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Hanna L, Porter J, Bauer J, Nguo K. Energy Expenditure in Upper Gastrointestinal Cancers: a Scoping Review. Adv Nutr 2023; 14:1307-1325. [PMID: 37562709 PMCID: PMC10721480 DOI: 10.1016/j.advnut.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023] Open
Abstract
Malnutrition is prevalent in people with upper gastrointestinal (GI) cancers and is associated with shorter survival and poor quality of life. In order to effectively prevent or treat malnutrition, nutrition interventions must ensure appropriate energy provision to meet daily metabolic demands. In practice, the energy needs of people with cancer are frequently estimated from predictive equations which are not cancer-specific and are demonstrated to be inaccurate in this population. The purpose of this scoping review was to synthesize the existing evidence regarding energy expenditure in people with upper GI cancer. Three databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus) were systematically searched to identify studies reporting on resting energy expenditure using indirect calorimetry and total energy expenditure using doubly labeled water (DLW) in adults with any stage of upper GI cancer at any point from diagnosis. A total of 57 original research studies involving 2,125 individuals with cancer of the esophagus, stomach, pancreas, biliary tract, or liver were eligible for inclusion. All studies used indirect calorimetry, and one study used DLW to measure energy expenditure, which was reported unadjusted in 42 studies, adjusted for body weight in 32 studies, and adjusted for fat-free mass in 13 studies. Energy expenditure in upper GI cancer was compared with noncancer controls in 19 studies and measured compared with predicted energy expenditure reported in 31 studies. There was heterogeneity in study design and in reporting of important clinical characteristics between studies. There was also substantial variation in energy expenditure between studies and within and between cancer types. Given this heterogeneity and known inaccuracies of predictive equations in patients with cancer, energy expenditure should be measured in practice wherever feasible. Additional research in cohorts defined by cancer type, stage, and treatment is needed to further characterize energy expenditure in upper GI cancer.
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Affiliation(s)
- Lauren Hanna
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Judi Porter
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Judy Bauer
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia
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Ukleja A, Andrzejewska M, Skroński MK, Ławiński M, Włodarek D, Korba M, Nyckowski P, Słodkowski M. Assessment of resting energy demand and body composition in oncological patients undergoing partial resections of the liver. PRZEGLAD GASTROENTEROLOGICZNY 2019; 14:62-68. [PMID: 30944679 PMCID: PMC6444109 DOI: 10.5114/pg.2019.83427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/12/2018] [Indexed: 12/04/2022]
Abstract
INTRODUCTION The metabolism of the body is a complicated process. The most important organ of the organism that affects the intensity of changes is the liver. An effective treatment method of primary and metastatic tumours is a partial resection of the organ. The analysis of changes in the body composition of patients undergoing this type of treatment allows identification of problems coexisting with the underlying disease. AIM To evaluate changes in the parameters of body composition and the amount of resting metabolism. MATERIAL AND METHODS The study group consisted of 87 patients who underwent resection of changes in the liver or thermoablation of focal lesions during hospitalisation. RESULTS Analysis of the data showed that the surgical intervention contributes to a statistically significant (p < 0.05) decrease in the value of the phase angle. A significant increase was noted within the extra cellular water content. The amount of resting metabolism in the postoperative period did not differ significantly; however, there was an upward trend in women and a downward trend in men. CONCLUSIONS Surgical resection of lesions aimed at extending the survival of patients are performed more and more often, while the consequences of these operations are not sufficiently known. The adverse effect of resection treatments on body composition parameters, mainly imaged by decreasing the phase angle value, should be minimised. Effects on metabolism remain ambiguous because no significant changes have been demonstrated in the postoperative period.
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Affiliation(s)
- Anna Ukleja
- Department of Clinical Dietetics, Medical University of Warsaw, Warsaw, Poland
| | - Marta Andrzejewska
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał K. Skroński
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Ławiński
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Dariusz Włodarek
- Department of Dietetics, Warsaw University of Life Sciences, Warsaw, Poland
| | - Michał Korba
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Nyckowski
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Słodkowski
- Department of General, Gastroenterological, and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
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Kajiura D, Yamanaka-Okumura H, Hirayama A, Tatano H, Endo K, Honma M, Igarashi K, Shoji F, Ikeda S, Yamaguchi N, Katayama T, Morine Y, Imura S, Utsunomiya T, Soga T, Tomita M, Shimada M. Perioperative serum and urine metabolome analyses in patients with hepatocellular carcinoma undergoing partial hepatectomy. Nutrition 2019; 58:110-119. [DOI: 10.1016/j.nut.2018.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 05/30/2018] [Accepted: 06/03/2018] [Indexed: 12/15/2022]
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Wada S, Yamanaka-Okumura H, Katayama T, Morine Y, Imura S, Shimada M. Major liver resection reduces nonprotein respiratory quotient and increases nonesterified fatty acid at postoperative day 14 in patients with hepatocellular carcinoma. Clin Nutr ESPEN 2018; 23:194-199. [PMID: 29460798 DOI: 10.1016/j.clnesp.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/26/2017] [Accepted: 10/09/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND & AIMS We reported decreased nonprotein respiratory quotient (npRQ) after liver resection in patients with hepatocellular carcinoma (HCC); however, whether liver resection volume affects energy metabolism in these patients is unclear. We aimed to examine the relationship between liver resection and energy metabolism indices. METHODS NpRQ was measured in 53 patients with HCC and seven with at the pre- and postoperative days. Patients were classified into four groups: Minor-lowICG group (n = 17): minor (subsegment or less) resection and low indocyanine green retention rate at 15 min (ICGR15) (<15%); Minor-highICG group (n = 18): minor resection and high ICGR15 (≥15%) and Major-lowICG group (n = 18): major (lobe) resection and low ICGR15 (<15%). We investigated dietary intake and blood biochemistry at energy measurement. The difference in npRQ and nonesterified fatty acid (NEFA) pre- and post-hepatectomy was shown as ΔnpRQ and ΔNEFA, respectively. RESULTS Compared with the preoperative values, npRQ significantly decreased in the Minor-highICG and Major-lowICG groups and NEFA significantly increased in the Major-lowICG group at postoperative day 14. In single regression analysis, ΔnpRQ significantly correlated with HCV infection and ΔNEFA with resection volume, HCV infection, and ICGR15. In multiple regression analysis, ΔNEFA significantly correlated with resection volume after adjusting for age, etiology, and ICGR15. CONCLUSIONS These results suggest that postoperative nutritional recovery is slower in major resection than in minor resection patients. Hence, nutritional care to prevent starvation is needed in major resection patients.
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Affiliation(s)
- Shoko Wada
- Departments of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Hisami Yamanaka-Okumura
- Departments of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.
| | - Takafumi Katayama
- Departments of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Hyogo, Japan
| | - Yuji Morine
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Satoru Imura
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Mitsuo Shimada
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
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Taguchi K, Yamanaka-Okumura H, Mizuno A, Nakamura T, Shimada M, Doi T, Takeda E. Insulin resistance as early sign of hepatic dysfunction in liver cirrhosis. THE JOURNAL OF MEDICAL INVESTIGATION 2015; 61:180-9. [PMID: 24705764 DOI: 10.2152/jmi.61.180] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Glucose intolerance characterized by postprandial hyperglycemia and hyperinsulinemia is commonly seen in patients with liver cirrhosis (LC). The aim of this study is to clarify the relation between glucose intolerance and disorder of liver function in patients with LC. The 75 g oral glucose tolerance test (75 g OGTT) and the hyperinsulinemic euglycemic clamp combined with 0.2 g/kg oral glucose load (HECGL) were conducted in 61 patients with LC. Based on the results of 75 g OGTT, the 61 patients with LC were divided into groups, 21 (34.4%) patients with normal glucose tolerance (LC-NGT), 12 (19.7%) patients with impaired glucose tolerance (LC-IGT) and 28 (45.9%) patients with diabetes mellitus (LC-DM). Fasting plasma glucose (FPG) level was normal in 50 (82.0%) patients with LC. All patients with LC showed insulin resistance in both peripheral (skeletal and adipose) and hepatic tissues evaluated by HECGL, although significant correlation between the degree of glucose intolerance and the severity of hepatic dysfunction was not observed. Insulin resistance in both liver and peripheral tissues is the early sign in the patients with LC. This fact indicates that nutritional care from early stages of LC would be necessary in the patients.
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Affiliation(s)
- Kayo Taguchi
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School
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Sugihara K, Yamanaka-Okumura H, Teramoto A, Urano E, Katayama T, Morine Y, Imura S, Utsunomiya T, Shimada M, Takeda E. Recovery of nutritional metabolism after liver transplantation. Nutrition 2014; 31:105-10. [PMID: 25441593 DOI: 10.1016/j.nut.2014.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 05/08/2014] [Accepted: 05/23/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Perioperative nutritional assessment is critically important to reflect nutritional management because liver transplantation (LTx) often is undertaken in patients with poor nutritional status. The aim of this study was to evaluate nutritional status, including the non-protein respiratory quotient (npRQ), resting energy expenditure (REE), nitrogen balance, and blood biochemical parameters in patients before and after LTx. METHODS Fourteen patients undergoing LTx and 10 healthy controls were enrolled in this study. The npRQ and REE were measured using indirect calorimetry before LTx and at 2, 3, and 4 wk after the procedure. Blood biochemistry and nitrogen balance calculated by 24-h urine collection were performed concurrently with indirect calorimetric measurement; the results were compared between the two groups. RESULTS Before LTx, npRQ was significantly lower and serum non-esterified fatty acid levels were significantly higher in the patients than in the controls. Furthermore, a negative nitrogen balance was observed in the patients. These, however, improved significantly at 4 wk after LTx. REE did not significantly increase compared with the preoperative values in recipients. Blood biochemistry showed gradually increasing levels of serum cholinesterase and albumin. These failed to reach to normal levels by 4 wk post-transplant. CONCLUSIONS The findings revealed that improvement of nutritional metabolism after LTx may require 4 wk. Additional nutritional strategies, therefore, may be needed to minimize catabolic state during the early post-transplant period. Adequate, individualized nutritional guidance before and after LTx should be performed in these patients.
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Affiliation(s)
- Kohei Sugihara
- Departments of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Hisami Yamanaka-Okumura
- Departments of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
| | - Arisa Teramoto
- Departments of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Eri Urano
- Departments of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Takafumi Katayama
- Department of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Hyogo, Japan
| | - Yuji Morine
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Satoru Imura
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Tohru Utsunomiya
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Mitsuo Shimada
- Departments of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
| | - Eiji Takeda
- Departments of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
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Taguchi K, Yamanaka-Okumura H, Mizuno A, Nakamura T, Shimada M, Doi T, Takeda E. <b>Insulin resistance as early sign of hepatic dysfunction in </b><b>liver cirrhosis </b>. THE JOURNAL OF MEDICAL INVESTIGATION 2000. [DOI: 10.2152/jmi.40.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kayo Taguchi
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Hisami Yamanaka-Okumura
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Akira Mizuno
- Department of Clinical Biology and Medicine, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Taki Nakamura
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Mitsuo Shimada
- Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Toshio Doi
- Department of Clinical Biology and Medicine, Institute of Health Biosciences, University of Tokushima Graduate School
| | - Eiji Takeda
- Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School
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