Cited by 196Nutrition and Health in AgingClinical Nutrition and GastroenterologyInflammatory Biomarkers in Disease Prognosis

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Albumin Synthesis Rates Are Not Decreased in Hypoalbuminemic Cachectic Cancer Patients With an Ongoing Acute-Phase Protein Response

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Fearon, Kenneth C. H., Falconer, J. Stuart, Slater, Christine, McMillan, Donald C., Ross, James A., Preston, Tom·1998·Annals of Surgery

DOI 10.1097/00000658-199802000-00015PMC PMC1191243

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Abstract

OBJECTIVE: To determine whether suppression of albumin synthesis contributes to the hypoalbuminemia observed in weight-losing cancer patients with evidence of an ongoing acute-phase protein response (APPR). BACKGROUND DATA: Proinflammatory cytokines such as tumor necrosis factor (TNF) and interleukin 6 (IL-6) are known to downregulate albumin synthesis and increase acute-phase protein production in isolated hepatocytes. However, whether albumin synthesis is suppressed in hypoalbuminemic cancer patients with evidence of an ongoing acute-phase response is unknown. METHODS: Albumin synthesis rates were determined in six healthy controls and in six weight-losing pancreatic cancer patients with an ongoing APPR using a flooding dose technique with [2H5]-phenylalanine. The presence of an APPR was defined as a serum C-reactive protein concentration >10 mg/L. Serum cytokines (TNF, IL-6) and soluble TNF receptors (sTNF-R 55 and 75), along with serum cortisol and insulin, were also measured in both groups. RESULTS: Cancer patients had reduced serum albumin (median 32 [range, 23-36] vs. 42 g/L [40-45]; p < 0.01) and increased serum C-reactive protein concentrations (72 [23-126] vs. <5 mg/L; p < 0.01) when compared with controls. TNF was not detected in either group. sTNF-R 55 levels were significantly elevated in the cancer patients (3.8 [1.9-8.1] vs. 1.2 pg/mL [0.9-2.2]; p < 0.01). Circulating IL-6, insulin, and cortisol concentrations were not significantly different between the groups. The intravascular albumin mass was lower (88 [56-93] vs. 133 g [105-177]; p < 0.01), but the intravascular albumin fractional synthetic rate was higher (13.9 [13.5-18.5] vs. 10.3%/d [71-11.3]; p < 0.01) in the cancer patients compared with the controls. The total intravascular albumin synthetic rate was, however, similar between the two groups (12.7 [7.7-15.7] vs. 11.7 g/d [8.5-18.7]; p NS). CONCLUSIONS: In weight-losing pancreatic cancer patients with evidence of an ongoing APPR, hypoalbuminemia is not caused by a decreased rate of albumin synthesis.

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Authors: Fearon, K. C. H., Falconer, J. S., Slater, C., McMillan, D. C., Ross, J. A., & Preston, T.
Affiliations: Edinburgh Royal Infirmary (GB)
Scottish Universities Environmental Research Centre (GB)
Glasgow Royal Infirmary (GB)
Corresponding author: Fearon, Kenneth C. H.
Falconer, J. Stuart
Ross, James A.
ORCID: Slater, Christine
McMillan, Donald C.
Preston, Tom
Venue: Annals of Surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998-02
Volume: 227
Issue: 2
Pages: 249-254
ISSN: 0003-4932 (ISSN-L)
DOI: 10.1097/00000658-199802000-00015
PMC: PMC1191243
OpenAlex: W2068129622
Cited by: 196
References: 31
Citations by year: 2026: 3 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 9 · 2021: 12 · 2020: 5 · 2019: 9 · 2018: 5 · 2017: 4 · 2016: 13 · 2015: 10 · 2014: 5 · 2013: 10 · 2012: 2
FWCI: 7.17
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Annals of Surgery (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
Keywords: hypoalbuminemia, cancer cachexia, pancreatic cancer, TNF-α, interleukin-6, C-reactive protein, inflammatory cytokines, weight loss, phenylalanine
MeSH terms: Acute-Phase Proteins, Acute-Phase Reaction, Aged, Albumins, Cachexia, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Plasma Volume, Serum Albumin, Cytokines

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Albumin Synthesis Rates Are Not Decreased in Hypoalbuminemic Cachectic Cancer Patients With an Ongoing Acute-Phase Protein Response

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