Open AccessEffects of oral meal feeding on whole body protein breakdown and protein synthesis in cachectic pancreatic cancer patients
Author(s) -
Dijk David P.J.,
Poll Marcel C.G.,
Moses Alastair G.W.,
Preston Thomas,
Olde Damink Steven W.M.,
Rensen Sander S.,
Deutz Nicolaas E.P.,
Soeters Peter B.,
Ross James A.,
Fearon Kenneth C.H.,
Dejong Cornelis H.C.
Publication year - 2015
Publication title -
journal of cachexia, sarcopenia and muscle
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.803
H-Index - 66
eISSN - 2190-6009
pISSN - 2190-5991
DOI - 10.1002/jcsm.12029
Subject(s) - cachexia , lean body mass , medicine , endocrinology , protein catabolism , pancreatic cancer , phenylalanine , wasting , cancer , chemistry , gastroenterology , body weight , biochemistry , amino acid
Background Pancreatic cancer is often accompanied by cachexia, a syndrome of severe weight loss and muscle wasting. A suboptimal response to nutritional support may further aggravate cachexia, yet the influence of nutrition on protein kinetics in cachectic patients is poorly understood. Methods Eight cachectic pancreatic cancer patients and seven control patients received a primed continuous intravenous infusion of l ‐[ring‐ 2 H 5 ]phenylalanine and l ‐[3,3‐ 2 H 2 ]tyrosine for 8 h and ingested sips of water with l ‐[1‐ 13 C]phenylalanine every 30 min. After 4 h, oral feeding was started. Whole body protein breakdown, protein synthesis, and net protein balance were calculated. Results are given as median with interquartile range. Results Baseline protein breakdown and protein synthesis were higher in cachectic patients compared with the controls (breakdown: 67.1 (48.1–79.6) vs. 45.8 (42.6–46.3) µmol/kg lean body mass/h, P = 0.049; and synthesis: 63.0 (44.3–75.6) vs. 41.8 (37.6–42.5) µmol/kg lean body mass/h, P = 0.021). During feeding, protein breakdown decreased significantly to 45.5 (26.9–51.1) µmol/kg lean body mass/h ( P = 0.012) in the cachexia group and to 33.7 (17.4–37.1) µmol/kg lean body mass/h ( P = 0.018) in the control group. Protein synthesis was not affected by feeding in cachectic patients: 58.4 (46.5–76.1) µmol/kg lean body mass/h, but was stimulated in controls: 47.9 (41.8–56.7) µmol/kg lean body mass/h ( P = 0.018). Both groups showed a comparable positive net protein balance during feeding: cachexia: 19.7 (13.1–23.7) and control: 16.3 (13.6–25.4) µmol/kg lean body mass/h ( P = 0.908). Conclusion Cachectic pancreatic cancer patients have a higher basal protein turnover. Both cachectic patients and controls show a comparable protein anabolism during feeding, albeit through a different pattern of protein kinetics. In cachectic patients, this is primarily related to reduced protein breakdown, whereas in controls, both protein breakdown and protein synthesis alterations are involved.