Endocrinology and Metabolism

Liver export protein synthetic rates are increased by oral meal feeding in weight-losing cancer patients

Matthew D. Barber, Kenneth C. H. Fearon, Donald C. McMillan, Christine Slater, James A. Ross, Tom Preston


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 [2H5]- or [2H8]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.

  • albumin
  • fibrinogen
  • acute-phase protein response
  • pancreatic cancer


  • Financial assistance for this study was received from Ross Products Division, Abbott Laboratories; Scotia Pharmaceuticals; and the Royal Infirmary of Edinburgh National Health Service Trust.

  • Address for reprint requests and other correspondence: T. Preston, Isotope Biochemistry Laboratory, Scottish Universities Research and Reactor Centre, East Kilbride, UK G75 0QF (E-mail:T.Preston{at}surrc.gla.ac.uk).

  • The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. §1734 solely to indicate this fact.

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