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Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients

Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients

Journal of Clinical Oncology 13(10): 2600-2605

Purpose: To determine whether an increased resting energy expenditure (REE) and weight loss in lung cancer patients are related to a systemic inflammatory response. Materials and Methods: REE was measured by indirect calorimetry using a ventilated hood system. Soluble tumor necrosis factor receptor 55 (sTNF-R55) and sTNFR75, soluble intercellular adhesion molecule (sICAM)-1, soluble E (sE)-selectin, lipopolysaccharide (LPS)-binding protein (LBP), interleukin (IL)-6, and TNF-alpha were measured using sandwich enzyme-linked immunosorbent assay (ELISA), and C-reactive protein (CRP) was measured by turbidimetry. A cross-sectional study was performed to compare inflammatory mediators between hypermetabolic (REE/Harris Benedict (HB) equation gtoreq 110%) versus normometabolic (REE/HB lt 110%) patients and between patients who lost weight (more than 10% loss of preillness weight) versus those whose weight remained stable. Results: Eighty-seven patients with primary nonsmall-cell lung cancer were consecutively entered onto the study. Mean REE expressed as a percentage of the HB reference values was 118% +- 12%; 67 patients were considered hypermetabolic. Twenty-six patients had a substantial loss of more than 10% of their preillness weight. Hypermetabolic patients were found to have significantly increased levels of sTNF-R55, sE-selectin, LBP, and CRP compared with normometabolic patients. Weight loss was related with increased levels of the sTNF-Rs, sICAM-1, IL-6, LBP, and CRP. Conclusion: Hypermetabolism and weight loss are relate to the presence of a systemic inflammatory response as reflected by enhanced levels of inflammatory mediators and acute phase proteins in patients with primary non-small-cell lung cancer.

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Accession: 043376559

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PMID: 7595713

DOI: 10.1200/jco.1995.13.10.2600

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