987 ) ; 27 , Powell - Tuck & Glynn ( 1985 ) ; 28 , Fearon et al . ( 1988 ) . k In one study ( Jackson et al . 1983 ) flux ratio was 81 in children given 1·7 g protein / kg per d and was 47 in those given 0·7 g protein / kg per d . { In this study protein intake was 1·8 and 2·3 g protein / kg per d for habitual and weight - reducing diets , respectively * * Not possible to calculate an SD or SD not reported i"
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    • "Reproducibility of the MG had previously been assessed to be high (Nieman et al, 2003) and therefore was not repeated in this study. Reproducibility of traditional indirect calorimetry methods is often reported to be high, with measurement error in the order of less than 5% (Hansell et al, 1986; Fearon et al, 1988; Falconer et al, 1994). Although reproducibility of the VM was not measured in this study, if it is assumed to be of a similar magnitude to that reported by other studies, it is highly unlikely that any of the conclusions from these studies, where limits of agreement were approximately 730 to 40%, would be altered. "
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