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Master Thesis

Dépense énergétique de repos en cancérologie. Étude clinique sur 390 patients

Abstract : Background. Cachexia is a major cause of death in cancer patients and has limited treatment options. The role of resting energy expenditure (REE) in cancer cachexia is unclear. We studied the relationship between resting energy expenditure and clinic- biological markers of cachexia in cancer patients. Patients and Methods. We measured REE using indirect calorimetry in cancer patients. We compared it to estimated REE calculated by the Harris and Benedict equation to define hypermetabolics patients (Hm) (measured REE >110% of estimated REE), normometabolics (Nm) (90% - 110%) and hypometabolics (Hom) (<90%). We recorded weight loss, performance status (PS), CRP, Albumin, Nutritional Risk Index (NRI), daily energy intake and calculated energy balance (daily energy intakes – REE). Results. Among 390 patients, we found 49% Hm, 30% Nm and 21% Hom. Hm were more malnourished than Nm: weight loss was 5.9% vs 3.94% (p=0,02), weight loss > 5% represented 67% vs 50% OR=4 p=0.014. Serum albumin was lower : 39.01 g/l vs 40.13 g/l p= 0.042, NRI ≤97,5 was 40% vs 27%, OR=1.75 p=0.036, CRP≥10 mg/ml was 52% vs 33% p=0.001, PS≥2 40% vs 29% OR=1.7 p=0.038. Negative energy balance represented 45% vs 32% OR=1.74 p=0.024. Compared to patients with positive energy balance, negative energy balance patients were significantly more malnourished. There was no significant difference between Hom and Nm. Conclusion. In cancer patients, hypermetabolism induces cachexia by negative energy
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Master Thesis
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Clara Vazeille. Dépense énergétique de repos en cancérologie. Étude clinique sur 390 patients. Médecine humaine et pathologie. 2016. ⟨dumas-01490445⟩

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