Effect of a fish oil-enriched nutritional supplement on metabolic mediators in patients with pancreatic cancer cachexia

被引:95
作者
Barber, MD
Fearon, KCH
Tisdale, MJ
McMillan, DC
Ross, JA
机构
[1] Univ Edinburgh, Royal Infirm Edinburgh, Dept Surg, Edinburgh EH3 9YW, Midlothian, Scotland
[2] Aston Univ, Dept Pharmaceut Sci, Birmingham B4 7ET, W Midlands, England
[3] Univ Glasgow, Royal Infirm, Dept Surg, Glasgow G31 2ER, Lanark, Scotland
来源
NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL | 2001年 / 40卷 / 02期
关键词
D O I
10.1207/S15327914NC402_7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Weight loss in advanced cancer patients is refractory to conventional nutritional support. This may he due to metabolic changes mediated by proinflammatory cytokines, hormones, and tumor-derived products. We previously showed that a nutritional supplement enriched with fish oil will reverse weight loss in patients with pancreatic cancer cachexia. The present study examines the effect of this supplement on a number of mediators thought to play a role in cancer cachexia. Twenty weight-losing patients with pancreatic cancer were asked to consume a nutritional supplement providing 600 kcal and 2 g of eicosapentaenoic acid per day. At baseline and after 3 wk, patients were weighed and samples were collected to measure serum concentrations of interleukin (IL)-6 and its soluble receptor tumor necrosis factor receptors I and II, cortisol, insulin, and leptin, peripheral blood mononuclear cell production of IL-1, IL-6, and tumor necrosis factor, and urinary excretion of proteolysis inducing factor. After 3 wk of consumption of the fish oil-enriched nutritional supplement, there was a significant fall in production of IL-6 (from median 16.5 to 13.7 ng/ml, P = 0.015), a rise in serum insulin concentration (from 3.3 to 5.0 mU/l, P = 0.0064), a fall in the cortisol-to-insulin ratio (P = 0.0084), and a fall in the proportion of patients excreting proteolysis inducing factor (from 88% to 40%, P = 0.008). These changes occurred in association with weight gain (median 1 kg, P = 0.024). Various mediators of catabolism in cachexia are modulated by administration of a fish oil-enriched nutritional supplement in pancreatic cancer patients. This may account for the reversal of weight loss in patients consuming this supplement.
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页码:118 / 124
页数:7
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