title: Effect of total parenteral nutrition on the protein kinetics of patients with cancer cachexia.
abstract: OBJECTIVE
  The question of whether TPN is able to reverse lean body mass depletion in cachectic cancer patients and, in particular, its effect on protein kinetics is a matter of some controversy. This study investigates the impact of TPN on protein kinetics in patients with gastric cancer.
  
  
  METHODS
  The study involved three patients with 14-30% weight loss. They were administered a TPN regimen including 33-40 kcal/kg/day and 1.4-1.7 g amino acid/kg/day. The protein metabolism was studied before and during TPN using a stable amino acid isotope.
  
  
  RESULTS
  Whole body protein turnover and breakdown did not change during TPN, whereas whole body protein synthesis increased from 3.39 +/- 1.04 to 6.05 +/- 0.48 g/kg/day (P = 0.03). However, the net balance, which was slightly negative prior to TPN, became positive during nutritional support. In the skeletal muscle compartment the synthesis improved with TPN (from 9.38 +/- 2.6 nmol/100 mL/min to 35.95 +/- 3.4 nmol/100 mL/min; P = 0.0143), whereas breakdown did not change significantly.
  
  
  CONCLUSIONS
  TPN triggers a positive metabolic response in cachectic cancer patients. Whether this results in a clinical benefit for the patient requires further investigation.
authors.affiliation: Nutritional Support Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. dottfb@tin.it
authors.forename: F
authors.initials: F
authors.lastname: Bozzetti
authors.forename: C
authors.initials: C
authors.lastname: Gavazzi
authors.forename: P
authors.initials: P
authors.lastname: Ferrari
authors.forename: F
authors.initials: F
authors.lastname: Dworzak
mesh_terms: D000328:Adult; D000368:Aged; D002100:Cachexia / Q000209:etiology / Q000378:metabolism* / Q000628:therapy*; D005215:Fasting; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010289:Parenteral Nutrition, Total; D011506:Proteins / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000150:complications* / Q000378:metabolism; D015431:Weight Loss
chemical_list: D011506:Proteins