Lower Carnitine Plasma Values from Malnutrition Cancer Patients

Abstract

Understanding the consequences of cancer for energy metabolism is required in order to define strategies that both prevent and treat malnutrition. Carnitine is essential for lipid energy metabolism. The objective of this study was to assess presurgical plasma carnitine levels in cancer patients and their association with dietary intake, anthropometry, bioelectrical impedance, indirect calorimetry, plasma amino acid levels, and urinary carnitine and nitrogen values. This was a prospective study in which two groups were randomly selected: one consisting of esophageal and gastric cancer patients (n = 24) and the other of healthy volunteers (control group, n = 12). Average plasma and urinary carnitine values ranged from 60 to 80 μM and 78 to 124 μM, respectively, in both groups, with no significant difference between them. Moreover, methionine and lysine levels, as well as resting energy expenditure, did not differ between cancer patients and controls. Plasma free carnitine levels, however, were significantly lower in cancer patients, 80 % (p < 0.05) of whom had deficient urinary carnitine excretion, insufficient dietary protein intake, and low body fat reserves. Although cancer patients had carnitine deficiency and lower carnitine stores, these did not affect resting energy expenditure, total food intake, or plasma lysine and methionine levels.