Study on elucidation of pathophysiology of cardiac cachexia from the viewpoint of energy metabolism and new nutritional therapy

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K00853
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Eating habits
• Research Institution: Shiga University of Medical Science
• Principal Investigator: Masaya Sasaki 滋賀医科大学, 医学部, 教授 (40242979)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 心不全 / エネルギー代謝 / 炎症性サイトカイン / 体組成 / サルコペニア

Outline of Final Research Achievements

Subjects were 50 patients with heart failure. On admission, nutritional status was assessed and biochemical blood tests including serum TNF-α, IL-6, ghrelin, and leptin levels were measured. Resting energy expenditure (REE) was also measured by indirect calorimetry to examine its association with severity of heart failure and levels of TNF-α, IL-6 and appetite-regulating hormones.There were significant associations between serum BNP level and nutrition indices, indicating that nutritional status was worse when heart failure was more severe. Inflammatory cytokine levels showed significant positive correlations with BNP level. REE/body weight was not associated with severity of heart failure, but was negatively associated with body fat percentage and leptin levels.Energy metabolism was not associated with serum BNP level among patients with heart failure with NYHA class up to III. ％Body fat and leptin levels can be a good predictor of energy metabolism in patients with heart failure.

Free Research Field

栄養学

Academic Significance and Societal Importance of the Research Achievements

心臓悪液質で代表されるように、心不全患者の低栄養は予後に大きく関わる。しかし、心不全とがんにおける栄養代謝病態の相違点については、明らかとなっていなかった。
本研究において、心不全患者においては重症度と炎症性サイトカインは関連が認められた。また、炎症性サイトカインと心不全患者のサルコペニアとの関連が明らかとなった。しかしながら、がん患者と異なり、病態の進行によるエネルギー消費量の増加は認められず、安静時エネルギー消費量と炎症性サイトカインとの関連は確認されなかった。
以上の結果は、Annals Nutrtion Metabolismに投稿し、掲載された。