The Huffington Center on Aging, Baylor College of Medicine, Houston, TX 77030, USA.
J Investig Med. 2010 Mar;58(3):554-9. doi: 10.231/JIM.0b013e3181cf91ca.
Anorexia, cachexia, and insulin resistance are commonly seen in patients with cancer. Adipocyte-derived hormones or adipokines play a role in the regulation of appetite, body weight, and insulin sensitivity. However, their role in cancer-induced cachexia has not been well-established. The objective of this study was to determine the levels of adipokines and their relation to appetite, weight loss, insulin resistance, and other hormones in cancer cachexia.
We measured adiponectin, resistin, and leptin plasma levels in 21 men with cancer cachexia, 24 noncachectic cancer subjects, and 25 noncancer controls matched by age, sex, and pre-illness body weight. Body weight change, appetite scores, insulin resistance assessed by homeostasis model assessment, and other cytokines and hormones were also measured. Differences between groups were measured by analysis of covariance. Relations between variables were examined by linear regression analyses.
Adiponectin levels were similarly elevated in cachectic and noncachectic cancer patients compared with noncancer controls. Leptin levels were significantly decreased in cancer cachexia and were directly associated with appetite and insulin resistance, explaining 37% and 19% of the variance seen in cancer patients, respectively. Resistin levels were not different between groups.
Leptin may play a role in the increased insulin resistance seen in cancer patients. However, these patients are resistant to the orexigenic effects of hypoleptinemia. Other mechanisms besides weight loss are responsible for the increased adiponectin level seen in cancer patients. It is unlikely that resistin plays a major metabolic role in this setting.
厌食、恶病质和胰岛素抵抗在癌症患者中很常见。脂肪细胞衍生的激素或脂肪因子在调节食欲、体重和胰岛素敏感性方面发挥作用。然而，它们在癌症引起的恶病质中的作用尚未得到很好的确立。本研究的目的是确定脂肪因子的水平及其与癌症恶病质患者的食欲、体重减轻、胰岛素抵抗和其他激素的关系。
我们测量了 21 名癌症恶病质患者、24 名非恶病质癌症患者和 25 名年龄、性别和患病前体重相匹配的非癌症对照者的血浆脂联素、抵抗素和瘦素水平。还测量了体重变化、食欲评分、通过稳态模型评估的胰岛素抵抗以及其他细胞因子和激素。通过协方差分析测量组间差异。通过线性回归分析检查变量之间的关系。
与非癌症对照组相比，恶病质和非恶病质癌症患者的脂联素水平相似升高。瘦素水平在癌症恶病质中显著降低，与食欲和胰岛素抵抗直接相关，分别解释了癌症患者中 37%和 19%的差异。抵抗素水平在各组之间没有差异。
瘦素可能在癌症患者中观察到的胰岛素抵抗增加中发挥作用。然而，这些患者对低瘦素血症的食欲刺激作用有抗性。除了体重减轻之外，其他机制可能导致癌症患者中观察到的脂联素水平增加。抵抗素在这种情况下不太可能发挥主要代谢作用。
