Lipolysis and lipid oxidation in weight-losing cancer patients and healthy subjects

doi:10.1053/meta.2000.6740

Metabolism

Volume 49, Issue 7, July 2000, Pages 931-936

https://doi.org/10.1053/meta.2000.6740 Get rights and content

Abstract

Increased lipolysis has been suggested as one of the possible mechanisms underlying cancer cachexia. The study aim was to assess whether lipolysis is increased in weight-losing cancer patients, considering their differences in food intake and body composition. Sixteen healthy subjects and 18 cancer patients with different tumor types and a weight loss of at least 5% in the previous 6 months were included in the study. Food intake was recorded for 4 days. After an overnight fast, [1,1,2,3,3-²H₅]glycerol was infused to determine the rate of appearance (Ra) of glycerol as a measure of whole-body lipolysis, and [1-¹³C]palmitic acid was infused to determine the Ra of palmitate as a measure of adipocyte fatty acid release. Palmitate oxidation was determined by measuring ¹³CO₂ enrichment in breath samples, and body composition was measured by bioelectrical impedance analysis. After adjustment for energy intake, whole-body lipolysis was significantly higher in cancer patients versus healthy subjects (6.46 ± 0.63 and 4.67 ± 0.46 μmol/kg ± min, respectively, P < .05). The difference in adipocyte fatty acid release did not reach statistical significance. The rate of palmitate oxidation was also significantly higher in patients than in healthy subjects (1.15 ± 0.10 and 0.93 ± 0.07 μmol/kg · min, respectively, P < .05). No differences in body composition were observed between groups. In conclusion, whole-body lipolysis (as measured by the Ra of glycerol) and palmitate oxidation were elevated in weight-losing cancer patients, but fatty acid release was not significantly different.

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Citation Excerpt :
In particular, lipolysis [triglyceride (TG) hydrolysis into free fatty acids (FFAs) and glycerol] is linked to wasting, and increased plasma FFA and glycerol levels are often observed in patients with cachexia [10]. Lipolysis and palmitate oxidation are increased in weight-losing cancer patients [11], and elevated lipolysis in cachectic patients with gastrointestinal adenocarcinoma is associated with increased expression of one of the key lipolytic enzymes, hormone sensitive lipase (HSL), in AT [12]. Indeed, the activities of both key enzymes involved in lipolysis, HSL and adipocyte triglyceride lipase (ATGL), are elevated in AT of patients with cachexia, and knockout studies in mice have confirmed a central role of these lipases for cachexia progression [13].
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^☆: Supported by Numico Research, Wageningen, The Netherlands.

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Lipolysis and lipid oxidation in weight-losing cancer patients and healthy subjects☆

Abstract