Analysis of energy utilization and body composition in kidney, bladder, and adrenal cancer patients.
OBJECTIVE
To investigate resting energy expenditure (REE) and body composition and the relationship between substrate utilization and energy expenditure in urologic cancer patients.


METHODS
Measured resting energy expenditure (mREE) was detected by indirect calorimetry in 122 urologic cancer patients and 131 control subjects. Extracellular fluid (ECF), intracellular fluid (ICF), and total water (TW) were measured by bioelectrical impedance appliance. Fat oxidation rate (F-O), carbohydrate oxidation rate, fat mass (FM), and fat free mass (FFM) were further determined.


RESULTS
Compared with the controls, cancer patients showed significantly elevated mREE and mREE/FFM (P = 0.049; P < 0.001). Of all the cancer patients, 50% (n = 61) were hypermetabolic, 43.4% (n = 53) normometabolic, and 6.6% (n = 8) hypometabolic, whereas 35.1% (n = 46) of the controls were hypermetabolic, 56.5% (n = 74) normometabolic, and 8.4% (n = 11) hypometabolic. REE was correlated to substrate oxidation rate (R(2) = 0.710). Cancer patients exhibited no significant difference in FM, FM/body weight (BW) and FFM, compared with controls. Cancer patients presented no significant difference in TW compared with controls (P = 0.791), but they had increased ECF (P < 0.001) and decreased ICF (P < 0.001).


CONCLUSIONS
Aberrations in substrate utilization may contribute to the elevated energy expenditure in urologic cancer patients. Cancer type and pathologic stage are influential factors of REE.
Xu
Wen P
WP
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
Cao
Dong X
DX
Lin
Zong M
ZM
Wu
Guo H
GH
Chen
Lian
L
Zhang
Jian P
JP
Zhang
Bo
B
Yang
Zi A
ZA
Jiang
Yi
Y
Han
Yu S
YS
Xu
Le
L
Zhu
Yu
Y
Chen
Wen F
WF
D000273:Adipose Tissue / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001823:Body Composition; D001834:Body Water / Q000378:metabolism; D001835:Body Weight; D002153:Calorimetry, Indirect; D050260:Carbohydrate Metabolism; D017097:Electric Impedance; D004734:Energy Metabolism; D045604:Extracellular Fluid / Q000378:metabolism; D005260:Female; D006801:Humans; D007424:Intracellular Fluid / Q000378:metabolism; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010084:Oxidation-Reduction; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology