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Metabolic Balance across the Leg in Weight-losing Cancer Patients Compared to Depleted Patients without Cancer¹

Surgical Metabolic Research Laboratory, Department of Surgery I [K. L., L. E., T. S.], and Department of Anaesthesiology II [K. B., E. E.], Sahigren's Hospital, University of Gothenburg, Gothenburg, Sweden

Oxygen uptake, glucose, lipid, and amino acid metabolism across the leg were measured in cancer patients who had lost 7 to 28% of their normal weight. Three control groups were used: depleted non-cancer patients with the same loss of body weight as the cancer patients; one well-nourished group of patients with acute illness which should lead to malnutrition; one well-nourished group of hospitalized patients without any disease of importance for this study.

Blood flow, oxygen uptake, carbon dioxide production, and glucose, pyruvate, lactate, glycerol, free fatty acids, alanine, and tyrosine balance were measured across the leg in relation to insulin. Depleted cancer patients differed from depleted controls only with respect to glucose uptake. Cancer patients had no significant uptake of glucose across the leg after an overnight fast in contrast to the other groups of patients. Well-nourished patients with acute illness had elevated blood flow, pyruvate, lactate, glycerol, alanine, and tyrosine release compared with well-nourished conlrols. These changes were associated with high fasling levels of insulin. Cancer palienls had decreased glucose uplake, decreased alanine release, and increased glycerol release compared wilh well-nourished controls.

The results support that weight-losing cancer palients have metabolic reaclions quantitatively similar to those of depleted non-cancer patients when compared on Ine basis of body composition. Therefore, we conclude that tumor-host metabolism in humans is not unique but seems lo represent a normal physiological response to nutritional deprivation.

¹ This work was supported by grants from The Swedish Cancer Society (Project 93), The Swedish Medical Research Council (Project 536), The Assar Gabrielsson Foundation, and The Serena Ehrenström Foundation.

² To whom requests for reprints should be addressed, at Department of Surgery I, Sahigren's Hospital, S-413 45 Gothenburg, Swedn.

Received 3/11/82. Accepted 7/ 2/82.

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