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


METHODS
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.


METHODS
Rudolf-Virchow Krankenhaus, Berlin, Germany.


METHODS
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/m2 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/m2). The data were compared with six control patients with benign gastrointestinal diseases (BMI = 25.0 +/- 0.8 kg/m2).


RESULTS
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.
Körber
J
J
Abteilung Innere Medizin, Gastroenterologie, Rudolf Virchow Klinikum, Medizinische Fakultät der Humboldt Universität, Berlin, Germany.
Pricelius
S
S
Heidrich
M
M
Müller
M J
MJ
D019540:Area Under Curve; D001823:Body Composition; D001835:Body Weight; D002100:Cachexia / Q000378:metabolism*; D002153:Calorimetry, Indirect; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000378:metabolism* / Q000503:physiopathology; D015309:Glucose Clamp Technique; D006207:Half-Life; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D014280:Triglycerides / Q000494:pharmacology; D015431:Weight Loss
D005230:Fatty Acids, Nonesterified; D014280:Triglycerides