Serum carnitine levels in patients with tumoral cachexia.
BACKGROUND
Cachexia is a serious complication of many cancers that is common in cancer and AIDS patients. However, the key factors and mechanisms involved in the development of cachexia are not yet understood. There is little data currently available regarding carnitine metabolism in patients with neoplasm and cachexia.


METHODS
Forty-six neoplastic patients with different localizations of their primary disease gave signed, informed consent before enrolling in the present study. They underwent routine laboratory investigation, including examination of the levels of the various forms of carnitine present in serum (i.e., long-chain acylcarnitine, short-chain acylcarnitine, soluble acid acylcarnitine, free carnitine, and total carnitine). These values were compared with those found in 30 cancer patients in good nutritional status as well as with those of 30 healthy control subjects.


RESULTS
In the comparison of serum plasma carnitine of cachectic patients versus controls, the difference in free carnitine was - 8.20 micromol/L (p=0.000); the difference in short-chain acylcarnitine - 2.60 micromol/L (p=0.029); the difference in soluble acid carnitine - 10.80 micromol/L (p=0.000); the difference in long-chain acylcarnitine - 0.40 micromol/L (p=0.036); and the difference in total carnitine -11.20 micromol/L (p=0.000). In the comparison of serum plasma carnitine of cachectic versus neoplastic patients in good nutritional status, the difference in free carnitine was -5.80 micromol/L (p=0.006); the difference in soluble acid carnitine - 7.20 micromol/L (p=0.000); and the difference in total carnitine - 7.50 micromol/L (p=0.000).


CONCLUSIONS
Our study showed that, in the multifactorial pathogenesis of cachexia, the low serum levels of carnitine in terminal neoplastic patients, which are due to a decreased dietary intake as well as to an impaired endogenous synthesis of this substance, could play an important role. These low serum carnitine levels may also contribute to the development of cachexia in cancer patients.
Vinci
Ernesto
E
Department of Senescence, Urological and Neurological Sciences, University of Catania, Cannizzaro Hospital, Via Messina, 829-95126 Catania, Italy.
Rampello
Elvira
E
Zanoli
Luca
L
Oreste
Giovanni
G
Pistone
Giovanni
G
Malaguarnera
Mariano
M