Alberta Institute for Human Nutrition, University of Alberta, 4-10 Agriculture/Forestry Centre Edmonton, Alberta, T6G 2P5, Canada.
Clin Nutr. 2010 Aug;29(4):482-7. doi: 10.1016/j.clnu.2009.11.006. Epub 2009 Dec 2.
BACKGROUND & AIMS: Extensive loss of adipose tissue is a key feature of cancer cachexia. Advanced cancer patients also exhibit low plasma phospholipids. It is not known whether these processes coincide across the cancer trajectory nor has their relationship with survival been defined. Changes in adipose tissue mass and plasma phospholipids were characterized within 500days prior to death and prognostic significance assessed.
Adipose tissue rate of change was determined in a retrospective cohort of patients who died of colorectal and lung cancers (n=108) and who underwent >2 computed tomography scans in the last 500days of life. Plasma phospholipid fatty acids were measured prospectively in a similar cohort of patients with metastatic cancer (n=72).
Accelerated loss of adipose tissue begins at 7months from death reaching an average loss of 29% of total AT 2months from death. Plasma phospholipid fatty acids were 35% lower in patients closest to death versus those surviving >8months. Losses of phospholipid fatty acids and adipose tissue occur in tandem and are predictive of survival.
Depletion of plasma phospholipids likely indicates a deficit of essential fatty acids in the periphery which may contribute to loss of adipose tissue.
大量脂肪组织的丧失是癌症恶病质的一个关键特征。晚期癌症患者的血浆磷脂也较低。目前尚不清楚这些过程是否在癌症发展过程中同时发生，也不知道它们与生存的关系。本研究在 500 天内死亡前对脂肪组织质量和血浆磷脂的变化进行了特征描述，并评估了其预后意义。
对死于结直肠癌和肺癌（n=108）且在生命的最后 500 天内接受>2 次 CT 扫描的患者进行回顾性队列研究，以确定脂肪组织变化率。对患有转移性癌症的类似患者（n=72）前瞻性地测量血浆磷脂脂肪酸。
从死亡开始，脂肪组织的加速丢失在 7 个月时开始，在死亡前 2 个月达到总 AT 丢失的 29%。与存活>8 个月的患者相比，最接近死亡的患者的血浆磷脂脂肪酸降低了 35%。磷脂脂肪酸和脂肪组织的丢失是同时发生的，并具有预测生存的能力。
磷脂的消耗可能表明外周必需脂肪酸的缺乏，这可能导致脂肪组织的丢失。
