Weight loss and resting energy expenditure in male patients with newly diagnosed esophageal cancer

Objectives: Cancer cachexia is associated with impaired nutritional status and systemic inflammation. The goal of this study was to evaluate the nutritional status and resting energy expenditure (REE) changes in patients with newly detected esophageal cancer, and the influence of weight loss on REE. Methods: Fifty-six patients and 30 healthy controls were prospectively enrolled, and patients were further divided into weight-stable (WS) and weight-loss (WL) subgroups. Body composition, measured REE (mREE), and the ratio of mREE to predicted REE (pREE) by Harris-Benedict formula were assessed. Blood levels of hemoglobin, albumin, prealbumin, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha), and interleukin (IL)-6 were measured in patients. Results: Cancer patients had lower body mass index (BMI) and percentage of fat mass, but higher mREE and percentage of mREE/pREE compared with healthy controls (P < 0.05). WS (n = 32) and WL patients (n = 24) had similar BMI and body composition indices, but the latter had obviously higher mREE, mREE per kilogram body weight (mREE/BW), percentage of mREE/pREE, hs-CRP and IL-6 levels, and lower albumin and prealbumin levels. Percentage of weight loss was positively correlated with REE/BW, hs-CRP, and IL-6 level (r = 0.238,P = 0.044; r = 0.446, P = 0.01; r = 0.196, P = 0.047, respectively). Conclusion: Impaired nutrition status, elevated energy expenditure, and higher inflammation status tend to be apparent in weight-losing patients with newly diagnosed esophageal cancer, which suggested that early recognition of body weight change and routine nutritional risk screening followed by adequate nutrition intervention should be applied in these patients. (C) 2013 Elsevier Inc. All rights reserved.