Glucose metabolism in advanced lung cancer patients
Richards, E.W.; Long, C.L.; Nelson, K.M.; Pinkston, J.A.; Navari, R.M.; Geiger, J.W.; Gandy, R.E.; Blakemore, W.S.
Nutrition 8(4): 245-251
1992
ISSN/ISBN: 0899-9007 PMID: 1498456 Document Number: 393507
Resting energy expenditure (REE) was estimated by indirect calorimetry and glucose kinetics by a primed constant infusion of D-[U-14C]glucose and D-[6-superscript 3H]glucose over the last 4 h of a 24-h fast in 32 advanced lung cancer patients immediately after diagnosis and before any chemotherapy or radiotherapy and in 19 healthy subjects. REE for the lung cancer group was not different form that in the control group (1535.8+or-78.0 vs. 1670.2+or-53.9 kcal/day, respectively, P = 0.151). When REE was expressed as a function of body weight, or lean body mass, no differences between the 2 groups were observed. The rate of glucose appearance was 9.88+or-0.36 in the cancer patients and 10.15+or-0.53 micro mol kg-1 min-1 in control subjects (P = 0.667), of which 50.4 vs. 58.2%, respectively, was oxidised. The amount of glucose recycled was 13.54+or-1.22% in cancer patients and 15.08+or-0.99% in control subjects (P = 0.394). The amount of CO2 produced from direct oxidation of glucose was 23.39+or-0.74% in cancer patients and 27.45+or-1.36% in control subjects (P = 0.006). The data suggest that the early diagnosed advanced lung cancer patient does not demonstrate increases in REE, glucose appearance, or glucose recycling. However, the differences observed with regard to glucose oxidation and percentage CO2 produced from glucose oxidation suggest a small but significant shift between the oxidative and non-oxidative pathways of glucose metabolism in the advanced lung cancer patient. The results suggest that many of the differences reported in the literature may stem from an ill-defined time window of disease progression and treatment. This notion is supported by the fact that several studies were reported in patients during antineoplastic treatment.