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Nutrient intake and nitrogen losses during antineoplastic chemotherapy
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POSTABSORPTIVE SERUM TRYPTOPHAN AND POSTPRANDIAL PLASMA AMINO ACIDS IN CANCER PATIENTS. U. Staedt, F. Schimpf, J.-P. Striebel, B. Viell, H. Leweling, E. Holm. Dept. of Pathophysiology, Medical Clinic I Mannheim, and Institute of Anesthesiology Mannheim, University of Heidelberg, Mannheim, FRG Raised concentrations of serum tryptophan (Trp), particularly of free Trp, resulting in increased brain serotonin turnover, have been suggested to contribute to decreased food intake in cancer patients (pts). Malnutrition (MN) could, in part, also be brought about by malabsorption. Under these pathophysiological and under therapeutic aspects, a controlled study on both postabsorptive values of serum Trp and diet-induced levels of plasma AA was conducted. Four groups of subjects participated in the study: non-cancer pts (subgroups: without MN: n=9, with MN: n=7) and lung cancer pts (subgroups: without MN: n=6, with MN: n=8). We defined MN by 5 criteria. Trp was determined by means of HPLC. To get an estimate of amino acid (AA) absorption from an oligopeptide diet (Survimed OPD), Ithis diet was given at 8.00 a.m. (0.259 AA/kg) and 1.00 p.m. (0.59 AA/kg). Venous blood samples were drawn before (8.00 a.m.) as well as 30 and 60 min after ingestion of the diet for measuring plasma AA (Biotronic LC 5000). Thus, our data reflects absorption as well as metabolic influences. Table 1: Trp ( umol/l; mean+SEM); table 2: essential AA (mean values and percentages). Tables 1 and 4: no significant differences between the groups. Controls Table 1 Controls Cancer Pts Table 2 Cancer Pts MN No MN MN No MN MN No MN MN No MN /umol/l % jumol/l % /umol/l % /umol/l % Tatal Trp 76 51 82 65 8 00 813 100 683 100 818 100 18/ 100 t7 +ll t9 +4 9:oo aa::: 1216 150 1068 156 1450 165 1106 141 Free Trp 4:1 '4.3 4:6 5:5 1.00 p.m. 746 92 615 90 830 95 684 87 to.4 to.8 to.9 2.00 p.m. 1293 159 1237 181 1719 196 1197 152 -- to.7 Conclusiotis:7_T'hZ Trp values do not support the initially mentioned hypothesis. 2 The absorption of essential AA from the oligopeptide diet does not appear to be impaired by MN or the presence of cancer or even the combination of both.
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NUTRIENT INTCIKE CIND NITROGEN LOSSES DURING ANTINEOPLASTIC G.OllenschlPaer, K.Konkol, H-Fischer, B.Miidder. Medical Dep. II, Univ. of Cologne, FRG.
CHEMOTHERfiPY.
Inadequate spontaneous oral intake of tumor patients seems to be the main factor of malnutrition following cytostatic treatment. So far, there are no data, whether also impaired nutrient absorption and disturbances of N-metabolism contribute to malnutrition or not. weight loss prior to therapy and normal Creat. Methods: 13 pat. without High Ind. (CHI) have been studied during a total of 110 days of cytostat. treatm. under oral nutrition. No patient suffered from diarrheas during the study period. Tumors: 7 acut. myel.leukem., 3 gastric, 1 testic., 1 branch. ca, 1 Hodgk. dir;. Daily investig. of nutr. intake, body weight, urinary excret. of total N, urea, treat., uric acid, and its serum concentr.; and of total N-losses via faeces. Results of pat. with weight loss during therapy (gr.1) and without it (gr.11) were compared with those of volunteers (ctrl,n=lZ) using the median test. Results: (tledians/99% CR) Daily prot. intake gr.1 0.55 g/kg IBW (O-1.751, gr.11 1.27 (0.63-2.01, ctrl 1.2 (0.65-2.62); energy int. I: 16.5 kcal/kq IBW (O-47.71, II: 37.2 (14.6-59.61, ctrl 36.9 (26.4-58.4). CHI after ther. I: 73% (54-87), II: 99(99-1001, ctrl 101 (90-116). Fee. N (g/24h): turn-pat.: 0.98 (0.7%1,5), ctrl 1.52 (O-99-2.15), ~(0.05. N-balance :tam.pat. -5.2 (-9-l-+3.21, ctt-I -1.21 t--2.9-+1.26), ~(0.05. C.*clusion: Protein-absorption was not impaired as a consequence of the investigated cytostatic regimens. Fecal N-losses correlated directly with N-intake, but not with urinary N-losses. The course of body weight correlated inversely with daily total nutrient intake. In patients without clinical signs of malabsorption (diarrhea), oral or enteral nutrition is the adeauate wav of feeding during antineoplastic chemotherapy.
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POSTABSORPTIVE SERUM TRYPTOPHAN AND POSTPRANDIAL PLASMA AMINO ACIDS IN CANCER PATIENTS. U. Staedt, F. Schimpf, J.-P. Striebel, B. Viell, H. Leweling, E. Holm. Dept. of Pathophysiology, Medical Clinic I Mannheim, and Institute of Anesthesiology Mannheim, University of Heidelberg, Mannheim, FRG Raised concentrations of serum tryptophan (Trp), particularly of free Trp, resulting in increased brain serotonin turnover, have been suggested to contribute to decreased food intake in cancer patients (pts). Malnutrition (MN) could, in part, also be brought about by malabsorption. Under these pathophysiological and under therapeutic aspects, a controlled study on both postabsorptive values of serum Trp and diet-induced levels of plasma AA was conducted. Four groups of subjects participated in the study: non-cancer pts (subgroups: without MN: n=9, with MN: n=7) and lung cancer pts (subgroups: without MN: n=6, with MN: n=8). We defined MN by 5 criteria. Trp was determined by means of HPLC. To get an estimate of amino acid (AA) absorption from an oligopeptide diet (Survimed OPD), Ithis diet was given at 8.00 a.m. (0.259 AA/kg) and 1.00 p.m. (0.59 AA/kg). Venous blood samples were drawn before (8.00 a.m.) as well as 30 and 60 min after ingestion of the diet for measuring plasma AA (Biotronic LC 5000). Thus, our data reflects absorption as well as metabolic influences. Table 1: Trp ( umol/l; mean+SEM); table 2: essential AA (mean values and percentages). Tables 1 and 4: no significant differences between the groups. Controls Table 1 Controls Cancer Pts Table 2 Cancer Pts MN No MN MN No MN MN No MN MN No MN /umol/l % jumol/l % /umol/l % /umol/l % Tatal Trp 76 51 82 65 8 00 813 100 683 100 818 100 18/ 100 t7 +ll t9 +4 9:oo aa::: 1216 150 1068 156 1450 165 1106 141 Free Trp 4:1 '4.3 4:6 5:5 1.00 p.m. 746 92 615 90 830 95 684 87 to.4 to.8 to.9 2.00 p.m. 1293 159 1237 181 1719 196 1197 152 -- to.7 Conclusiotis:7_T'hZ Trp values do not support the initially mentioned hypothesis. 2 The absorption of essential AA from the oligopeptide diet does not appear to be impaired by MN or the presence of cancer or even the combination of both.
p.76
NUTRIENT INTCIKE CIND NITROGEN LOSSES DURING ANTINEOPLASTIC G.OllenschlPaer, K.Konkol, H-Fischer, B.Miidder. Medical Dep. II, Univ. of Cologne, FRG.
CHEMOTHERfiPY.
Inadequate spontaneous oral intake of tumor patients seems to be the main factor of malnutrition following cytostatic treatment. So far, there are no data, whether also impaired nutrient absorption and disturbances of N-metabolism contribute to malnutrition or not. weight loss prior to therapy and normal Creat. Methods: 13 pat. without High Ind. (CHI) have been studied during a total of 110 days of cytostat. treatm. under oral nutrition. No patient suffered from diarrheas during the study period. Tumors: 7 acut. myel.leukem., 3 gastric, 1 testic., 1 branch. ca, 1 Hodgk. dir;. Daily investig. of nutr. intake, body weight, urinary excret. of total N, urea, treat., uric acid, and its serum concentr.; and of total N-losses via faeces. Results of pat. with weight loss during therapy (gr.1) and without it (gr.11) were compared with those of volunteers (ctrl,n=lZ) using the median test. Results: (tledians/99% CR) Daily prot. intake gr.1 0.55 g/kg IBW (O-1.751, gr.11 1.27 (0.63-2.01, ctrl 1.2 (0.65-2.62); energy int. I: 16.5 kcal/kq IBW (O-47.71, II: 37.2 (14.6-59.61, ctrl 36.9 (26.4-58.4). CHI after ther. I: 73% (54-87), II: 99(99-1001, ctrl 101 (90-116). Fee. N (g/24h): turn-pat.: 0.98 (0.7%1,5), ctrl 1.52 (O-99-2.15), ~(0.05. N-balance :tam.pat. -5.2 (-9-l-+3.21, ctt-I -1.21 t--2.9-+1.26), ~(0.05. C.*clusion: Protein-absorption was not impaired as a consequence of the investigated cytostatic regimens. Fecal N-losses correlated directly with N-intake, but not with urinary N-losses. The course of body weight correlated inversely with daily total nutrient intake. In patients without clinical signs of malabsorption (diarrhea), oral or enteral nutrition is the adeauate wav of feeding during antineoplastic chemotherapy.
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