Engelen Mariëlle P K J, van der Meij Barbara S, Deutz Nicolaas E P
Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA.
Curr Opin Clin Nutr Metab Care. 2016 Jan;19(1):39-47. doi: 10.1097/MCO.0000000000000236.
Preventing unintentional weight and muscle loss is of crucial importance to maintain the condition and well-being of patients with cancer, improve treatment response and tolerance, and prolong survival. Anabolic resistance might explain why some cancer patients do not respond to nutritional intervention, but does recent evidence actually support this? We will discuss recent literature that casts doubt on attenuated anabolic potential in cancer.
Although anabolic resistance was observed in the past, more recent studies have shown that advanced cancer patients have an anabolic potential after intake of high-quality proteins. Furthermore, a consistent linear relationship is observed in cancer between (essential) amino acid availability from the diet and net protein gain. The studied cancer patients, however, were often characterized by a normal or obese body weight, following the trend in the general population, and mild systemic inflammation. Factors like recent chemotherapy, surgery, or cachexia do not seem to attenuate the anabolic potential to feeding.
Cancer patients have a normal anabolic potential which relates to the amount of essential amino acids in the meal. It remains to be determined if this is also the case in weak cancer patients with a short life expectancy and high systemic inflammation.
预防非故意性体重减轻和肌肉流失对于维持癌症患者的身体状况和健康、提高治疗反应和耐受性以及延长生存期至关重要。合成代谢抵抗可能解释了为什么一些癌症患者对营养干预没有反应，但近期的证据真的支持这一点吗？我们将讨论近期对癌症患者合成代谢潜能减弱提出质疑的文献。
尽管过去观察到存在合成代谢抵抗，但最近的研究表明，晚期癌症患者在摄入优质蛋白质后具有合成代谢潜能。此外，在癌症患者中，饮食中（必需）氨基酸的可利用量与净蛋白质增加之间存在一致的线性关系。然而，所研究的癌症患者通常具有正常或肥胖的体重，这与一般人群的趋势一致，且存在轻度全身炎症。近期化疗、手术或恶病质等因素似乎并未削弱进食后的合成代谢潜能。
癌症患者具有正常的合成代谢潜能，这与膳食中必需氨基酸的量有关。对于预期寿命短且全身炎症严重的虚弱癌症患者是否也是如此，仍有待确定。
