Peripheral amino acid levels in patients with cancer.

Peripheral arterial and venous whole blood amino acid concentrations were determined in four groups of subjects after an overnight fast 1) normal people, 2) patients with cancer who had not lost body weight, 3) subjects with cancer who had lost more than 20% of body weight and 4) patients who had lost more than 20% of body weight from diminished intake due to cause other than cancer. Comparison of the arterial blood levels in the four groups showed that patients with cancer and weight loss had amino acid patterns different from patients who were malnourished for other reasons. Branched chain amino acids were normal in patients with malignant disease. Some gluconeogenic amino acids were reduced as in other subjects with weight loss but the characteristic rise in glycine seen with malnutrition was not present. Arterio venous differences in whole blood across the forearm showed no evidence of increase in venous excess in patients with progressive malignant disease, indicating no excessive protein catabolism in muscle tissue. The data are consistent with increased gluconeogenesis in malnourished cancer subjects, probably due to intrinsic change in hepatic metabolism.