Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.
Clin Nutr. 2010 Feb;29(1):72-7. doi: 10.1016/j.clnu.2009.07.001. Epub 2009 Aug 3.
BACKGROUND & AIMS: Elevated resting energy expenditure (REE) may be a major determinant in the development of cancer cachexia. The aim of the study was to evaluate REE and body composition in cancer patients and find out the relationship between energy expenditure and substrate utilization.
Measured resting energy expenditure (mREE), carbohydrate oxidation (C-O), and fat oxidation (F-O) were measured by indirect calorimetry in 714 cancer patients and 642 controls. Extracellular fluid (ECF), intracellular fluid (ICF), and total water (TW) were measured by bioelectrical impedance appliance; fat mass (FM), fat free mass (FFM), and body cell mass (BCM) were further determined.
Compared with the controls, cancer patients showed no significant difference in mREE, but had higher mREE/FFM and mREE/pREE. 46.7% (n=333) of cancer patients were hypermetabolic, 43.5% (n=310) normometabolic, and 9.8% (n=71) hypometabolic; whereas 25.2% (n=162) of control subjects were hypermetabolic, 56.5% (n=363) normometabolic, and 18.3% (n=117) hypometabolic. Cancer patients showed an increase in F-O, ECF, TW/BW and ECF/BW; and a decrease in C-O, npRQ, ICF, ICF/BW. REE was correlated to substrate oxidation rate. Cancer patients exhibited an elevation in FM, FM/BW, FFM, and BCM, and a decrease in FFM/BW.
静息能量消耗（REE）升高可能是癌症恶病质发生的主要决定因素。本研究旨在评估癌症患者的REE 和身体成分，并发现能量消耗与底物利用之间的关系。
通过间接测热法测量了 714 例癌症患者和 642 例对照者的静息能量消耗（mREE）、碳水化合物氧化（C-O）和脂肪氧化（F-O）。通过生物电阻抗仪测量细胞外液（ECF）、细胞内液（ICF）和总水（TW）；进一步确定脂肪量（FM）、去脂体重（FFM）和身体细胞量（BCM）。
与对照组相比，癌症患者的 mREE 无显著差异，但 mREE/FFM 和 mREE/pREE 较高。46.7%（n=333）的癌症患者为高代谢，43.5%（n=310）为正常代谢，9.8%（n=71）为低代谢；而 25.2%（n=162）的对照组为高代谢，56.5%（n=363）为正常代谢，18.3%（n=117）为低代谢。癌症患者的 F-O、ECF、TW/BW 和 ECF/BW 增加，C-O、npRQ、ICF、ICF/BW 减少。REE 与底物氧化率相关。癌症患者的 FM、FM/BW、FFM 和 BCM 增加，FFM/BW 减少。
