Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 89, Issue 4, Pages 1173-1179Publisher
OXFORD UNIV PRESS
DOI: 10.3945/ajcn.2008.27273
Keywords
-
Categories
Funding
- NIH
- NIDDK
- Canadian Institutes for Heath Research Canada Graduate Scholarship Masters Award
- Alberta Cancer Board Graduate Studentship
- Canadian Institute of Health Research
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada
- Alberta Cancer Board
- Alberta Cancer Foundation
Ask authors/readers for more resources
Background: Cancer cachexia-associated weight loss is poorly understood; energetically demanding tissues (eg, organ and tumor mass) and resting energy expenditure (REE) are reported to increase with advanced cancer. Objective: The objective was to quantify the potential contribution of increasing masses of energetically demanding tissues to REE with colorectal cancer cachexia progression. Design: A longitudinal computed tomography (CT) image review was performed to quantify organ size (liver, including metastases, and spleen) and peripheral tissues (skeletal muscle and adipose tissue) during colorectal cancer cachexia progression (n = 34). Body composition was prospectively evaluated by CT and dual-energy X-ray absorptiometry, and REE was determined by indirect calorimetry in advanced colorectal cancer patients (n 18). Results: Eleven months from death, the liver (2.3 +/- 0.7 kg) and spleen (0.32 +/- 0.2 kg) were larger than reference values. One month from death, liver weight increased to 3.0 +/- 1.5 kg (P 0.010), spleen showed a trend to increase (P = 0.077), and concurrent losses of muscle (4.2 kg) and fat (3.5 kg) (P < 0.05) were observed. The estimated percentage of fat-free mass (FFM) occupied by the liver increased from 4.5% to 7.0% (P < 0.001). The most rapid loss of peripheral tissues and liver and metastases gain occurred within 3 mo of death. A positive linear relation existed between liver mass and measured whole-body REE (r(2) = 0.35, P 0.010); because liver accounted for a larger percentage of FFM, measured REE center dot kg FFM-1 center dot d(-1) increased (r(2) = 0.35, P = 0.010). Conclusions: Increases in mass and in the proportion of high metabolic rate tissues, including liver and tumor, represented a cumulative incremental REE of approximate to 17,700 kcal during the last 3 mo of life and may contribute substantially to cachexia-associated weight loss. Am J Clin Nutr 2009;89:1173-9.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available