Cancer cachexia: measured and predicted resting energy expenditures for nutritional needs evaluation.
OBJECTIVE
Cancer cachexia is associated with weight loss, poor nutritional status, and systemic inflammation. Accurate nutritional support for patients is calculated on resting energy expenditure (REE) measurement or prediction. The present study evaluated the agreement between measured and predicted REE (mREE and pREE, respectively) and the influence of acute phase response (APR) on REE.


METHODS
Thirty-six patients with cancer were divided into weight-stable (WS; weight loss <2%) and weight-losing (WL; weight loss >5%) patients. Measured REE was measured by indirect calorimetry and adjusted for fat-free mass (FFM). The Bland-Altman approach was used to assess the agreement between mREE and pREE from the Harris-Benedict equations (HBE). Blood levels of C-reactive protein were assessed.


RESULTS
There was no difference in mREE between groups (WS 1677 +/- 273, WL 1521 +/- 305) even when mREE was adjusted for FFM (WS 1609 +/- 53, WL 1589 +/- 53). In WL patients, FFM-adjusted REE correlated with blood C-reactive protein levels (r = 0.471, P = 0.048). HBEs tend to underestimate REE in both groups.


CONCLUSIONS
WL and WS patients with cancer had similar REEs but were different in terms of APR. APR could contribute to weight loss through enhancing REE. In a clinical context, HBE was in poor agreement with mREE in both groups.
Johnson
Gyasi
G
Institut National de la Santé et de la Recherche Médicale, Unité 694, Université d'Angers; Laboratoire de biochimie et biologie moléculaire, Centre Hospitalier Universitaire, Angers, France.
Sallé
Agnès
A
Lorimier
Gérard
G
Laccourreye
Laurent
L
Enon
Bernard
B
Blin
Vincent
V
Jousset
Yann
Y
Arnaud
Jean-Pierre
JP
Malthièry
Yves
Y
Simard
Gilles
G
Ritz
Patrick
P
D000210:Acute-Phase Reaction / Q000378:metabolism*; D001481:Basal Metabolism / Q000502:physiology*; D001823:Body Composition / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D002100:Cachexia / Q000378:metabolism*; D002153:Calorimetry, Indirect; D003110:Colonic Neoplasms / Q000378:metabolism; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011237:Predictive Value of Tests; D015431:Weight Loss
D002097:C-Reactive Protein