title: Leptin and adiponectin as new markers of undernutrition in cancer.
abstract: OBJECTIVE
  To evaluate leptin and adiponectin as markers of undernutrition in cancer patients, and compare their performances with those of other biomarkers.
  
  
  METHODS
  This was a prospective and observational study of 132 patients with various types of cancer. Following the recommended professional criteria, we diagnosed undernutrition at the time of blood sampling for the biological analysis of leptin, adiponectin, paraoxonase (hydrolysis rate of three substrates: paraoxon (PON), phenylacetate (ARE) and thiolactone (LAC)), and the calculation of the Prognostic Inflammatory and Nutritional Index (PINI). Patients were monitored for one year to establish the mortality rate of the group. Relationships between biological variables and undernutrition were evaluated using univariate and multivariate logistic regression models. The Kaplan Meier method was used to analyse survival curves. Hazard ratios for death were calculated according to the quartiles of each biological variable.
  
  
  RESULTS
  In the case of undernutrition, a decrease was observed in levels of leptin and in the lactonase activity (LAC) of paraoxonase, while adiponectin levels increased. Besides PINI, leptin was the only parameter that was independently related to undernutrition. While no relation was found between survival and leptin or adiponectin levels, evidence was found that PINI, LAC and ARE were associated with survival, even in multivariate analysis.
  
  
  CONCLUSIONS
  Leptin and PINI are good markers of installed undernutrition, and PINI and ARE or LAC are reliable markers of the risk of death in patients suffering from cancer.
authors.affiliation: Institut de Cancérologie de l'Ouest, Biopathologie, Saint-Herblain, France; Université de Nantes, EA 2160 - IUML FR3473 CNRS and Centre de Recherche en Nutrition Humaine Ouest, Nantes, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Bobin-Dubigeon
authors.affiliation: Institut de Cancérologie de l'Ouest, Biopathologie, Saint-Herblain, France.
authors.forename: Armelle
authors.initials: A
authors.lastname: Lefrançois
authors.affiliation: Institut de Cancérologie de l'Ouest, Oncologie Médicale, Saint-Herblain, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Vansteene
authors.affiliation: Institut de Cancérologie de l'Ouest, Biopathologie, Saint-Herblain, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Dupé
authors.affiliation: Institut de Cancérologie de l'Ouest, Biopathologie, Saint-Herblain, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Joalland
authors.affiliation: Institut de Cancérologie de l'Ouest, Biopathologie, Saint-Herblain, France; Université de Nantes, EA 2160 - IUML FR3473 CNRS and Centre de Recherche en Nutrition Humaine Ouest, Nantes, France. Electronic address: jean-marie.bard@univ-nantes.fr.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Bard
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052242:Adiponectin / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D018572:Disease-Free Survival; D020738:Leptin / Q000097:blood; D044342:Malnutrition / Q000097:blood / Q000401:mortality; D009369:Neoplasms / Q000097:blood / Q000401:mortality; D009752:Nutritional Status; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D052242:Adiponectin; D014408:Biomarkers, Tumor; D020738:Leptin
keywords: Adipokines; Cancer; Paraoxonase; Survival