Effects of oral meal feeding on whole body protein breakdown and protein synthesis in cachectic pancreatic cancer patients

Journal of Cachexia, Sarcopenia and Muscle

David P.J. van Dijk²  Marcel C.G. van de Poll²  Alastair G.W. Moses³  Thomas Preston¹  Steven W.M. Olde Damink²  Sander S. Rensen²  Nicolaas E.P. Deutz²  Peter B. Soeters²  James A. Ross³  Kenneth C.H. Fearon³ 

[1] Stable Isotope Biochemistry Laboratory, Scottish Universities Environmental Research Centre, Glasgow, UK;Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands;Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK

关键词: Cancer cachexia;    Pancreatic cancer;    Nutrition;    Protein synthesis;    Protein breakdown;    Anabolic resistance;   

DOI  :  10.1002/jcsm.12029

来源: Wiley

【 摘 要 】

Abstract

Background

Pancreatic cancer is often accompanied by cachexia, a syndrome of severe weight loss and muscle wasting. A suboptimal response to nutritional support may further aggravate cachexia, yet the influence of nutrition on protein kinetics in cachectic patients is poorly understood.

Methods

Eight cachectic pancreatic cancer patients and seven control patients received a primed continuous intravenous infusion of l-[ring-²H₅]phenylalanine and l-[3,3-²H₂]tyrosine for 8 h and ingested sips of water with l-[1-¹³C]phenylalanine every 30 min. After 4 h, oral feeding was started. Whole body protein breakdown, protein synthesis, and net protein balance were calculated. Results are given as median with interquartile range.

Results

Baseline protein breakdown and protein synthesis were higher in cachectic patients compared with the controls (breakdown: 67.1 (48.1–79.6) vs. 45.8 (42.6–46.3) µmol/kg lean body mass/h, P = 0.049; and synthesis: 63.0 (44.3–75.6) vs. 41.8 (37.6–42.5) µmol/kg lean body mass/h, P = 0.021). During feeding, protein breakdown decreased significantly to 45.5 (26.9–51.1) µmol/kg lean body mass/h (P = 0.012) in the cachexia group and to 33.7 (17.4–37.1) µmol/kg lean body mass/h (P = 0.018) in the control group. Protein synthesis was not affected by feeding in cachectic patients: 58.4 (46.5–76.1) µmol/kg lean body mass/h, but was stimulated in controls: 47.9 (41.8–56.7) µmol/kg lean body mass/h (P = 0.018). Both groups showed a comparable positive net protein balance during feeding: cachexia: 19.7 (13.1–23.7) and control: 16.3 (13.6–25.4) µmol/kg lean body mass/h (P = 0.908).

Conclusion

Cachectic pancreatic cancer patients have a higher basal protein turnover. Both cachectic patients and controls show a comparable protein anabolism during feeding, albeit through a different pattern of protein kinetics. In cachectic patients, this is primarily related to reduced protein breakdown, whereas in controls, both protein breakdown and protein synthesis alterations are involved.

【 授权许可】

CC BY-NC-ND   
© 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders

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