{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:31:18Z","timestamp":1788877878680,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The detrimental impact of malnutrition and cachexia in cancer patients subjected to surgical resection is well established. However, how systemic and local metabolic alterations in cancer patients impact the serum metabolite signature, thereby leading to cancer\u2010specific differences, is poorly defined. In order to implement metabolomics as a potential tool in clinical diagnostics and disease follow\u2010up, targeted metabolite profiling based on quantitative measurements is essential. We hypothesized that the quantitative metabolic profile assessed by <jats:sup>1<\/jats:sup>H nuclear magnetic resonance (NMR) spectroscopy can be used to identify cancer\u2010induced catabolism and potentially distinguish between specific tumour entities. Importantly, to prove tumour dependency and assess metabolic normalization, we additionally analysed the metabolome of patients' sera longitudinally post\u2010surgery in order to assess metabolic normalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty two metabolites in sera of patients with tumour entities known to cause malnutrition and cachexia, namely, upper gastrointestinal cancer and pancreatic cancer, as well as sera of healthy controls, were quantified by <jats:sup>1<\/jats:sup>H NMR spectroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Comparing serum metabolites of patients with gastrointestinal cancer with healthy controls and pancreatic cancer patients, we identified at least 15 significantly changed metabolites in each comparison. Principal component and pathway analysis tools showed a catabolic signature in preoperative upper gastrointestinal cancer patients. The most specifically upregulated metabolite group in gastrointestinal cancer patients was ketone bodies (3\u2010hydroxybutyrate, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001; acetoacetate, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001; acetone, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001; false discovery rate [FDR] adjusted). Increased glycerol levels (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), increased concentration of the ketogenic amino acid lysine (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) and a significant correlation of 3\u2010hydroxybutyrate levels with branched\u2010chained amino acids (leucine, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02; isoleucine, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04 [FDR adjusted]) suggested that ketone body synthesis was driven by lipolysis and amino acid breakdown. Interestingly, the catabolic signature was independent of the body mass index, clinically assessed malnutrition using the nutritional risk screening score, and systemic inflammation assessed by CRP and leukocyte count. Longitudinal measurements and principal component analyses revealed a quick normalization of key metabolic alterations seven days post\u2010surgery, including ketosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Together, the quantitative metabolic profile obtained by <jats:sup>1<\/jats:sup>H NMR spectroscopy identified a tumour\u2010induced catabolic signature specific to upper gastrointestinal cancer patients and enabled monitoring restoration of metabolic homeostasis after surgery. This approach was critical to identify the obtained metabolic profile as an upper gastrointestinal cancer\u2010specific signature independent of malnutrition and inflammation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13131","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T12:34:32Z","timestamp":1669293272000},"page":"298-309","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Tumour catabolism independent of malnutrition and inflammation in upper GI cancer patients revealed by longitudinal metabolomics"],"prefix":"10.1002","volume":"14","author":[{"given":"Janusz","family":"von Renesse","sequence":"first","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"von Bechtolsheim","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Jonas","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital and Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Seifert","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago C.","family":"Alves","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital and Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian M.","family":"Seifert","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Komorek","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guergana","family":"Tritchkova","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Menschikowski","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital and Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Bork","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"Meisterfeld","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Distler","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Triantafyllos","family":"Chavakis","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Hospital and Faculty of Medicine, Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Weitz","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery University Hospital Carl Gustav Carus Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"},{"name":"National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ)  Heidelberg Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Dresden, Dresden, German Cancer Research Center (DKFZ) 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