Lipid Metabolism and Fat Loss in Cancer Patients

The pathophysiology of cancer cachexia is multi-factorial and involves many different mediators producing various metabolic effects that could be categorised as metabolic effects of the tumour on the host, and metabolic effects of the host's response to the tumour [1]. As previously mentioned, cachexia is characterised by profound changes in intermediary metabolism, particularly in lipid metabolism. Fat loss is frequently observed in cancer cachexia as well as in starvation, since adipose tissue comprises 90% of adult fuel reserves. Cachectic cancer patients show increased glycerol and fatty-acid turnover compared to normal subjects [2]. Also, their fasting plasma glycerol concentrations are higher, suggesting increased lipolysis [3]. In healthy individuals, lipid mobilisation is suppressed by glucose administration. In cancer patients, glucose infusion does not suppress lipid mobilisation and fatty acid oxidation [4]. This phenomenon appears as an early event in cancer patients, occurring even before weight loss and cachexia develop [5].

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