Profiling Determinants of Resting Energy Expenditure in Colorectal Cancer

Abstract

Background: Understanding resting energy expenditure (REE) is important for determining energy requirements; REE might be altered in individuals with cancer. The objective of this study was to characterize determinants of REE in patients with stages II–IV colorectal cancer (CRC).

Methods: REE was measured via indirect calorimetry in patients with newly diagnosed CRC. Computerized tomography images from medical records ascertained skeletal muscle and total adipose tissue cross-sectional areas, which were then transformed to lean soft tissue (LST) and fat mass (FM) values (in kg). Linear regression assessed determinants of REE.

Results: 86 patients were included (n = 55, 64.0% male; 60 ± 12 years old; median body mass index: 27.6, interquartile range: 24.3–31.2 kg/m²), with most (n = 40) having stage III disease. Age, sex, and weight were significant predictors of REE [R² = 0.829, standard error of the estimate (SEE): 128 kcal/day, P < 0.001]. Replacing weight with LST and FM yielded a similar model, with age, sex, LST, and FM predictive of REE (R² = 0.820, SEE: 129 kcal/day, p < 0.001).

Conclusion: Age, sex, weight, LST, and FM were the main contributors to REE. Further investigation of REE changes over time and its relationship to total energy expenditure, dietary intake, and clinical outcomes should be explored.

Acknowledgments

The authors would like to thank Leticia Cristina Radin Pereira for discussion and insight of the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Study 1 received financial support from the Canadian Institutes of Health Research and the Alberta Cancer Board. CMP is supported by a Canadian Institutes of Health Research (CIHR) New Investigator Salary Award and the Campus Alberta Innovates Program.

Notes on contributors

Sarah A. Purcell

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Vickie E. Baracos

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Quincy S.C. Chu

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Michael B. Sawyer

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Diane Severin

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Marina Mourtzakis

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Jessica R. Lieffers

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.

Carla M. Prado

SAP, VEB, and CMP contributed to conception and design, acquisition of data, and analysis and interpretation of the data. SAP drafted the article. QSCC, MBS, and DS contributed to the acquisition of data. All authors contributed to the interpretation of the data, revising the article critically for important intellectual content, and approved the final version.