A viscerally driven cachexia syndrome in patients with advanced colorectal cancer: contributions of organ and tumor mass to whole-body energy demands

作者: Marina Mourtzakis , Kevin D Hall , Linda J McCargar , Carla MM Prado , Vickie E Baracos

DOI: 10.3945/AJCN.2008.27273

关键词: MedicineEndocrinologyColorectal cancerWeight lossMetastasisInternal medicineBasal metabolic rateAdipose tissueCachexiaCancerResting energy expenditure

摘要: BACKGROUND Cancer cachexia-associated weight loss is poorly understood; energetically demanding tissues (eg, organ and tumor mass) resting energy expenditure (REE) are reported to increase with advanced cancer. OBJECTIVE The objective was quantify the potential contribution of increasing masses REE colorectal cancer cachexia progression. DESIGN A longitudinal computed tomography (CT) image review performed size (liver, including metastases, spleen) peripheral (skeletal muscle adipose tissue) during progression (n = 34). Body composition prospectively evaluated by CT dual-energy X-ray absorptiometry, determined indirect calorimetry in patients 18). RESULTS Eleven months from death, liver (2.3 +/- 0.7 kg) spleen (0.32 0.2 were larger than reference values. One month increased 3.0 1.5 kg (P 0.010), showed a trend 0.077), concurrent losses (4.2 fat (3.5 < 0.05) observed. estimated percentage fat-free mass (FFM) occupied 4.5% 7.0% 0.001). most rapid metastases gain occurred within 3 mo death. positive linear relation existed between measured whole-body (r(2) 0.35, P 0.010); because accounted for FFM, . FFM(-1) d(-1) 0.010). CONCLUSIONS Increases proportion high metabolic rate tissues, tumor, represented cumulative incremental approximately 17,700 kcal last life may contribute substantially loss.

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