Energy metabolism and nutritional status in hospitalized patients with lung cancer

Abstract

This study aimed to investigate the energy metabolism of patients with lung cancer and the relationship between energy metabolism and proinflammatory cytokines. Twenty-eight patients with lung cancer and 18 healthy controls were enrolled in this study. The nutritional status upon admission was analyzed using nutritional screening tools and laboratory tests. The resting energy expenditure and respiratory quotient were measured using indirect calorimetry, and the predicted resting energy expenditure was calculated using the Harris-Benedict equation. Energy expenditure was increased in patients with advanced stage disease, and there were positive correlations between measured resting energy expenditure/body weight and interleukin-6 levels and between measured resting energy expenditure/predicted resting energy expenditure and interleukin-6 levels. There were significant relationships between body mass index and plasma leptin or acylated ghrelin levels. However, the level of appetite controlling hormones did not affect dietary intake. There was a negative correlation between plasma interleukin-6 levels and dietary intake, suggesting that interleukin-6 plays a role in reducing dietary intake. These results indicate that energy expenditure changes significantly with lung cancer stage and that plasma interleukin-6 levels affect energy metabolism and dietary intake. Thus, nutritional management that considers the changes in energy metabolism is important in patients with lung cancer.

Keywords: energy metabolism; indirect calorimetry; lung cancer; nutritional status.

Fig. 1

Correlations between plasma interleukin-6 (IL-6) levels and tumor necrosis factor-α (TNF-α) levels with measured resting energy expenditure (mREE)/body weight or mREE/predicted resting energy expenditure (mREE/pREE) in patients with lung cancer. Plasma IL-6 levels exhibited a positive correlation with mREE/body weight (A) and with mREE/pREE (B). However, there was no significant correlation between plasma TNF-α levels and mREE/body weight (C) or mREE/pREE (D).

Fig. 2

Correlations between plasma leptin levels and body mass index (BMI), the percent of body fat (%FAT), intake, and the percent of recommended needs in patients with lung cancer. Plasma leptin levels exhibited a positive correlation with BMI (A) and %FAT (B). However, there was no significant correlation between plasma leptin levels and intake (C) or percent of recommended needs (D).

Fig. 3

Correlation between acylated ghrelin levels and body mass index (BMI), the percent of body fat (%FAT), intake and the percent of recommended needs. Acylated ghrelin levels exhibited negative correlation with BMI (A) and %FAT (p = 0.090) (B). However, there was no significant correlation between acylated ghrelin levels and intake (C) or the percent of recommended needs (D).

Fig. 4

Correlation between plasma interleukin-6 (IL-6) levels and tumor necrosis factor-α (TNF-α) levels or intake or the percent of recommended needs. Plasma IL-6 levels exhibited negative correlation with intake (A) and the percent of recommended needs (B). However, there was no significant correlation between plasma TNF-α levels and intake (C) or the percent of recommended needs (D).