title: L-carnitine and cancer cachexia. I. L-carnitine distribution and metabolic             disorders in cancer cachexia.
abstract: Cancer cachexia (CC), a progressive loss of body mass, is associated with decreased energy production. Abnormally low levels of L-carnitine (LC) in skeletal muscle means that mitochondrial β-oxidation of long-chain fatty acids (LCFA) does not occur efficiently in patients with CC. We assessed the influence of CC on LC distribution and the effects of parenteral lipid emulsions on plasma LC levels and urinary excretion. Fifty patients with CC were randomly assigned to total parenteral nutrition (TPN) with long-chain triglycerides (LCTs), or LCTs plus medium-chain triglycerides (MCTs) as 50/50. Patients were further separated into those with body-mass index (BMI) ≤ 19 kg/m(2) and BMI >19 kg/m(2). Plasma concentrations of total LC (TC) and free LC (FC) and their urinary excretion were measured, along with skeletal muscle LC levels. On average, plasma FC and TC were higher than reference values in all patients. Patients with BMI ≤ 19 kg/m(2) had lower plasma FC and TC than those with BMI >19 kg/m(2). Skeletal muscle FC in the BMI ≤ 19 kg/m(2) group was lower than reference value, but within the normal range in others. LC and FC urinary excretion was higher than reference values. Plasma LC and its urinary excretion were higher in patients administered pure LCTs relative to those given MCTs/LCTs. A decrease in skeletal muscle LC in cancer patients with CC (BMI ≤ 19 kg/m(2)) correlates with an increase in its plasma levels and increased renal excretion. A diet of MCTs/LCTs reduces LC release from muscle to plasma and urine more effectively than LCTs.
authors.affiliation: Department of Surgical Oncology, Gdynia Oncology Centre, PCK's Maritime Hospital in Gdynia, Gdynia, Poland. jaszefel@mp.pl
authors.forename: Jarosław
authors.initials: J
authors.lastname: Szefel
authors.forename: Wiesław Janusz
authors.initials: WJ
authors.lastname: Kruszewski
authors.forename: Maciej
authors.initials: M
authors.lastname: Ciesielski
authors.forename: Mariusz
authors.initials: M
authors.lastname: Szajewski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kawecki
authors.forename: Ewa
authors.initials: E
authors.lastname: Aleksandrowicz-Wrona
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jankun
authors.forename: Wiesława
authors.initials: W
authors.lastname: Lysiak-Szydłowska
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002100:Cachexia / Q000097:blood* / Q000209:etiology / Q000628:therapy; D002331:Carnitine / Q000097:blood* / Q000378:metabolism / Q000652:urine; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism; D009369:Neoplasms / Q000097:blood* / Q000150:complications / Q000628:therapy; D012016:Reference Values; D014280:Triglycerides / Q000008:administration & dosage
chemical_list: D005217:Fat Emulsions, Intravenous; D014280:Triglycerides; D002331:Carnitine