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Doctoral Thesis
DOI
10.11606/T.17.2007.tde-10092013-164405
Document
Author
Full name
Estela Iraci Rabito
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2007
Supervisor
Committee
Marchini, Julio Sérgio (President)
Camelo Junior, Jose Simon
Cameron, Luiz Claudio
Chiarello, Paula Garcia
Paiva, Sérgio Alberto Rupp de
Title in Portuguese
Carnitinemia em pacientes oncológicos
Keywords in Portuguese
câncer
carnitina
ingestão alimentar
Abstract in Portuguese
A subnutrição é uma das comorbidades mais freqüentes que atinge os pacientes oncológicos. Entender as conseqüências do câncer nas alterações do metabolismo energético é necessário para o estabelecimento de estratégias que previnam o desenvolvimento e tratem a má-nutrição. A carnitina desempenha papel fundamental no metabolismo energético lipídico. Sendo que o objetivo deste estudo foi avaliar os níveis plasmáticos nos pacientes com câncer no pré cirúrgico e relacionar com os resultados da história alimentar, antropometria, impedância bioelétrica, calorimetria indireta, aminoacidemia e valores urinários de carnitina e nitrogênio. Trata-se de um trabalho prospectivo no qual foram escolhidos aleatoriamente 4 grupos, sendo um de pacientes portadores de câncer esofágico ou gástrico (n=24), e os outros 3 considerados controles. O primeiro grupo controle foi o obesos (n=16), o segundo de voluntários saudáveis (n=12), enterectomizados (n=6) Os valores médios de carnitinemia , em todos os grupos, variou entre 60 e 80 µM no plasma e urinária entre 78 e 124 µM, sem diferenças estatísticas entre os grupos. Quando avaliados os níveis de carnitina plasmático, 80% (p<0.05) dos pacientes com câncer apresentaram deficiência associados à excreção urinária inferior a 5 mol/kg/dia, consumo insuficiente de proteínas e baixa reserva adiposa. No entanto os níveis de metionina e lisina, bem como o gasto energético de repouso não apresentaram diferença com os controles. A deficiência de carnitina nestes pacientes pode comprometer o metabolismo energético além de estar associado à ocorrência de fadiga e piora da qualidade de vida.
Title in English
Carnitine in cancer patients
Keywords in English
câncer
carnitine
intake food
Abstract in English
The malnutrition is one most common comorbidity among hospitalized patients. Understanding cancer consequences in energetic metabolim changes is necessary in order to avoid malnutrition or to treat it. Carnitine has a important role in lipid metabolism. The aim of this study was to evaluate the levels of serum carnitine in patients with stomach and esophagus cancer and correlated with dietary intake, body composition, resting energy expenditure, carnitine and amino acid serum levels and urinary excretion of carnitine. Twenty-four cancer patients were assessed. Cancer patients were compared with obese (n=16), healthful (n=12) and short bowel disease (n=6). The mean values of serum carnitine and urinary carnitine among all groups were 60-80 µM and 74-124 µM respectively. Serum carnitine levels between cancer patients and other groups were significantly different. 80% of cancer patients had low serum levels, which was associated with urinary below 5 µmol/Kg/day, decreased protein and low adipose tissue. However, the methionine and lysine levels, as well as the resting energy expenditure had no difference when compared with the healthy volunteers. Carnitine deficiency in cancer patients can affect energetic metabolism and contribute to the progression of cachexia.
 
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Publishing Date
2014-09-01
 
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