title: Integrated analysis of glucose, lipid, and urea metabolism in patients with bladder cancer. Impact of tumor stage.
abstract: OBJECTIVE
  The aim of the study was to characterize the metabolic changes in non-weight-losing patients with cancer of the bladder and to investigate the effect of tumor stage. The kinetics of glucose, glycerol, and urea metabolism were assessed in 22 weight-stable patients with non-metastatic bladder cancer (tumor stage p </= T2, n = 8; tumor stage p > T2, n = 14) and 10 patients with benign uterine myoma (controls).
  
  
  METHODS
  The kinetics of glucose, glycerol, and urea metabolism were assessed by [6,6-(2)H(2)]glucose, [1,1,2,3,3-(2)H(5)]glycerol, and [(15)N(2)]urea. Plasma concentrations of glucose, glycerol, urea, lactate, free fatty acids, insulin, glucagon, cortisol, epinephrine, and norepinephrine also were determined.
  
  
  RESULTS
  Plasma concentrations of glucose, urea, and insulin were higher in cancer patients than in controls (P < 0.05). Whereas glucose production was similar in both groups, glucose clearance was lower in patients with bladder cancer (P < 0.05). Glycerol turnover rate was comparable between groups. Whole-body urea synthesis rate was higher in the cancer group than in the control group (P < 0.05), but there was no difference in urea synthesis when calculated per kilogram of fat-free body mass. Plasma concentrations of glycerol, lactate, free fatty acids, glucagon, cortisol, epinephrine, and norepinephrine were similar in both groups. There was no difference in any parameter between patients with an early tumor stage (p < T2) and patients with a later tumor stage (p > T2).
  
  
  CONCLUSIONS
  Patients with bladder cancer had a lower rate of glucose clearance than did control subjects. Lipid metabolism was not affected, whereas urea synthesis rate was elevated in cancer patients. However, when expressed per kilogram of fat-free body mass, no difference in protein breakdown could be observed. The tumor stage had no effect on glucose, lipid, or protein metabolism.
authors.affiliation: Department of Anesthesia, McGill University, Montreal, Quebec, Canada.
authors.forename: Ralph
authors.initials: R
authors.lastname: Lattermann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Geisser
authors.forename: Michael
authors.initials: M
authors.lastname: Georgieff
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wachter
authors.forename: Axel
authors.initials: A
authors.lastname: Goertz
authors.forename: Ralf
authors.initials: R
authors.lastname: Gnann
authors.forename: Thomas
authors.initials: T
authors.lastname: Schricker
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D005990:Glycerol / Q000378:metabolism; D006801:Humans; D007700:Kinetics; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D014508:Urea / Q000378:metabolism*; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D001786:Blood Glucose; D014508:Urea; D005990:Glycerol