title: Mini Nutritional Assessment (MNA) and biochemical markers of cachexia in metastatic lung cancer patients: interrelations and associations with prognosis.
abstract: OBJECTIVE
  Lung cancer patients frequently present with weight loss in the context of the cachexia syndrome. Despite its high clinical significance, definite diagnostic criteria of cachexia are lacking. Nutritional screening questionnaires, like the Mini Nutritional Assessment (MNA), have been proposed for the timely diagnosis of the syndrome. The aim of this study was to evaluate the correlation of MNA with laboratory markers of inflammation/cachexia in patients with metastatic lung cancer. The prognostic value of the measured parameters was also examined.
  
  
  METHODS
  Patients with metastatic lung cancer referred for systemic therapy were eligible. Baseline clinical characteristics were recorded and nutritional status was assessed using MNA. Blood samples were also collected and the following parameters were measured: hemoglobin (Hb), albumin (Alb), C-reactive protein (CRP), ghrelin, adiponectin, leptin and insulin growth factor I (IGF-I).
  
  
  RESULTS
  Totally, 115 patients (101 males) [median age 66 years (range 32-86)] were evaluated. According to MNA score, 27 (23.5%) patients were well nourished, 59 (51.3%) were at nutritional risk and 29 (25.2%) were already malnourished at diagnosis. MNA correlated with the following parameters: Hb (p=0.001), albumin (p<0.001), CRP (p=0.002), adiponectin (p=0.037) and leptin (p=0.008). After a median follow up of 38.2 months, multivariate analysis revealed that age (p=0.008), number of metastatic sites (p<0.001), MNA (p=0.044) and leptin (p=0.004) independently correlated with overall survival.
  
  
  CONCLUSIONS
  Based on the MNA, the majority of patients were either malnourished or at nutritional risk. MNA correlated with laboratory parameters related to inflammation/cachexia and was independently associated with survival.
authors.affiliation: Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece. rodopatis@gmail.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Gioulbasanis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Georgoulias
authors.forename: Panagiotis J
authors.initials: PJ
authors.lastname: Vlachostergios
authors.forename: Vickie
authors.initials: V
authors.lastname: Baracos
authors.forename: Sunita
authors.initials: S
authors.lastname: Ghosh
authors.forename: Zoe
authors.initials: Z
authors.lastname: Giannousi
authors.forename: Christos N
authors.initials: CN
authors.lastname: Papandreou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Mavroudis
authors.forename: Vassilis
authors.initials: V
authors.lastname: Georgoulias
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002100:Cachexia; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011014:Pneumonia
chemical_list: D015415:Biomarkers