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Determinants of change in resting energy expenditure in patients with stage III/IV colorectal cancer.

Journal article
Authors Sarah A Purcell
Ola Wallengren
Vickie E Baracos
Kent Lundholm
Britt-Marie Iresjö
Quincy S C Chu
Sunita S Ghosh
Carla M Prado
Published in Clinical Nutrition
Volume 39
Issue 1
Pages 134-40
ISSN 0261-5614
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Pages 134-40
Language en
Links dx.doi.org/10.1016/j.clnu.2018.12.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Energy expenditure, Cancer, Neoplasm, Body composition, Energy metabolism
Subject categories Cancer and Oncology

Abstract

Resting energy expenditure (REE) is variable in cancer and might be influenced by changes in tumor burden, systemic inflammation, and body composition. The objective of this study was to assess REE change and the predictors of such in patients with stage III or IV colorectal cancer.REE was measured via indirect calorimetry and fat mass and fat-free mass (FFM) were assessed using dual X-ray absorptiometry as part of a unique analysis of two studies. C-reactive protein (CRP) was measured as an inflammatory marker. Linear regression was used to assess the determinants of REE at baseline and REE change, with days between baseline and follow-up measures included as a covariate.One-hundred and nine patients were included at baseline (59.6% male; 67 ± 12 years; body mass index 24.1 ± 4.3 kg/m2); 49 had follow-up data (61.2% male; 65 ± 12 years; body mass index 25.4 ± 4.3 kg/m2), with median follow-up of 119 days (interquartile range: 113-127 days). At baseline, age, FFM, and CRP explained 68.9% of the variability in REE. A wide variability in REE change over time was observed, ranging from -156 to 370 kcal/day, or -13.0 to 15.7%/100 days. CRP change (1.7 ± 0.4 mg/L, p < 0.001) and stage (81.3 ± 38.7, p = 0.042) predicted REE change in multivariate analysis, controlling for age, FFM change, and days between visits (R2: 0.417 ± 88.2, p < 0.001).Age, FFM, and CRP predicted REE at a single time point. REE change was highly variable and explained by inflammation and stage. Future research should investigate the validity and feasibility of incorporating these measures into energy needs recommendations.

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