Staal-van den Brekel A J, Schols A M, ten Velde G P, Buurman W A, Wouters E F
Department of Pulmonology, University Hosital, Maastricht, The Netherlands.
Cancer Res. 1994 Dec 15;54(24):6430-3.
Previous studies have shown that an elevated resting energy expenditure (REE) frequently occurs in lung cancer patients. The aim of the present study was to assess the balance between REE and dietary intake and to analyze the contributing factors of elevated REE in newly detected lung cancer patients. One hundred newly detected lung cancer patients were evaluated. Measured values of REE were adjusted for the values predicted by the Harris-Benedict formula and for fat-free mass assessed by the bioelectrical impedance method. Dietary intake was measured using a dietary history. A substantial number of patients (30%) had a weight loss of 10% or more from their preillness stable weight. An elevated REE was found in 74% of the patients. Stratification by tumor localization revealed that patients with a central tumor had a significantly higher REE [121 +/- 13% (SD) versus 110 +/- 10% of predicted, P < 0.001] and significantly higher level of C-reactive protein (35 +/- 35 mg/liter versus 16 +/- 26 mg/liter, P = 0.006) compared with patients with a peripheral tumor. Dietary intake was significantly lower in the weight-losing group (1872 +/- 542 kcal/day versus 2169 +/- 782 kcal/day, P < 0.05) compared with the weight-stable group. We conclude that both elevated REE and decreased dietary intake contribute to weight loss in lung cancer patients. Tumor localization and inflammation were found to be contributing factors to the elevated REE.
先前的研究表明，肺癌患者常常出现静息能量消耗（REE）升高的情况。本研究的目的是评估REE与饮食摄入量之间的平衡，并分析新确诊肺癌患者REE升高的影响因素。对100名新确诊的肺癌患者进行了评估。根据哈里斯-本尼迪克特公式预测的值以及通过生物电阻抗法评估的去脂体重，对REE的测量值进行了调整。通过饮食史来测量饮食摄入量。相当多的患者（30%）体重较患病前稳定体重减轻了10%或更多。74%的患者存在REE升高的情况。按肿瘤定位分层显示，与周围型肿瘤患者相比，中央型肿瘤患者的REE显著更高[121±13%（标准差），而预测值为110±10%，P<0.001]，C反应蛋白水平也显著更高（35±35毫克/升，而周围型肿瘤患者为16±26毫克/升，P = 0.006）。与体重稳定组相比，体重减轻组的饮食摄入量显著更低（1872±542千卡/天，而体重稳定组为2169±782千卡/天，P<0.05）。我们得出结论，REE升高和饮食摄入量减少均导致肺癌患者体重减轻。肿瘤定位和炎症被发现是REE升高的影响因素。
