Ghrelin, adiponectin and leptin in cancer cachexia

Abstract

8113 Background: The hormone ghrelin and the adipocytokines leptin and adiponectin participate in body weight regulation. In response to severe weight loss, ghrelin and adiponectin levels increase and leptin decreases. Here we studied the association between plasma levels of these mediators and cancer cachexia. Methods: Study population included breast (n=14) and colon (n=26) cancer patients. The mean age was 65±14. Fasting plasma ghrelin, adiponectin and leptin levels, as well as weight loss, were determined prior to administration of cancer therapy. Patients who had other acute or chronic cachectic states were excluded. Results: Patients were classified as either cachectics (defined as ≥5% loss of body mass index, n=18) or non-cachectics (n=22). Similar distribution of age, gender and diagnosis was observed in both study groups, but the cachectic patients had higher rates of metastatic disease and lower albumin levels (p<0.02 for both variables). Mean plasma ghrelin levels (pg/ml) were higher among cachectic compared to non-cachectic patients, for all categories examined (table). Yet, statistical significance was not reached for the differences between cachectic and non-cachectic men and colon cancer patients (table). Notably, the association between ghrelin levels and weight loss was only modest (r=-0.49) and in a third of the cachectic patients, ghrelin levels were equal or lower than the mean levels of the non-cachectic group. Mean plasma adiponectin levels were higher among cachectic patients compared to the control (12.3±5.2 ng/ml vs. 9.6±3.6 ng/ml respectively, p=0.06). Mean leptin levels were similar in both study groups. No correlation was found between ghrelin, adiponectin and leptin levels. Conclusions: Baseline plasma ghrelin and adiponectin levels are high among cancer cachexia patients. Yet, these expected physiologic responses are absent in a significant proportion of these patients and seem be gender and tumor type dependent. No significant financial relationships to disclose.