Skeletal muscle protein mass correlates with the lipid status in children with solid tumors and before bone marrow transplantation

Introduction Glucose, fatty acids, ketone bodies, amino acids and lactate are the fuels for daily energy metabolism. In healthy man, approximately 55-70% of the total energy requirements are delivered as [...]
Objective: To evaluate the changes in lipid status in children during anticancer therapy, with special reference to the effect of protein-energy malnutrition on plasma lipids. Design: Prospective follow-up study. Setting: The study was carried out in the Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland Subjects: The study group consisted of 33 children going through bone marrow transplantation (BMT) and 10 children with malignant solid tumors. The BMT patients were evaluated before transplantation and 1 and 3 months after BMT, and the tumor patients were studied at diagnosis and in remission. The reference group consisted of 23 healthy children. Interventions: As indicators of lipid status, lipoproteins and the concentration of cholesterol and triacylglycerol were measured. Protein reserves were expressed as muscle index (MI), derived from ultrasonographic measurement of the femoral quadriceps muscle. Body weight, triceps skinfold thickness and the serum concentration of albumin, prealbumin and transferrin were measured. Results: In both groups, plasma concentration of total triacylglycerol was increased and high-density lipoprotein (HDL) cholesterol decreased as compared to the reference subjects. Plasma triacylglycerol concentration had a negative correlation with skeletal muscle protein mass (MI; r=0.34, P=0.02). The concentration of serum prealbumin correlated positively with plasma total cholesterol concentration (r=0.47, P=0.002). Conclusions: In children with cancer, abnormalities of lipid status are associated with changes in skeletal muscle protein reserves. Sponsorship: This study was supported by the Foundation of Pediatric Research, Helsinki, Finland and the Nona and Kullervo Vare Foundation, Helsinki, Finland. Descriptors: muscle protein mass; ultrasonography; plasma lipids; bone marrow transplantation (BMT)