Leptin role in advanced lung cancer. A mediator of the acute phase response or a marker of the status of nutrition?

MR Alemán Valls, B Alonso Alvareza , M Llanos Muñoza, J Oramas Rodrígueza , JL Gómez Sirvent, MM Alonso Socas, J Cruz Juradoa, E González Reimers, N Batista Lópeza, F Santolaria Fernández.

Service of Internal Medicine and Oncology Medicine. Hospital Universitario de Canarias. Tenerife. Canary Islands. Spain.

Aim: Leptin is produced in fat cells and by fat under proinflammatory cytokine action. Our objective is to study serum leptin levels, nutritional assessment, and response inflammatory in advanced-stage non-small cell lung cancer (NSCLC), and relationship between serum leptin levels, nutritional status and acute phase response. Methods: We studied 76 patients diagnosed NSCLC before chemotherapy. Weight, height, anorexia were recorded at admittance. The fat mass were assessed by bioelectric impedance. We determined serum levels of ferritin, (a)α 1 antitrypsin, C reactive protein (CRP), leptin, IL6, TNF(a)α, sTNF-RII, IL10, IL2 and IFN (g)γ. Same analysis were performed to 30 controls. Results: Serum leptin levels were lower in patients regarding to the controls (p < 0,001). When we compared proinflammatory cytokines (IL6, TNF(a)α, sTNF-RII, sIL-2R), antiinflammatory cytokine (IL10), acute phase reactants ((a)α 1antitrypsin, ferritin, CRP) and proimmune cytokines (IL-2 e IFN(g)γ) showed that all parameters were raised with a significant difference in patients respect to the controls with the exception of the IL2. When we analized the relationship between leptin with nutritional status parameters we found a direct relation, higher serum leptin levels was related with better nutritional state. Also, we observed a close and significant positive association between serum leptin levels and fat mass assessed by bioimpedancia (s = 0,800). Conclusion: Cancer anorexia/cachexia is not due to a simple dysregulation of leptin production. Leptin concentrations are not elevated in weight-losing cancer patients and are not related to the magnitude of the inflammatory response, it would appear that the concentrations of leptin are appropriate for the amount of body fat in lung cancer patients.

For more information, contact

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Diagnostic Markers.