Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Institute for Pediatric Research, Shanghai, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Nutrition. 2013 Nov-Dec;29(11-12):1310-4. doi: 10.1016/j.nut.2013.04.010. Epub 2013 Sep 4.
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.
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-α), and interleukin (IL)-6 were measured in patients.
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).
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.
癌症恶病质与营养状态受损和全身炎症有关。本研究的目的是评估新诊断食管癌患者的营养状况和静息能量消耗（REE）变化，以及体重减轻对 REE 的影响。
前瞻性纳入 56 例患者和 30 例健康对照者，患者进一步分为体重稳定（WS）和体重减轻（WL）亚组。评估身体成分、实测 REE（mREE）和 Harris-Benedict 公式预测 REE（pREE）的比值。测量患者的血红蛋白、白蛋白、前白蛋白、高敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）和白细胞介素（IL）-6 水平。
癌症患者的 BMI 和体脂百分比较低，但 mREE 和 mREE/pREE 百分比较高（P < 0.05）。WS（n = 32）和 WL 患者（n = 24）的 BMI 和身体成分指数相似，但后者的 mREE、mREE/体重（mREE/BW）、mREE/pREE 百分比、hs-CRP 和 IL-6 水平明显更高，白蛋白和前白蛋白水平更低。体重减轻百分比与 REE/BW、hs-CRP 和 IL-6 水平呈正相关（r = 0.238，P = 0.044；r = 0.446，P = 0.01；r = 0.196，P = 0.047）。
新诊断食管癌体重减轻患者的营养状况受损、能量消耗增加和炎症状态升高更为明显，这提示应早期识别体重变化，常规进行营养风险筛查，并对这些患者进行充分的营养干预。
