Decrease of serum carnitine levels in patients with or without gastrointestinal cancer cachexia

• Published in: World journal of gastroenterology : WJG Vol. 12; no. 28; pp. 4541 - 4545
• Main Author: Malaguarnera, Mariano
• Format: Journal Article
• Language: English
• Published: United States Department of Senescence, Urological and Neurological Sciences,University of Catania, Cannizzaro Hospital, Catania, Italy%Department of Surgical Sciences, University of Catania, Italy 28.07.2006; Baishideng Publishing Group Co., Limited
• Subjects: Adult; Breast Neoplasms - blood; Cachexia - blood; Cachexia - etiology; Cachexia - physiopathology; Carnitine - blood; Case-Control Studies; Diet; Disease Progression; Female; Gastrointestinal Neoplasms - blood; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - physiopathology; Humans; Kidney Neoplasms - blood; Lung Neoplasms - blood; Male; Middle Aged; Prostatic Neoplasms - blood; Rapid Communication; Skin Neoplasms - blood; 恶病体质; 肉毒碱; 胃肠道疾病; Fatigue; Anorexia; Acetyl carnitine; Malnutrition; Nutritional status
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v12.i28.4541

AIM： To evaluate the levels of serum carnitine in patients with cancer in digestive organs and to compare them with other cancers in order to provide new insights into the mechanisms of cachexia. METHODS： Fifthy-five cachectic patients with or without gastrointestinal cancer were enrolled in the present study. They underwent routine laboratory investigations, including examination of the levels of various forms of carnitine present in serum （i.e., long-chain acylcarnitine, short-chain acylcarnitine, free carnitine, and total carnitine）. These values were compared with those found in 60 cancer patients in good nutritional status as well as with those of 30 healthy control subjects. RESULTS： When the cachectic patients with gastrointestinal cancer were compared with the cachectic patients without gastrointestinal cancer, the difference was -6.8 μmol/L in free carnitine （P 〈 0.005）, 0.04 μmol/ L in long chain acylcarnitine （P 〈 0.05）, 8.7 μmol/L in total carnitine （P 〈 0.001）. In the cachectic patients with or without gastrointestinal cancer, the difference was 12.2 μmol/L in free carnitine （P 〈 0.001）, 4.60 μmol/L in short chain acylcarnitine （P 〈 0.001）, and 0.60 μmol/L in long-chain acylcarnitine （P 〈 0.005） and 17.4 μmol/L in total carnitine （P 〈 0.001）. In the cachectic patients with gastrointestinal cancer and the healthy control subjects, the difference was 15.5 μmol/L in free carnitine （P 〈 0.001）, 5.2 μmol /L in short-chain acylcarnitine （P 〈 0.001）, 1.0 μmol/L in long chain acylcarnitine （P 〈 0.001）, and 21.8 μmol/L in total carnitine （P 〈 0.001）. CONCLUSION： Low serum levels of carnitine in terminal neoplastic patients are decreased greatly due to the decreased dietary intake and impaired endogenous synthesis of this substance. These low serum carnitine levels also contribute to the progression of cachexia in cancer patients.