Glucose metabolism in cachectic patients with colorectal cancer

Abstract We have studied a defined group of 12 weight-losing patients with metastatic colorectal cancer to evaluate the occurrence of and possible relationship between those determinants of carbohydrate metabolism which have been reported to occur commonly in cancer cachexia. The rates of endogenous glucose production and recycling via lactate (Cori cycle) were measured following an infusion of 50 to 100 µCi of [1- 14 C]glucose. Compared to an age-related group of control subjects without cancer, significantly elevated rates of glucose production [136.4 ± 9.0 (S.E.) versus 101.0 ± 4.6 mg/kg/hr; p versus 15.4 mg/kg/hr; p p p In order to obtain an estimate of hepatic glycogen reserves, glucagon, 15 ng/kg/min, was infused over 40 min in seven subjects. A significantly blunted glycemic response was observed in the cancer patients compared to controls (δ25.0 ± 6.9 versus 57.8 ± 8.5 mg/dl; p We have shown that diverse abnormalities of carbohydrate metabolism commonly occur in cancer cachexia and that significant metabolic heterogeneity may be expected, despite a uniform diagosis. These results should prove useful in the interpretation and development of clinical studies on cancer cachexia.