We have demonstrated previously that, in the fasting state, whereas
albumin synthesis is similar in cachectic
cancer patients compared with controls,
fibrinogen synthesis is increased. Whether synthesis of these
proteins is altered after an oral meal was examined in eight weight-losing
pancreatic cancer patients and six healthy controls by use of an intravenous flooding dose of [(2)H(5)]- or [(2)H(8)]
phenylalanine.
Cancer patients had a median
weight loss of 19%, a significantly lower
serum albumin concentration, and a significantly higher plasma
fibrinogen concentration than controls (P < 0.005). Fasting
albumin synthesis rates were similar between
cancer patients and controls (median total synthesis rate 11.3 vs. 13.9 g/day, respectively) and rose on feeding by a similar degree (median 29 and 24%). The fasting
fibrinogen total synthetic rate was significantly higher in
cancer patients than in controls (median 3.3 vs. 1.0 g/day, P = 0.0019). In
cancer patients in the fed state,
fibrinogen synthetic rate rose by a median of 38% (P = 0.012), whereas in controls there was no significant change. These findings demonstrate significant upregulation by feeding of
acute-phase protein synthesis in cachectic
cancer patients.