The Measurement Of The Resting Energy Expenditure Of Pancreatic Cancer Patients And Its Relation To Nutritional Status And Cytokines

The measurement of resting energy expenditure of pancreatic cancer patients and its relation to nutritional status and cytokineObjective. Cancer patients are often accompanied by changes in metabolism, and metabolic changes in patients with pancreatic cancer are more obvious. The changes in metabolism can lead to changes in body composition. The study was designed to assess the metabolic changes by detecting resting energy expenditure (REE) of pancreatic cancer patients and to explore the relationship of REE and nutritional status and the role of cytokine.Methods. The REE of 34 patients who were diagnosed with pancreatic cancer (test group) and 30 cases of inguinal hernia patients (control group) was measured by indirect calorimetry, body composition was analysed by body composition analyzer [body mass index (BMI), muscle weight, fat free mass, fat mass, intracellular fluid volume (ICF), extracellular fluid volume (ECF)], and plasma proteins (albumin, prealbumin, transferrin) and cytokines (TNF-a, IL-6, IL-1) were also measured. The relationships between the REE of pancreatic cancer patients and nutrition indicators and between the REE and cytokines were analysed. And whether different parts of cancer, with or without jaundice, different pathological stages, with or without malnutrition have effect on REE of pancreatic cancer patients were further analyzed.Results. Compared with control group, in pancreatic cancer patients, the REE was significantly higher (1449.03±315.47 vs 1344.67±128.52, P <0.01), respiratory quotient (RQ) is significantly lower than the control group (0.81±0.06 vs 0.88±0.08, P<0.01), nutritional indicators [body mass index (BMI), body weight, muscle mass, fat free mass, fat, ICF, albumin, prealbumin, transferrin] were significantly decreased, TNF-a and IL-6 were significantly higher (P<0.01), while the IL-1 was not significantly different (P> 0.05). The REE of pancreatic cancer patients and nutritional status had significantly negative correlation. TNF-a and IL-6 of pancreatic cancer patients and REE had significantly positive correlation. The change of REE was not the same in different pancreatic cancer patients, with the increased proportion of 55.88%, the reduced proportion of 29.41%, and the normal proportion of 14.71%. After corrected by fat free mass (FFM), REE in cancer patients of the pancreatic head was significantly lower than that in pancreatic body and tail (29.48±5.46 vs 30.68±8.24, P <0.05). The jaundice had no significant effect on REE. REE in patients with stage IV pancreatic cancer was significantly higher when caopared with patients with stageⅡand stageⅢpancreatic cancer (P<0.01). REE in malnourished patients was significantly higher than those witnout malnutrition (1506.33±252.46 vs 1394.54±392.78, p<0.01).Conclusion. In pancreatic cancer patients, the REE is significantly increased, the nutritional status is significantly lower and TNF-a and IL-6 are significantly increased. Tumor location,pathological stage and malnutrition have an obvious impact on REE. The elevated REE is positively correlated with malnutrition in pancreatic cancer patients, and the elevated TNF-a and IL-6 may be one cause.