Short communicationAdiponectin and the systemic inflammatory response in weight-losing patients with non-small cell lung cancer
Introduction
The systemic inflammatory response is an obligatory response of the body to infection, surgery or trauma. It appears to be driven by pro-inflammatory cytokines including interleukin-6 [1]. Under the influence of these cytokines blood lipids rise, catabolic hormone production is increased, gluconeogenesis is enhanced, acute phase protein production is increased, muscle protein is lost and there is decreased insulin sensitivity. Although a systemic inflammatory response and insulin insensitivity may initially exert a beneficial effect during the response to infection or injury it has an adverse effect in chronic disease states [2], [3]. Indeed, it is now recognised that a systemic inflammatory response also occurs commonly in advanced cancer and is associated with poor outcome independent of clinical stage [4], [5].
Recently, it has been shown that adipose tissue derived hormones or cytokines play an important role in determining insulin sensitivity in apparently healthy subjects. In particular, circulating adiponectin concentrations have been shown to fall with decreasing insulin sensitivity and administration of recombinant adiponectin suppresses hepatic glucose production and reverses insulin resistance associated with both lipodystrophy and obesity [6], [7], [8].
Therefore, the relationship of adiponectin and the systemic inflammatory response in patients with advanced cancer is of considerable interest. The aim of the present study was to examine the relationship between adiponectin and the systemic inflammatory response in weight-losing patients with non-small cell lung cancer (NSCLC).
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Results
Baseline characteristics, anthropometric and biochemical parameters of healthy subjects and cancer patients are shown in Table 1. The groups were age and sex matched. The median (range) weight loss in the cancer group was 16.5 (2.7–31.7). Compared with the controls the cancer group had a lower BMI (p<0.01), mid-upper arm circumference (p<0.001), triceps skinfold thickness (p<0.05) and circulating concentrations of albumin (p<0.001), haemoglobin (p<0.05), free and total leptin (p<0.05) and
Discussion
In the present study although adiponectin concentrations together with leptin (total and free) were lower, approximately 20% for adiponectin and 60% for leptin, in weight-losing cancer patients compared with normal subjects, adiponectin was inversely correlated with leptin, both total and free. These results, triceps skinfold thickness approximately 50% lower, are consistent with the concept that free and total leptin track the loss of fat mass, in cancer patients [9], [10] and that adiponectin
Patients
Patients with advanced non-small cell lung cancer were recruited to take part in the study from palliative care centres in the West of Scotland. All patients included in the study had a firm clinical or histological diagnosis of locally advanced or metastatic disease that was no longer amenable to curative treatment and had documented evidence of weight loss in the previous 6 months. Healthy individuals were recruited from volunteers of the palliative care centres to serve as normal controls.
References (14)
- et al.
Insulin resistance in patients with cancer: relationships with tumor site, tumor stage, body-weight loss, acute-phase response, and energy expenditure
Nutrition
(2001) - et al.
A longitudinal study of leptin and appetite, resting energy expenditure and body fat mass in weight-stable cancer patients
Cytokine
(2002) - et al.
Acute-phase proteins and other systemic responses to inflammation
N Engl J Med
(1999) Cachexia
Ann Intern Med
(2000)- et al.
Prognostic factors in advanced gastrointestinal cancer patients with weight loss
Nutr Cancer
(2000) - et al.
The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer
Br J Cancer
(2002) - et al.
The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity
Nat Med
(2001)
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