말기암환자의 혈중 Visfatin 농도와 식욕부진의 관계 = The Relationship of Plasma Visfatin Level and Anorexia in Terminal Cancer Patients

다국어 초록 (Multilingual Abstract)

Purpose: Anorexia is a common symptom in terminal cancer patients. Some data have suggested a role of visfatin in regulating feeding behavior. We studied the relationship of a serum visfatin level and anorexia in cancer patients provided with hospice care. Methods: After informed consent was obtained, 69 cancer patients over 20 years old at a hospice center were enrolled in the study from July 2009 to July 2010. We characterized patients by age, sex, body mass index, primary cancer site, and Eastern Cooperative Oncology Group (ECOG) performance status, etc. Also, blood tests were performed to measure the level of hemoglobin, white blood cell (WBC), C-reactive protein (CRP), total cholesterol, albumin, lymphocyte count, glucose, blood urea nitrogen (BUN), creatinine, tumor necrosis factor-alpha (TNF-${\alpha}$), interukin-6, leptin and visfatin. Results: The mean age of subjects was 65.5 years old, According to univariate analysis, pulse, ECOG performance scale, opioid use and visfatin level were different between the anorexia and non-anorexic group (P<0.05). The median visfatin level was higher in the anorexia group than the good appetite group (P=0.0323). Serum visfatin concentrations were not related with either body mass index or serum leptin or total cholesterol levels, but it was negatively correlated with serum albumin levels (P=0.0198) and lymphocyte counts (P=0.0013). Conclusion: This study did not identify a novel link between visfatin levels and anorexia in cancer patients at a hospice.

참고문헌 (Reference)

1 Fukuhara A, "Visfatin: a protein secreted by visceral fat that mimics the effects of insulin" 307 : 426-430, 2005

2 Carrero JJ, "Visfatin is increased in chronic kidney disease patients with poor appetite and correlates negatively with fasting serum amino acids and triglyceride levels" 25 : 901-906, 2010

3 Kovacikova M, "Visfatin expression in subcutaneous adipose tissue of pre-menopausal women: relation to hormones and weight reduction" 38 : 516-522, 2008

4 Zabel R, "The relationship between subjective appetite sensations, markers of inflammation and appetite in dialysis patients" 22 : 343-350, 2009

5 Morita T, "The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients" 7 : 128-133, 1999

6 Sun G, "Serum visfatin concentrations are positively correlated with serum triacylglycerols and down-regulated by overfeeding in healthy young men" 85 : 399-404, 2007

7 Hallschmid M, "Relationship between cerebrospinal fluid visfatin (PBEF/Nampt)levels and adiposity in humans" 58 : 637-640, 2009

8 Weeks JC, "Relationship between cancer patients’ predictions of prognosis and their treatment preferences" 279 : 1709-1714, 1998

9 Vigano A, "Quality of life and survival prediction in terminal cancer patients: a multicenter study" 101 : 1090-1098, 2004

10 Maltoni M, "Prediction of survival of patients terminally ill with cancer: Results of an ltalian prospective multicentric study" 75 : 2613-2622, 1995

11 Rosenthal MA, "Prediction of life-expectancy in hospice patients: identification of novel prognostic factors" 7 : 199-204, 1993

12 Olszanecka-Glinianowicz M, "Plasma visfatin and tumor necrosis factor-alpha (TNF-α) levels in metabolic syndrome" 69 : 802-807, 2011

13 Robertson MD, "Plasma ghrelin response following a period of acute overfeeding in normal weight men" 28 : 727-733, 2004

14 McMillan DC, "Measurement of the systemic inflammatory response predicts cancer-specific and non-cancer survival in patients with cancer" 41 : 64-69, 2001

15 Chow E, "How accurate are physicians' clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review" 13 : 209-218, 2001

16 Engel JH, "Hardiness, depression, and emotional well-being and their association with appetite in older adults" 59 : 482-487, 2011

17 Böttcher Y, "Genetic variation in the visfatin gene (PBEF1) and its relation to glucose metabolism and fat-specific messenger ribonucleic acid expression in humans" 91 : 2725-2731, 2006

18 Lajunen TK, "Full-length visfatin levels are associated with inflammation in women with polycystic ovary syndrome" 42 : 321-328, 2012

19 Bruera E, "Estimate of survival of patients admitted to a palliative care unit:a prospective study" 7 : 82-86, 1992

20 Geissbühler P, "Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over fiveyears" 20 : 93-103, 2000

21 Chen MP, "Elevated plasma level of visfatin/pre-B cell colony enhancing factor in patients with type 2 diabetes mellitus" 91 : 295-299, 2006

22 Suh SY, "Construction of a new, objective prognostic score for terminally ill cancer patients: a multicenter study" 18 : 151-157, 2010

23 Sungurtekin H, "Comparison of two nutrition assessment techniques in hospitalized patients" 20 : 428-432, 2004

24 Caliskan Y, "Comparison of markers of appetite and inflammation between hemodialysis patients with and without failed renal transplants" 22 : 258-267, 2012

25 Reuben DB, "Clinical symptoms and length of survival in patients with terminal cancer" 148 : 1586-1591, 1988

26 Cline MA, "Central visfatin causes orexigenic effects in chicks" 186 : 293-297, 2008

27 Kalantar-Zadeh K, "Appetite and inflammation, nutrition, anemia, and clinical outcome in hemodialysis patients" 80 : 299-307, 2004

28 Smiechowska J, "Adipokines in patients with cancer anorexia and cachexia" 58 : 554-559, 2010

29 Bruera E, "ABC of palliative care. Anorexia, cachexia, and nutrition" 315 : 1219-1922, 1997

30 Blakemore AI, "A rare variant in the visfatin gene (NAMPT/PBEF1) is associated with protection from obesity" 17 : 1549-1553, 2009

31 Pirovano M, "A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. ltalian Multicenter and Study Group on Palliative Care" 17 : 231-239, 1999