title: Cancer cachexia and diabetes: similarities in metabolic alterations and possible treatment.
abstract: Cancer cachexia is a metabolic syndrome featuring many alterations typical of type 2 diabetes (T2D). While muscle wasting is a hallmark of cachexia, epidemiological evidence also supports an accelerated age-related muscle loss in T2D. Insulin resistance manifests in both conditions and impairs glucose disposal and protein anabolism by tissues. A greater contribution of gluconeogenesis to glucose production may limit amino acid availability for muscle protein synthesis, further aggravating muscle loss. In the context of inter-dependence between glucose and protein metabolism, the present review summarizes the current state of knowledge on alterations that may lead to muscle wasting in human cancer. By highlighting the similarities with T2D, a disease that has been more extensively studied, the objective of this review is to provide a better understanding of the pathophysiology of cancer cachexia and to consider potential treatments usually targeted for T2D. Nutritional approaches aimed at stimulating protein anabolism might include specially formulated food with optimal protein and amino acid composition. Because the gradual muscle loss in T2D may be attenuated by diabetes treatment, anti-diabetic drugs might be considered in cachexia treatment. Metformin emerges as a choice candidate as it acts both on reducing gluconeogenesis and improving insulin sensitivity, and has demonstrated tumour suppressor properties in multiple cancer types. Such a multimodal approach to slow or reverse muscle wasting in cachexia warrants further investigation.
authors.affiliation: a Department of Medicine and School of Dietetics and Human Nutrition, Crabtree Nutrition Laboratories, McGill University Health Centre-Royal Victoria Hospital, 687 ave des Pins Ouest, room H6.61, Montreal, QC H3A 1A1, Canada.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Chevalier
authors.forename: Samaneh
authors.initials: S
authors.lastname: Farsijani
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000818:Animals; D002100:Cachexia / Q000209:etiology* / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D004734:Energy Metabolism; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use; D009133:Muscular Atrophy; D009369:Neoplasms / Q000150:complications* / Q000378:metabolism* / Q000503:physiopathology; D018529:Nutritional Support; D011506:Proteins / Q000378:metabolism; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D011506:Proteins; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D008687:Metformin; D005947:Glucose
keywords: cachexie du cancer; cancer cachexia; diabetes; diabète; dietary protein; gluconeogenesis; gluconéogenèse; insulin resistance; insulinorésistance; leucine; metformin; metformine; métabolisme des protéines; nutrition; protein metabolism; protéines alimentaires