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. 1997 Apr;52(4):338–341. doi: 10.1136/thx.52.4.338

Metabolism in patients with small cell lung carcinoma compared with patients with non-small cell lung carcinoma and healthy controls

d Staal-van, A M Schols, M A Dentener, V ten, W A Buurman, E F Wouters
PMCID: PMC1758535  PMID: 9196516

Abstract

BACKGROUND: Weight loss is a frequently occurring problem in patients with lung cancer due to an increased resting energy expenditure (REE) and a decreased energy intake. The aim of the present study was to compare the metabolic and inflammatory characteristics of patients with small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). The metabolic parameters of the lung cancer population were compared with those of a healthy control group. METHODS: REE was measured in 66 patients with lung cancer, subdivided according to their histology, and in 33 healthy controls matched for sex, age, and fat free mass (FFM). Inflammatory mediators were measured in the plasma of the patients with lung cancer. RESULTS: An increased REE adjusted for FFM was found in the patients with lung cancer. Those with small cell lung carcinoma (SCLC) had an increased REE adjusted for FFM (mean 1925 kcal/day) compared with those with non-small cell lung carcinoma (NSCLC) (mean 1789 kcal/day, 95% CI for difference 36 to 236). FFM accounted for 69% and 48% of the inter-individual variation in REE in controls and those with NSCLC, respectively, while FFM accounted for only 25% of the variation in REE in patients with SCLC in whom the fat mass (FM) also contributed significantly (28%) to the variation in REE. Increased concentrations of soluble TNF-receptor 75 (sTNF-R75) and cortisol were found in patients with SCLC compared with those with NSCLC. Lipopolyasccharide binding protein (LBP) and sTNF-R55 were related to plasma levels of cortisol. CONCLUSION: An enhanced REE adjusted for FFM occurred in patients with SCLC compared with those with NSCLC. 




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Selected References

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  1. Brockhaus M., Bar-Khayim Y., Gurwicz S., Frensdorff A., Haran N. Plasma tumor necrosis factor soluble receptors in chronic renal failure. Kidney Int. 1992 Sep;42(3):663–667. doi: 10.1038/ki.1992.332. [DOI] [PubMed] [Google Scholar]
  2. Engelberts I., Stephens S., Francot G. J., van der Linden C. J., Buurman W. A. Evidence for different effects of soluble TNF-receptors on various TNF measurements in human biological fluids. Lancet. 1991 Aug 24;338(8765):515–516. doi: 10.1016/0140-6736(91)90591-c. [DOI] [PubMed] [Google Scholar]
  3. Engelmann H., Aderka D., Rubinstein M., Rotman D., Wallach D. A tumor necrosis factor-binding protein purified to homogeneity from human urine protects cells from tumor necrosis factor toxicity. J Biol Chem. 1989 Jul 15;264(20):11974–11980. [PubMed] [Google Scholar]
  4. Falconer J. S., Fearon K. C., Plester C. E., Ross J. A., Carter D. C. Cytokines, the acute-phase response, and resting energy expenditure in cachectic patients with pancreatic cancer. Ann Surg. 1994 Apr;219(4):325–331. doi: 10.1097/00000658-199404000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fong Y., Moldawer L. L., Marano M., Wei H., Barber A., Manogue K., Tracey K. J., Kuo G., Fischman D. A., Cerami A. Cachectin/TNF or IL-1 alpha induces cachexia with redistribution of body proteins. Am J Physiol. 1989 Mar;256(3 Pt 2):R659–R665. doi: 10.1152/ajpregu.1989.256.3.R659. [DOI] [PubMed] [Google Scholar]
  6. Fredrix E. W., Soeters P. B., von Meyenfeldt M. F., Saris W. H. Measurement of resting energy expenditure in a clinical setting. Clin Nutr. 1990 Dec;9(6):299–304. doi: 10.1016/0261-5614(90)90001-9. [DOI] [PubMed] [Google Scholar]
  7. Fredrix E. W., Wouters E. F., Soeters P. B., van der Aalst A. C., Kester A. D., von Meyenfeldt M. F., Saris W. H. Resting energy expenditure in patients with non-small cell lung cancer. Cancer. 1991 Oct 1;68(7):1616–1621. doi: 10.1002/1097-0142(19911001)68:7<1616::aid-cncr2820680725>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  8. Hansell D. T., Davies J. W., Burns H. J. The effects on resting energy expenditure of different tumor types. Cancer. 1986 Oct 15;58(8):1739–1744. doi: 10.1002/1097-0142(19861015)58:8<1739::aid-cncr2820580826>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  9. Jebb S. A., Osborne R. J., Dixon A. K., Bleehen N. M., Elia M. Measurements of resting energy expenditure and body composition before and after treatment of small cell lung cancer. Ann Oncol. 1994 Dec;5(10):915–919. doi: 10.1093/oxfordjournals.annonc.a058730. [DOI] [PubMed] [Google Scholar]
  10. Kern K. A., Norton J. A. Cancer cachexia. JPEN J Parenter Enteral Nutr. 1988 May-Jun;12(3):286–298. doi: 10.1177/0148607188012003286. [DOI] [PubMed] [Google Scholar]
  11. Larsen K. Creatinine assay by a reaction-kinetic principle. Clin Chim Acta. 1972 Oct;41:209–217. doi: 10.1016/0009-8981(72)90513-x. [DOI] [PubMed] [Google Scholar]
  12. Patel A. M., Dunn W. F., Trastek V. F. Staging systems of lung cancer. Mayo Clin Proc. 1993 May;68(5):475–482. doi: 10.1016/s0025-6196(12)60197-9. [DOI] [PubMed] [Google Scholar]
  13. Ravussin E., Bogardus C. Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization. Am J Clin Nutr. 1989 May;49(5 Suppl):968–975. doi: 10.1093/ajcn/49.5.968. [DOI] [PubMed] [Google Scholar]
  14. Russell D. M., Shike M., Marliss E. B., Detsky A. S., Shepherd F. A., Feld R., Evans W. K., Jeejeebhoy K. N. Effects of total parenteral nutrition and chemotherapy on the metabolic derangements in small cell lung cancer. Cancer Res. 1984 Apr;44(4):1706–1711. [PubMed] [Google Scholar]
  15. Schaur R. J., Semmelrock H. J., Schauenstein E., Kronberger L. Tumor host relations. II. Influence of tumor extent and tumor site on plasma cortisol of patients with malignant diseases. J Cancer Res Clin Oncol. 1979 Apr 12;93(3):287–292. doi: 10.1007/BF00964585. [DOI] [PubMed] [Google Scholar]
  16. Staal-van den Brekel A. J., Dentener M. A., Schols A. M., Buurman W. A., Wouters E. F. Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients. J Clin Oncol. 1995 Oct;13(10):2600–2605. doi: 10.1200/JCO.1995.13.10.2600. [DOI] [PubMed] [Google Scholar]
  17. Staal-van den Brekel A. J., Schols A. M., ten Velde G. P., Buurman W. A., Wouters E. F. Analysis of the energy balance in lung cancer patients. Cancer Res. 1994 Dec 15;54(24):6430–6433. [PubMed] [Google Scholar]
  18. Strassmann G., Fong M., Kenney J. S., Jacob C. O. Evidence for the involvement of interleukin 6 in experimental cancer cachexia. J Clin Invest. 1992 May;89(5):1681–1684. doi: 10.1172/JCI115767. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Tracey K. J., Wei H., Manogue K. R., Fong Y., Hesse D. G., Nguyen H. T., Kuo G. C., Beutler B., Cotran R. S., Cerami A. Cachectin/tumor necrosis factor induces cachexia, anemia, and inflammation. J Exp Med. 1988 Mar 1;167(3):1211–1227. doi: 10.1084/jem.167.3.1211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Westerterp K. R., Donkers J. H., Fredrix E. W., Boekhoudt P. Energy intake, physical activity and body weight: a simulation model. Br J Nutr. 1995 Mar;73(3):337–347. doi: 10.1079/bjn19950037. [DOI] [PubMed] [Google Scholar]

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