Abstract
Thyroid cancer, the most common endocrine neoplasia, consists of four main types of carcinomas: papillary, follicular, and anaplastic, all with thyroid follicular origin, and medullary thyroid cancer (MTC) related to para-follicular cells. Cronic diseases such as diverse cancers may be associated with cachexia, especially at advanced stage. Cancer-induced cachexia is associated with diminished quality of life, functional performance, reduced response to antitumor therapy, and increased morbidity and mortality. Myostatin (Mst) is one of the outstanding molecules in the skeletal muscle loss process in cancer and it may be released by both skeletal muscle and cachexia-inducing tumors. Recently changes in serum levels of Mst have been identified as an important factor of cancer-induced cachexia. The goal of this study was to assessserum Mst levels in MTC patients. In this descriptive and case-control study, 90 participants were selected, comprising 45 MTC patients (20 males, 29±13.9 years, 25 females, 29±14.5 years) and 45 control individuals (25 males, 23.1±11.6 years, 20 females, 31.5±14.4 years). Serum Mst was determined using an ELISA kit and body mass index (BMI) was calculated by weight and height measurements. The Kolmogorov Simonov test showed a normal distribution for log transformed Mst serum levels in both case and control groups. Geometric means were 5.9 and 8.2 ng/ml respectively, and a significant difference was found according to the independent t-test results (P<0.01) . There was also a significant difference mean of Mst between females in control and MTC groups, but not for the males. Pearson correlation test showed no correlation between age and BMI with Mst serum levels. The findings of this study support the hypothesis that Mst serum levels may have a potential ability for early diagnosis of cachexia in MTC patients, especially in females.
Highlights
Thyroid gland carcinoma is the most common endocrine system malignancy, including two main groups: 1) follicular thyroid cells derived cancers and 2) para-follicular thyroid cell derived carcinoma
The findings of this study support the hypothesis that Mst serum levels may have a potential ability for early diagnosis of cachexia in medullary thyroid cancer (MTC) patients, especially in females
According to the recent findings emphasizing Mst critical role in the cancer cachexia, in the present study we assumed that the Mst serum levels in the affected patients by MTC will be higher in comparison with healthy controls
Summary
Thyroid gland carcinoma is the most common endocrine system malignancy, including two main groups: 1) follicular thyroid cells derived cancers and 2) para-follicular thyroid cell derived carcinoma. Hereditary pattern of MTC is autosomal dominant (Alvandi et al, 2011; Majidi et al, 2011; Ghazi et al, 2014) and in its hereditary form in addition to thyroid, parathyroid and adrenal glands are involved (Hedayati et al, 2011; Zarif Yeganeh et al, 2015a; Zarif Yeganeh et al, 2015b). Some chronic diseases such as diverse cancers are associated with cachexia, especially at the advanced stages of diseases. It is a complex and multifactorial syndrome characterized by: 1) unintended body weight loss due to loss of skeletal muscle with or without fat mass wasting, 2) anorexia, 3) inflammation, 4) insulin resistance, 5) increased
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