Simons J P, Schols A M, Hoefnagels J M, Westerterp K R, ten Velde G P, Wouters E F
Department of Pulmonology, University Hospital, Maastricht, The Netherlands.
Cancer. 1998 Feb 1;82(3):553-60.
Anorexia and cachexia are well-known sequelae of cancer that contribute to morbidity and mortality. In several studies in patients with non-hormone-sensitive tumors, synthetic progestogens were shown to exert beneficial effects on appetite and weight loss. The current study was undertaken to investigate the effects of medroxyprogesterone acetate (MPA) on food intake, body composition, and resting energy expenditure (REE).
Fifty-four patients with non-hormone-sensitive cancer, generally characterized by substantial weight loss and hypermetabolism, received either MPA, 500 mg, or placebo twice daily for 12 weeks (double-blind study). Food intake was measured by dietary history, body composition was assessed by deuterium dilution (fat mass, fat-free mass), and REE was obtained by indirect calorimetry.
Compared with placebo, 12 weeks of MPA led to an increase in energy intake (between-group difference, 426 kcal/day; P = 0.01) that was significantly associated (r = 0.68, P = 0.003) with an increase in fat mass (between-group difference, 2.5 kg; P = 0.009). Fat-free mass was not significantly influenced. REE increased during MPA treatment: at 6 weeks, the between-group difference in change was 135 kcal/day (P = 0.009); after 12 weeks, this difference was 93 kcal/ day (P = 0.07).
The authors conclude that MPA is able to stimulate increased food intake significantly and to reverse fat loss concomitantly in patients with non-hormone-sensitive cancer.
厌食和恶病质是癌症常见的后遗症，会增加发病率和死亡率。在多项针对非激素敏感性肿瘤患者的研究中，合成孕激素被证明对食欲和体重减轻有有益影响。本研究旨在探讨醋酸甲羟孕酮（MPA）对食物摄入量、身体成分和静息能量消耗（REE）的影响。
54例非激素敏感性癌症患者，通常表现为体重显著减轻和代谢亢进，接受MPA 500mg或安慰剂治疗，每日两次，为期12周（双盲研究）。通过饮食史测量食物摄入量，通过氘稀释法评估身体成分（脂肪量、去脂体重），通过间接测热法获得REE。
与安慰剂相比，12周的MPA治疗导致能量摄入量增加（组间差异为426千卡/天；P = 0.01），这与脂肪量增加显著相关（r = 0.68，P = 0.003）（组间差异为2.5kg；P = 0.009）。去脂体重没有受到显著影响。MPA治疗期间REE增加：在6周时，组间变化差异为135千卡/天（P = 0.009）；12周后，差异为93千卡/天（P = 0.07）。
作者得出结论，MPA能够显著刺激非激素敏感性癌症患者增加食物摄入量，并同时逆转脂肪流失。
