Increased plasma ghrelin level in lung cancer cachexia.
OBJECTIVE
Ghrelin, a novel growth hormone-releasing peptide,has been shown to cause a positive energy balance by stimulating food intake and inducing adiposity. We sought to investigate the pathophysiology of ghrelin in cachexia associated with lung cancer.


METHODS
Plasma ghrelin level was measured in 43 patients with lung cancer and 21 control subjects. Patients with lung cancer were divided into two groups: patients with cachexia (n = 21) and those without cachexia (n = 22).


RESULTS
Plasma ghrelin level did not significantly differ between all patients with lung cancer and controls (157 +/- 10 versus 132 +/- 8 fmol/ml, P = 0.1). However, plasma ghrelin level was significantly higher in patients with cachexia than in those without cachexia (180 +/- 17 versus 135 +/- 10 fmol/ml, P = 0.011). Furthermore, plasma ghrelin level increased significantly in patients with decreased food intake after chemotherapy (from 136 +/- 11 fmol/ml to 170 +/- 16 fmol/ml on day 8, 179 +/- 20 fmol/ml on day 21 after start of chemotherapy), although plasma ghrelin level did not significantly change in those without decreased food intake.


CONCLUSIONS
Baseline plasma ghrelin level was elevated in cachectic patients with lung cancer, and follow-up plasma ghrelin level increased in patients with anorexia after chemotherapy. Considering the positive energy effects induced by ghrelin, increased ghrelin may represent a compensatory mechanism under catabolic-anabolic imbalance in cachectic patients with lung cancer.
Shimizu
Yoshito
Y
The Second Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan.
Nagaya
Noritoshi
N
Isobe
Takeshi
T
Imazu
Michinori
M
Okumura
Hiroyuki
H
Hosoda
Hiroshi
H
Kojima
Masayasu
M
Kangawa
Kenji
K
Kohno
Nobuoki
N
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002100:Cachexia / Q000097:blood / Q000209:etiology*; D002149:Energy Intake; D005260:Female; D054439:Ghrelin; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000145:classification / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D036361:Peptide Hormones / Q000097:blood*; D012016:Reference Values
D000970:Antineoplastic Agents; D015415:Biomarkers; D054439:Ghrelin; D036361:Peptide Hormones; D019382:Human Growth Hormone