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Change of the growth hormone–insulin-like growth factor-I axis in patients with gastrointestinal cancer: related to tumour type and nutritional status

Published online by Cambridge University Press:  08 March 2007

Qi Huang ,
Yong-Jun Nai ,
Zhi-Wei Jiang  and
Jie-Shou Li
Qi Huang*
Affiliation:
Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu Province, China
Yong-Jun Nai
Affiliation:
Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu Province, China
Zhi-Wei Jiang
Affiliation:
Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu Province, China
Jie-Shou Li
Affiliation:
Department of General Surgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, Jiangsu Province, China
*
*Corresponding author: Dr Qi Huang, fax +86 25 4801861, email hqhq007@hotmail.com
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Abstract

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Changes in the growth hormone (GH)–insulin-like growth factor-I (IGF-I) axis, especially acquired GH resistance, develop in many severe illnesses, including cachexia. To study changes in the GH–IGF-I axis in patients with cancer cachexia, biochemical markers and body composition parameters were measured in eighty-eight gastric cancer patients, thirty colorectal cancer patients (subclassified according to the presence or absence of cachexia) and twenty-four healthy control subjects. Fifty-nine patients were defined as cachectic, based on the percentage of weight loss compared with their previous normal weight. The remaining fifty-nine patients were defined as non-cachectic. Measurements were repeated in twenty-seven patients (sixteen with gastric cancer and eleven with colorectal cancer) 3 months after radical operation. Compared with the controls, the cachectic gastric cancer patients had high GH levels (1·36 v. 0·32 ng/ml; P=0·001), a trend towards high IGF-I levels (223·74 v. 195·15 ng/ml; P=0·128 compared with non-cachectic patients) and a low log IGF-I/GH ratio (2·55 and 2·66 v. 3·00; P=0·002), along with a decreased BMI; the cachectic colorectal cancer patients showed the biochemical characteristics of acquired GH resistance: high GH (0·71 v. 0·32 ng/ml; P=0·016), a trend towards decreased IGF-I levels (164·18 v. 183·24 ng/ml; P=0·127) and a low log IGF-I/GH ratio (2·54 v. 2·99; P=0·005), with increased IGF-I levels following radical surgery (200·49 v. 141·91 ng/ml; P=0·046). These findings suggest that normal GH reaction and sensitivity occur in gastric cancer patients, controlled by nutritional status, whereas acquired GH resistance develops in cachectic colorectal cancer patients, which may be caused by tumour itself.

Keywords

Growth hormone resistanceInsulin-like growth factor-ICancer cachexiaGastric cancerColorectal cancer
Type
Research Article
Information
British Journal of Nutrition , Volume 93 , Issue 6 , June 2005 , pp. 853 - 858
Copyright
Copyright © The Nutrition Society 2005

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