title: Interleukin-6 and leptin as markers of energy metabolic changes in advanced ovarian cancer patients.
abstract: The progression of the neoplastic disease is characterized by specific alterations of energy metabolism and by symptoms like fatigue, anorexia, nausea, anaemia, immunodepression and poor performance status (PS). The main cause of these symptoms and metabolic abnormalities is the chronic action of proinflammatory cytokines released both by tumour and immune cells. The present study aimed to assess the relationship between markers of inflammation (C-Reactive Protein, Fibrinogen, proinflammatory cytokines) and energy metabolic status (BMI, leptin, oxidative stress) according to clinical parameters in 104 ovarian cancer patients at different stage and, moreover, to evaluate prospectively the changes of these parameters in accordance to tumour response in a subgroup of 70 advanced stage ovarian cancer patients. Advanced stage and poor PS were associated to high-grade inflammation and impaired energy metabolism. Among inflammatory mediators, interleukin (IL)-6 had a central role as predictive factor of leptin, reactive oxygen species and glutathione peroxidase. In turn, leptin considered the key marker of the nutritional status and energy metabolism, was independently determined from stage and IL-6, not only from BMI. Moreover, the evaluation of the changes of these parameters during the course of the neoplastic disease in the subgroup of advanced ovarian cancer patients clearly unveils the central role of IL-6 and leptin as early markers of the metabolic alterations and symptoms associated to disease progression in advanced stage ovarian cancer. Their assessment should be included in monitoring disease outcome, especially when cancer is no longer curable and quality of life becomes the primary endpoint.
authors.affiliation: Department of Obstetrics and Gynecology, Sirai Hospital, Carbonia, Italy. a.maccio@tin.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Macciò
authors.forename: Clelia
authors.initials: C
authors.lastname: Madeddu
authors.forename: Daniela
authors.initials: D
authors.lastname: Massa
authors.forename: Giorgio
authors.initials: G
authors.lastname: Astara
authors.forename: Daniele
authors.initials: D
authors.lastname: Farci
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mantovani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004734:Energy Metabolism; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D005979:Glutathione Peroxidase / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000378:metabolism*; D020738:Leptin / Q000096:biosynthesis / Q000378:metabolism*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology; D017382:Reactive Oxygen Species; D016896:Treatment Outcome
chemical_list: D015850:Interleukin-6; D020738:Leptin; D017382:Reactive Oxygen Species; D005979:Glutathione Peroxidase