Hansell D T, Davies J W, Shenkin A, Burns H J
Ann Surg. 1986 Dec;204(6):637-42. doi: 10.1097/00000658-198612000-00004.
In an attempt to define the mechanism of weight loss in cancer patients, fat and carbohydrate oxidation rates were calculated in 93 patients. Seventy patients with colorectal or gastric cancer were compared with a control group of 23 patients with nonmalignant illness. Twenty-seven patients with cancer and 13 control patients had lost more than 10% of their pre-illness body weight. Fat and carbohydrate oxidation rates were derived from measurements of oxygen consumption, carbon dioxide production, and urinary nitrogen excretion. Patients with cancer had significantly higher fat oxidation rates (p less than 0.01) and significantly lower carbohydrate oxidation rates (p less than 0.05) when compared with controls. Weight-losing cancer patients had significantly higher fat oxidation rates when compared with weight-stable cancer patients (p less than 0.02), weight-stable controls (p less than 0.01), and weight-losing controls (p less than 0.02). Cancer patients with liver metastases (N = 14) had significantly higher fat oxidation rates (p less than 0.01) and significantly lower carbohydrate oxidation rates (p less than 0.01) compared with cancer patients who had localized disease. There were no significant differences among the groups with respect to resting energy expenditure when expressed as kilocalorie per kilogram lean body mass per day. The presence of cancer appears to be associated with abnormal fat and carbohydrate metabolism. The increased rate of fat oxidation seen in patients with cancer, especially those with weight loss or liver metastases, may be a significant factor in the development of cancer cachexia.
为了确定癌症患者体重减轻的机制，我们计算了93例患者的脂肪和碳水化合物氧化率。将70例结直肠癌或胃癌患者与23例非恶性疾病患者的对照组进行比较。27例癌症患者和13例对照患者的体重较病前减轻了10%以上。脂肪和碳水化合物氧化率通过测量耗氧量、二氧化碳产生量和尿氮排泄量得出。与对照组相比，癌症患者的脂肪氧化率显著更高（p<0.01），碳水化合物氧化率显著更低（p<0.05）。与体重稳定的癌症患者（p<0.02）、体重稳定的对照患者（p<0.01）和体重减轻的对照患者（p<0.02）相比，体重减轻的癌症患者的脂肪氧化率显著更高。与患有局限性疾病的癌症患者相比，有肝转移的癌症患者（N=14）的脂肪氧化率显著更高（p<0.01），碳水化合物氧化率显著更低（p<0.01）。当以每天每千克瘦体重的千卡数表示静息能量消耗时，各组之间没有显著差异。癌症的存在似乎与脂肪和碳水化合物代谢异常有关。在癌症患者中，尤其是那些体重减轻或有肝转移的患者中，脂肪氧化率的增加可能是癌症恶病质发展的一个重要因素。
