Short CommunicationLeptin and adiponectin as new markers of undernutrition in cancer

- Leptin is decreased in case of undernutrition, while adiponectin is increased.
- The relationship of leptin with undernutrition is independent of the other markers.
- Neither leptin nor adiponectin is related to survival.
- PINI and paraoxonase are related to survival.
- Leptin and PINI are good clinical markers of undernutrition in cancer disease.

ObjectivesTo evaluate leptin and adiponectin as markers of undernutrition in cancer patients, and compare their performances with those of other biomarkers.Design and methodsThis 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.ResultsIn 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.ConclusionsLeptin 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.

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