Adipokines and ghrelin in gastric cancer cachexia

doi:10.3748/wjg.14.3633

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Gastric Cancer

World J Gastroenterol. Jun 21, 2008; 14(23): 3633-3641
Published online Jun 21, 2008. doi: 10.3748/wjg.14.3633

Table 1 Clinical characteristics of the subjects (n = 30)

	Healthy controls	Patients with gastric cancer		P value
	Healthy controls	Non-cachexia	Cachexia	P value
Age (mean ± SD)	56.4 ± 3.0	55.8 ± 13.3	63.6 ± 13.8	0.001¹
Gender (%)				0.344²³
Male	20 (67)	25 (84)	23 (77)
Female	10 (33)	5 (16)	7 (23)
Tumor stage (%)				0.007²
I	-	6 (20)	0
II	-	12 (40)	3 (10)
III	-	8 (25)	12 (40)
IV	-	4 (15)	15 (50)
Tumor differentiation				0.347²
Differentiated		26 (87)	23 (77)
Undifferentiated		4 (13)	7 (23)
Operability				0.351²
Operable/No operable	-	30/0	28/2
Localization (%)				0.369²
Cardia	-	3 (10)	2 (6)
Corpus	-	6 (20)	10 (34)
Fundus	-	3 (10)	0
Antrum		18 (60)	18 (60)
WHO performance status (%)				0.108², < 0.001³
0	30 (100)	9 (30)	3 (10)
1	0	14 (45)	11 (36)
2	0	6 (20)	6 (20)
3	0	0	7 (24)
4	0	1 (5)	3 (10)
GPS				< 0.001²³
0	30 (100)	18 (60)	1 (5)
1	0	12 (40)	17 (55)
2	0	0	12 (40)

¹Patients with gastric cancer vs healthy control (ANOVA);

²Cachexia vs non-cachexia (χ²);

³Cachexia and non-cachexia vs healthy control (χ²).

Table 2 Changes in BMI and body weight and baseline biochemical findings (n = 30, mean ± SD)

	Healthy controls (n = 30)	Patients with gastric cancer		P value (between groups) (ANOVA)
	Healthy controls (n = 30)	Non-cachexia (n = 30)	Cachexia (n = 30)	P value (between groups) (ANOVA)
Initial BMI (kg/m²)	25.3 ± 2.3	27 ± 5.1	26.3 ± 2.5	0.985
Final BMI (kg/m²)	26.7 ± 2.8	24.8 ± 5.0	20.3 ± 2.5^a	0.002
Change BMI (%)	1.26 ± 2.6	-4.0 ± 2.4^c	-5.7 ± 5.2^a	< 0.001
Initial weight (kg)	75.4 ± 11.0	73.8 ± 13.3	70.0 ± 12.3	0.436
Final weight (kg)	76.2 ± 10.2	70.8 ± 16.3^c	53.6 ± 13.0^a	0.001
Change weight (kg)	0.15 ± 0.76	-2.9 ± 1.5^c	-10.4 ± 3.3^a	< 0.001
Hb (gr/L)	12.8 ± 2.8	12.6 ± 1.9	11.1 ± 1.3^a	< 0.001
TSH (mIU/mL)	1.96 ± 0.28	1.98 ± 0.85	2.11 ± 0.11	0.492
AST (IU/L)	23.3 ± 8.3	28.7± 8.2	26.5 ± 5.1	0.088
Creatinine (mg/dL)	0.81 ± 0.36	1.03 ± 0.27	0.97 ± 0.28	0.085
WBC (× 10⁹)	6.9 ± 1.2	7.1 ± 2.1	7.0 ± 2.2	0.230
Lymphocytes (%)	22.3 ± 4.2	24.3 ± 3.8	23.98 ± 4.8	0.156

^aP < 0.05 vs healthy controls and non cachexia;

^cP < 0.05 vs healthy controls.

Table 3 All biochemical parameters in blood in whole subjects are shown

	Healthy controls (n = 30)	Patients with gastric cancer		P-value (between groups) (ANOVA)
	Healthy controls (n = 30)	Non-cachexia (n = 30)	Cachexia (n = 30)	P-value (between groups) (ANOVA)
Albumin (gr/dL)	4.2 ± 0.2	4.0 ± 0.5	2.9± 0.2^a	0.03
CRP (mg/L)	5.95 ± 0.8	9.72 ± 4.3^e	12.9 ± 2.2^a	< 0.001
Prealbumin (ng/mL)	52.5 ± 8.3	49.2 ± 6.4	41.0 ± 12.3^a	0.001
Fasting glucose (mg/dL)	102.7 ± 8.3	105.7 ± 13.7	114.3 ± 13.8^a	0.005
Insulin (&mgr;IU/mL)	21.8 ± 9.0	24.4 ± 6.3	18.4 ± 6.0^c	0.04
HOMA-IR	5.58 ± 2.55	6.58 ± 1.89	5.05 ±1.68	0.07
IGF-1 (pg/mL)	95.0 ± 30.1	63.1 ± 13.1^e	43.8 ± 9.5^a	< 0.001
Resistin (ng/mL)	18.1	43.4^e	66.7^a	< 0.001
Ghrelin (ng/ml)	1332 ± 620	1980 ± 913	2305 ± 818^a	< 0.001
Adiponectin (&mgr;g/mL)	22.6 ± 12.4	27.8 ± 11.9	36.5 ± 15.0^a	0.045
Leptin (pg/mL)	2810 ± 818	2623 ± 665	3405 ± 640	0.003

^aP < 0.05 vs healthy controls and non cachexia;

^cP < 0.05 vs non-cachexia;

^eP < 0.05 vs healthy controls.

Table 4 Bivariate correlation analysis between different hormones and age, GPS and other parameters

		Resistin	Ghrelin	Leptin	Adiponectin	IGF-I
Age	R	0.115	0.267^a	0.253	-0.092	-0.331^a
	P	0.687	0.039^a	0.051	0.486	0.010^a
GPS	R	0.387^a	0.327^a	0.303^a	0.241^a	0.363^a
	P	0.0017^a	0.002^a	0.003^a	0.019^a	0.004^a
Insulin	R	0.348^a	-0.126	-0.225	0.197	0.06
	P	0.016^a	0.339	0.084	0.132	0.905
Glucose	R	0.418^a	0.194	-0.324^a	0.172	-0.358^a
	P	0.0018^a	0.138	0.012^a	0.190	0.005^a
HOMA-IR	R	0.518^a	-0.100	-0.181	-0.094	0.073
	P	0.0001^a	0.449	0.166	0.475	0.581
Prealbumin	R	-0.218	-0.223	-0.097	-0.341^a	0.287^a
	P	0.082	0.087	0.461	0.008^a	0.026^a

P: Pearson correlation coefficient; R: Kendall’s tau-b correlation coefficient. Significantly correlations and ^aP < 0.05.

Table 5 Multiple regression analysis with age, BMI change, gender, and tumor differentiation as predictors of ghrelin, leptin, adiponectin, and IGF-I in gastric cancer patients

		Resistin	Ghrelin	Leptin	Adiponectin	IGF-I
Age	β	0.148	0.168	0.019	-0.323	0.115
	P	0.402	0.305	0.899	0.053	0.377
Gender	β	0.126	0.286	-0.339^a	0.057	0.073
	P	0.387	0.085	0.032^a	0.726	0.377
BMI change	β	-0.583^a	-0.318^a	-0.418^a	-0.202	0.699^a
	P	0.001^a	0.009^a	0.008^a	0.21	< 0.0001^a

β: Standardized coefficient. Significant regression analysis and

^aP < 0.05 are shown.

Citation: Kerem M, Ferahkose Z, Yilmaz UT, Pasaoglu H, Ofluoglu E, Bedirli A, Salman B, Sahin TT, Akin M. Adipokines and ghrelin in gastric cancer cachexia. World J Gastroenterol 2008; 14(23): 3633-3641
URL: https://www.wjgnet.com/1007-9327/full/v14/i23/3633.htm
DOI: https://dx.doi.org/10.3748/wjg.14.3633