Metabolic abnormalities in cachexia and anorexia

An increased glucose requirement by many solid tumors produces an:increased metabolic demand on the Liver, resulting in an increased energy expenditur e. In:addition, several cytokines and tumor catabolic products have been su ggested as being responsible for the depletion of adipose tissue and skelet al-muscle mass in cachexia. A sulphated glycoprotein of molecular mass 24 k Da, produced by-cachexia-inducing tumors and present in the urine of cancer patients actively losing weight, has been shown to be capable of inducing direct muscle catabolism in vitro and a state of cachexia in vivo, with spe cific lass of the non-fat carcass mass. In vitro studies have shown the bio activity of this proteolysis-inducing factor to be attenuated by the polyun saturated fatty acid, eicosapentaenoic acid. Preliminary clinical studies, have shown that eicosapentaenoic acid stabilizes body weight and protein an d fat reserves in patients with pancreatic carcinoma. Further trials are re quired to confirm the efficacy of eicosapentaenoic acid and to determine th e anticachectic activity in other types of cancer. Nutrition 2000;16:1013-1 014. (C) Elsevier Science Inc. 2000.