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Hypermetabolism in the Elderly Lung Cancer Patient

Completed
Conditions
Non-small Cell Lung Carcinoma
Registration Number
NCT03141957
Lead Sponsor
University of Paris 5 - Rene Descartes
Brief Summary

Aging and cancer are two conditions associated with extensive metabolic changes that can cause malnutrition. However, the clinical features and the underlying mechanisms leading to malnutrition are different in these two cases. We therefore wonder how age can influence the metabolic response to cancer.

Detailed Description

During aging, among other physiological modifications, inactivity and insulin resistance cause a progressive muscle loss associated with a decrease in resting energy expenditure (REE). In cancer, loud inflammation background also provokes a decrease in muscle mass as well as in fat mass. However, previous studies reported an increased REE, termed hypermetabolism, probably linked to inflammation.

Data concerning response to aggression in the elderly patient is scarce and even inexistent when it comes to cancer. The investigators hypothesize that the mitochondrial dysfunction that comes with aging and that decreases the ATP rendering per unit of energy-producing nutrient oxidized increases the amount of nutrient to be consumed in order to sustain to energy needs. Therefore, in this situation, elderly patients could have a higher rate or degree of hypermetabolism than younger patients.

The primary objective of this study is to assess the effect of aging on the metabolic response to cancer assessed by resting energy expenditure measured by indirect calorimetry corrected by whole body fat free mass calculated from single slice CT imaging at the third lumbar vertebra.

The secondary objective of this study is to point out some inflammatory or endocrine determinants of these energy metabolism changes in the cancer patient.

Non-small cell lung carcinoma seems to be a relevant choice for this study because it is frequently associated with cachexia and the literature reports a high rate of hypermetabolism in this cancer.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
27
Inclusion Criteria
  • Non-small cell lung carcinoma
Exclusion Criteria
  • Imbalanced Diabetes
  • Imbalanced dysthyroidia
  • Surgery within two month prior inclusion
  • Any chronic auto-immune or inflammatory disease

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Measured resting energy expenditure (mREE) in kilocalorie per dayDay 0

Energy expenditure is measured by indirect calorimetry.

Secondary Outcome Measures
NameTimeMethod
Blood C-Reactive Protein in milligram per milliliterDay 0

Inflammatory status

Blood Interleukine-6 in picogram per milliliterDay 0

Inflammatory status

Albumin in gram per literDay 0

Nutritional Satus

Blood ultra-sensitive Thyroid Stimulating Hormone in milliunit per literDay 0

Endocrine Status - Thyroid Function

Blood Insulin-like Growth Factor 1 in nanogram per literDay 0

Endocrine Status - Somatotropic axis

Blood Tumor Necrosis Factor alpha in picogram per milliliterDay 0

Inflammatory status

Blood Insulin in milliunit per literDay 0

Endocrine Status - Glucose Homeostasis

Blood Glucose in millimole per literDay 0

Endocrine Status

Homeostasis Model assessment of Insulin resistanceDay 0

Aggregates blood Insulin and glucose level as an insulin resistance score

Lean Body Mass in kilogramDay 0

Estimated from muscular area at the third lombular vertebra from CT-scan

energy intake in kilocalorie per dayDay 0

Estimated by a qualified dietetican

Transthyretin in gram per literDay 0

Nutritional Satus

Predicted resting energy expenditure (HB) in kilocalorie per dayDay 0

REE estimated with Harris \& Benedict Formula

Percentage of estimated energy expenditureDay 0

Percentage of HB : (mREE/HB) x 100

Trial Locations

Locations (1)

Hopital Cochin

🇫🇷

Paris, France

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