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. 2013;8(1):e54564.
doi: 10.1371/journal.pone.0054564. Epub 2013 Jan 24.

Gut hormones, appetite suppression and cachexia in patients with pulmonary TB

Suzanne W Chang  1 , William S Pan, Daniel Lozano Beltran, Lizet Oleyda Baldelomar, Marco Antonio Solano, Iskra Tuero, Jon S Friedland, Faustino Torrico, Robert H Gilman
Affiliations

Gut hormones, appetite suppression and cachexia in patients with pulmonary TB

Suzanne W Chang et al. PLoS One. 2013.

Abstract

Background: Cachexia is a hallmark of pulmonary tuberculosis and is associated with poor prognosis. A better understanding of the mechanisms behind such weight loss could reveal targets for therapeutic intervention. The role of appetite-regulatory hormones in tuberculosis is unknown.

Methods and findings: 41 subjects with newly-diagnosed pulmonary TB (cases) were compared to 82 healthy controls. We measured appetite, body mass index (BMI), % body fat (BF), plasma peptide YY (PYY), leptin, ghrelin, and resistin for all subjects. Measurements were taken at baseline for controls and at treatment days 0, 30, and 60 for cases. Baseline appetite, BMI, and BF were lower in cases than in controls and improved during treatment. PYY, ghrelin, and resistin were significantly elevated in cases and fell during treatment. Leptin was lower in cases and rose with treatment. Appetite was inversely related to PYY in cases. High pre-treatment PYY predicted reduced gains in appetite and BF. PYY was the strongest independent predictor of appetite in cases across all time points.

Conclusions: Appetite-regulatory hormones are altered in TB patients. As hormones normalize during treatment, appetite is restored and nutritional status improves. High baseline PYY is an indicator of poor prognosis for improvement in appetite and nutrition during treatment. Wasting in TB patients may partly be mediated by upregulation of PYY with resulting appetite suppression.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PYY, Ghrelin, and Leptin in Patients Receiving Treatment for TB and in Healthy Controls.
Dots represent mean values. Bars represent 95% confidence intervals. The Y axis is pcg/ml.
Figure 2
Figure 2. Correlations between Hormones, Appetite, and Nutritional Status in Patients with Pulmonary TB.
See this image and copyright information in PMC

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