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

• Published in: Journal of clinical oncology Vol. 13; no. 10; p. 2600
• Main Authors: Staal-van den Brekel, A J, Dentener, M A, Schols, A M, Buurman, W A, Wouters, E F
• Format: Journal Article
• Language: English
• Published: United States 01-10-1995
• Subjects: Acute-Phase Proteins - analysis; Aged; Analysis of Variance; Antigens, CD - blood; Biological Factors - blood; Carcinoma, Non-Small-Cell Lung - metabolism; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - physiopathology; Case-Control Studies; Cell Adhesion Molecules - blood; Creatinine - blood; Energy Metabolism - physiology; Female; Humans; Inflammation - physiopathology; Interleukin-6 - blood; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Lung Neoplasms - physiopathology; Male; Middle Aged; Tumor Necrosis Factor-alpha - analysis; Weight Loss - physiology
• ISSN: 0732-183X
• DOI: 10.1200/jco.1995.13.10.2600

To determine whether an increased resting energy expenditure (REE) and weight loss in lung cancer patients are related to a systemic inflammatory response.
REE was measured by indirect calorimetry using a ventilated hood system. Soluble tumor necrosis factor receptor 55 (sTNF-R55) and sTNF-R75, 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 > or = 110%) versus normometabolic (REE/HB < 110%) patients and between patients who lost weight (more than 10% loss of preillness weight) versus those whose weight remained stable.
Eighty-seven patients with primary non-small-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.
Hypermetabolism and weight loss are related 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.