Journal of the American College of Nutrition, Vol 11, Issue 4 445-456, Copyright © 1992 by American College of Nutrition

JOURNAL ARTICLE

A review of cancer cachexia and abnormal glucose metabolism in humans with cancer

J. A. Tayek
Department of Medicine, Harbor-UCLA Medical Center, Torrance.

In 1919, glucose intolerance became the earliest recognized metabolic abnormality in cancer patients. Prior to the development of severe malnutrition, colon, gastric, sarcoma, endometrial, prostate, localized head, neck, and lung cancer patients had many of the metabolic abnormalities of type II (noninsulin dependent) diabetes mellitus. These metabolic abnormalities include glucose intolerance, an increase in both hepatic glucose production (HGP) and glucose recycling, and insulin resistance. In a study of over 600 cancer patients, a diabetic pattern of glucose tolerance test was noted in over one-third of the patients. An increased rate of HGP, commonly seen in diabetics, has been noted in almost all types of cancer patients studied to date. Etiology of the increased glucose production in the cancer patient is not known, but abnormalities in the counter regulatory hormones, especially growth hormone, may contribute to the development of abnormal glucose metabolism. A second possible stimulus for the increase in HGP could be the glucose needs of the tumor. Abnormally high glucose utilization rates in small amounts of tumor tissue have recently been described. This suggests that small tumors may have large needs for glucose calories. An increase in anaerobic glycolysis in the tumor tissue can increase lactate production in the tumor-bearing human, thus supplying substrate to the liver to increase glucose production rates. In this paper, the nature of abnormal glucose metabolism in cancer patients is described.

This article has been cited by other articles:

				K. Miles, C. Keith, H. W. M. van Laarhoven, L.-F. de Geus-Oei, B. Wiering, J. Lok, M. Rijpkema, J. H. A. M. Kaanders, P. F. M. Krabbe, T. Ruers, et al. Gadopentetate Dimeglumine and FDG Uptake in Liver Metastases Radiology, October 1, 2006; 241(1): 319 - 320. [Full Text] [PDF]

				P. Iozzo, A. Gastaldelli, M. J. Jarvisalo, J. Kiss, R. Borra, E. Buzzigoli, A. Viljanen, G. Naum, T. Viljanen, V. Oikonen, et al. 18F-FDG Assessment of Glucose Disposal and Production Rates During Fasting and Insulin Stimulation: A Validation Study J. Nucl. Med., June 1, 2006; 47(6): 1016 - 1022. [Abstract] [Full Text] [PDF]

				G. Mantovani, A. Maccio, C. Madeddu, G. Gramignano, M. R. Lusso, R. Serpe, E. Massa, G. Astara, and L. Deiana A Phase II Study with Antioxidants, Both in the Diet and Supplemented, Pharmaconutritional Support, Progestagen, and Anti-Cyclooxygenase-2 Showing Efficacy and Safety in Patients with Cancer-Related Anorexia/Cachexia and Oxidative Stress. Cancer Epidemiol. Biomarkers Prev., May 1, 2006; 15(5): 1030 - 1034. [Abstract] [Full Text] [PDF]

				M. J. Delano and L. L. Moldawer The Origins of Cachexia in Acute and Chronic Inflammatory Diseases Nutr Clin Pract, February 1, 2006; 21(1): 68 - 81. [Abstract] [Full Text] [PDF]

				G. Mantovani, C. Madeddu, A. Maccio, G. Gramignano, M. R. Lusso, E. Massa, G. Astara, and R. Serpe Cancer-Related Anorexia/Cachexia Syndrome and Oxidative Stress: An Innovative Approach beyond Current Treatment Cancer Epidemiol. Biomarkers Prev., October 1, 2004; 13(10): 1651 - 1659. [Abstract] [Full Text] [PDF]

				A. Inui Cancer Anorexia-Cachexia Syndrome: Current Issues in Research and Management CA Cancer J Clin, March 1, 2002; 52(2): 72 - 91. [Abstract] [Full Text] [PDF]

				W. Droge Free Radicals in the Physiological Control of Cell Function Physiol Rev, January 1, 2002; 82(1): 47 - 95. [Abstract] [Full Text] [PDF]

				M. P. K. J. ENGELEN, A. M. W. J. SCHOLS, J. D. DOES, N. E. P. DEUTZ, and E. F. M. WOUTERS Altered Glutamate Metabolism Is Associated with Reduced Muscle Glutathione Levels in Patients with Emphysema Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 98 - 103. [Abstract] [Full Text]

				A. Ushmorov, V. Hack, and W. Droge Differential Reconstitution of Mitochondrial Respiratory Chain Activity and Plasma Redox State by Cysteine and Ornithine in a Model of Cancer Cachexia Cancer Res., July 1, 1999; 59(14): 3527 - 3534. [Abstract] [Full Text] [PDF]

				V. Hack, R. Breitkreutz, R. Kinscherf, H. Rohrer, P. Bartsch, F. Taut, A. Benner, and W. Droge The Redox State as a Correlate of Senescence and Wasting and as a Target for Therapeutic Intervention Blood, July 1, 1998; 92(1): 59 - 67. [Abstract] [Full Text] [PDF]