Metabolic efficacy of enteral feeding in malnourished cancer and noncancer patients Journal Article
| Authors: | Dresler, C. M.; Jeevanandam, M.; Brennan, M. F. |
| Article Title: | Metabolic efficacy of enteral feeding in malnourished cancer and noncancer patients |
| Abstract: | Total parenteral nutrition and enteral nutrition are the two available methods for supplementary nutritional support of malnourished patients. Although supplemental alimentation is beneficial in malnourished patients, it is unclear whether malnourished cancer bearing patients are successfully replenished with similar nutritional support. We studied the efficacy of 2 weeks of enteral nutrition on intermediary glucose and protein metabolism in malnourished tumor-bearing (TB) and non-tumor bearing (NTB) patients. Both TB and NTB patients showed equivalent suppression of endogenous glucose production (2.13 ± 0.23 to 0.35 ± 0.16 mg/kg/min and 2.35 ± 0.18 to 0 mg/kg/min), suppression of alanine to glucose conversion (43.8 ± 10.6% to 0.75 ± 0.41% and 37.0 ± 10.7% to 0.11 ± 0.09%), attainment of positive nitrogen balance (-2.15 ± 1.18 to 4.26 ± 1.37 gN/d and -2.25 ± 0.63 to 4.32 ± 0.44 gN/d) and suppression of protein catabolism (2.39 ± 0.13 to 1.10 ± 0.27 gP/kg/d and 2.23 ± 0.04 to 1.34 ± 0.22 gP/kg/d). Following 2 weeks of enteral support, the TB patients differed from the NTB group with significantly elevated lactate levels (80 ± 8 v 48 ± 7 mg/L) and depressed plasma glycine levels (264 ± 12 v 356 ± 27 μmol/L plasma) and inability to replenish fat stores (triceps skin fold, 7.6 ± 1.5 to 7.1 ± 1.5 mm in TB v 5.9 ± 0.7 to 8.0 ± 1.2 mm in NTB). A significant reduction in whole body protein synthesis (2.08 ± 0.19 to 1.84 ± 0.18 gP/kg/d) in TB patients was obtained while NTB showed no significant change (1.86 ± 1.3 to 1.91 ± 0.26 gP/kg/d). These findings indicate that enteral nutrition successfully suppressed endogenous glucose production, in addition to suppressing whole body protein catabolism in both TB and NTB patients. Differences exist in intermediary metabolism between the two groups resulting in dissimilar alteration of whole body protein synthesis, total amino acid levels, lactate metabolism, and fat deposition. It remains to be explored why TB patients differ metabolically from NTB and how best to nutritionally replenish such patients. © 1987. |
| Keywords: | clinical article; controlled study; neoplasms; proteins; protein metabolism; protein synthesis; glucose; amino acids; therapy; glycine; enteral nutrition; enteric feeding; lactic acid; nutritional support; cancer; human; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s.; nutrition disorders |
| Journal Title: | Metabolism |
| Volume: | 36 |
| Issue: | 1 |
| ISSN: | 0026-0495 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1987-01-01 |
| Start Page: | 82 |
| End Page: | 88 |
| Language: | English |
| DOI: | 10.1016/0026-0495(87)90068-0 |
| PUBMED: | 3099124 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 February 2021 -- Source: Scopus |
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38Jeevanandam
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