BACKGROUND & AIMS:
:Advanced cancers are associated with a chronic inflammation, especially high interleukin-6 (IL-6) and with various levels of adipokines (leptin and adiponectin), while ghrelin counteracts the anorexigenic effect of leptin in cancer-induced anorexia-cachexia syndrome. We aimed to understand how IL-6, adipokines and ghrelin plasma levels could be influenced by cancer on the one hand, and by age, frailty, and nutritional status in old cancer patients on the other hand. Ninety-nine patients aged 79[76-83] years old were included. Sixty-six percent had advanced stages of cancer, and 34% had cachexia. Fifty percent were at risk of malnutrition, and 10% had overt malnutrition. None of the variables studied was significantly correlated with the advanced stage, or cachexia. In multiple regression, the only parameter significantly and positively associated with age was adiponectin (p = 0.008). Despite a high prevalence of frailty in our study, we did not find any independent association of frailty (assessed by G8) with IL-6, leptin, adiponectin, or ghrelin in multivariate analysis. We observed that a low albumin level was independently associated with a higher level of IL-6 (p < 0.0001), but not with the MNA score. However, leptin showed a positive correlation with BMI (p < 0.0001), confirming the persistence of a relationship between leptin and adiposity, even in older cancer patients. Finally, high IL-6 level was associated with a higher mortality rate (p = 0.027). In conclusion, IL-6, leptin, adiponectin, and ghrelin are not associated with advanced stages of cancer or cancer-induced cachexia in older subjects with cancer, but they are significantly correlated with anthropometric factors and body composition.
背景与目标:
晚期癌症与慢性炎症有关,尤其是高白介素6(IL-6)和各种水平的脂联素(瘦素和脂联素),而ghrelin抵消了瘦素在癌症诱发的厌食-恶病质综合征中的厌食作用。我们旨在了解一方面IL-6,脂肪因子和生长素释放肽血浆水平如何受到癌症的影响,另一方面又受老年癌症患者的年龄,虚弱和营养状况的影响。纳入年龄为79 [76-83]岁的99例患者。 66%患有癌症晚期,34%患有恶病质。百分之五十有营养不良的风险,百分之十有明显的营养不良。没有研究的变量与晚期或恶病质显着相关。在多元回归中,与年龄显着正相关的唯一参数是脂联素(p = 0.008)。尽管在我们的研究中脆弱性的患病率很高,但在多变量分析中,我们没有发现脆弱性(由G8评估)与IL-6,瘦素,脂联素或生长素释放肽的任何独立关联。我们观察到较低的白蛋白水平与较高的IL-6水平(p <0.0001)独立相关,但与MNA评分无关。然而,瘦素与BMI呈正相关(p <0.0001),证实了瘦素与肥胖之间的关系仍然存在,即使在老年癌症患者中也是如此。最后,高IL-6水平与更高的死亡率相关(p = 0.027)。总之,在老年癌症患者中,IL-6,瘦素,脂联素和生长素释放肽与癌症晚期或癌症诱发的恶病质无关,但它们与人体测量因素和身体组成显着相关。