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| Item Type: | Article |
|---|---|
| Title: | Association of an impaired GH‑IGF‑I axis with cardiac wasting in patients with advanced cancer |
| Creators Name: | Fröhlich, A.K., Porthun, J., Talha, K.M., Lena, A., Hadzibegovic, S., Wilkenshoff, U., Sonntag, F., Nikolski, A., Ramer, L.V., Zeller, T., Keller, U., Bullinger, L., Anker, S.D., Haverkamp, W., von Haehling, S., Doehner, W., Rauch, U., Skurk, C., Cleland, J.G.F., Butler, J., Coats, A.J.S., Landmesser, U., Karakas, M. and Anker, M.S. |
| Abstract: | BACKGROUND: Growth hormone (GH) resistance is characterized by high GH levels but low levels of insulin-like growth factor-I (IGF-I) and growth hormone binding protein (GHBP) and, for patients with chronic disease, is associated with the development of cachexia. OBJECTIVES: We investigated whether GH resistance is associated with changes in left ventricular (LV) mass (cardiac wasting) in patients with cancer. METHODS: We measured plasma IGF-I, GH, and GHBP in 159 women and 148 men with cancer (83% stage III/IV). Patients were grouped by tertile of echocardiographic LVmass/height(2) (women, < 50, 50–61, > 61 g/m(2); men, < 60, 60–74, > 74 g/m(2)) and by presence of wasting syndrome with unintentional weight loss (BMI < 24 kg/m(2) and weight loss ≥ 5% in the prior 12 months). Repeat echocardiograms were obtained usually within 3–6 months for 85 patients. RESULTS: Patients in the lowest LVmass/height(2) tertile had higher plasma GH (median (IQR) for 1(st), 2(nd), and 3(rd) tertile women, 1.8 (0.9–4.2), 0.8 (0.2–2.2), 0.5 (0.3–1.6) ng/mL, p = 0.029; men, 2.1 (0.8–3.2), 0.6 (0.1–1.7), 0.7 (0.2–1.9) ng/mL, p = 0.003). Among women, lower LVmass was associated with higher plasma IGF-I (68 (48–116), 72 (48–95), 49 (35–76) ng/mL, p = 0.007), whereas such association did not exist for men. Patients with lower LVmass had lower log IGF-I/GH ratio (women, 1.60 ± 0.09, 2.02 ± 0.09, 1.88 ± 0.09, p = 0.004; men, 1.64 ± 0.09, 2.14 ± 0.11, 2.04 ± 0.11, p = 0.002). GHBP was not associated with LVmass. Patients with wasting syndrome with unintentional weight loss had higher plasma GH and GHBP, lower log IGF-I/GH ratio, and similar IGF-I. Overall, GHBP correlated inversely with log IGF-I/GH ratio (women, r = − 0.591, p < 0.001; men, r = − 0.575, p < 0.001). Additionally, higher baseline IGF-I was associated with a decline in LVmass during follow-up (r = − 0.318, p = 0.003). CONCLUSION: In advanced cancer, reduced LVmass is associated with increased plasma GH and reduced IGF-I/GH ratio, suggesting increasing GH resistance, especially for patients with wasting syndrome with unintentional weight loss. Higher baseline IGF-I was associated with a decrease in relative LVmass during follow-up. |
| Keywords: | Left Ventricular Mass, Growth Hormone, Insulin-Like Growth Factor-I, Cardiology, Cancer, Echocardiography, Cachexia |
| Source: | Clinical Research in Cardiology |
| ISSN: | 1861-0684 |
| Publisher: | Springer |
| Date: | 8 April 2024 |
| Official Publication: | https://doi.org/10.1007/s00392-024-02400-x |
| PubMed: | View item in PubMed |
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