Dev Rony, Del Fabbro Egidio, Dalal Shalini
Symptom Control & Palliative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Internal Medicine, Division of Hematology, Oncology & Palliative Care, Richmond, Virginia, USA.
Curr Opin Support Palliat Care. 2019 Dec;13(4):286-291. doi: 10.1097/SPC.0000000000000464.
Cancer cachexia cannot be easily reversed by standard nutritional support and interventions directed at underlying metabolic derangements may be needed to prevent or reverse cachexia and maintain healthy body composition. The following review will highlight the contribution and potential therapeutic interventions for insulin resistance, alterations in ghrelin signaling, and hypogonadism in cancer patients.
In addition to decreased caloric intake, chronic inflammation, and altered metabolism of glucose, proteins and lipids, endocrine abnormalities can propagate weight loss or changes in body composition in cancer patients.
Cancer cachexia, loss of muscle mass with or without the loss of fat mass, is a multifactorial syndrome, which is associated with increased morbidity and mortality. Currently, limited therapeutic options for the treatment of weight loss in cancer patients exist, which lead to clinically meaningful improvements in weight gain and performance status. Treatment directed at underlying insulin resistance, low testosterone, and altered ghrelin sensitivity, in the future, may lead to potential therapeutic options for loss of lean body mass and cancer cachexia.
癌症恶病质难以通过标准营养支持轻易逆转,可能需要针对潜在代谢紊乱的干预措施来预防或逆转恶病质并维持健康的身体组成。以下综述将重点介绍胰岛素抵抗、胃饥饿素信号改变和性腺功能减退在癌症患者中的作用及潜在治疗干预措施。
除热量摄入减少、慢性炎症以及葡萄糖、蛋白质和脂质代谢改变外,内分泌异常可促使癌症患者体重减轻或身体组成发生变化。
癌症恶病质,即伴有或不伴有脂肪量减少的肌肉量减少,是一种多因素综合征,与发病率和死亡率增加相关。目前,治疗癌症患者体重减轻的治疗选择有限,难以实现体重增加和功能状态的临床显著改善。针对潜在的胰岛素抵抗、低睾酮水平和胃饥饿素敏感性改变进行治疗,未来可能为瘦体重减少和癌症恶病质带来潜在的治疗选择。