Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;11(4):899-908.
doi: 10.1002/jcsm.12553. Epub 2020 Feb 25.

Relationship between pancreatic cancer-associated diabetes and cachexia

Wei-Chih Liao  1   2 , Peng-Ruei Chen  3 , Cheng-Chieh Huang  3 , Yen-Tzu Chang  3 , Bo-Shih Huang  3 , Chin-Chen Chang  4   5 , Ming-Shiang Wu  1   2 , Lu-Ping Chow  3
Affiliations

Relationship between pancreatic cancer-associated diabetes and cachexia

Wei-Chih Liao et al. J Cachexia Sarcopenia Muscle. 2020 Aug.

Abstract

Background: Pancreatic cancer-associated diabetes mellitus (PCDM) is a paraneoplastic phenomenon characterized by worsening hyperglycaemia and weight loss. Galectin-3 and S100A9, mediators of PCDM, have pro-inflammatory functions and might thereby induce systemic inflammation and cachexia. We aimed to examine whether PCDM directly mediates cachexia.

Methods: Consecutive pancreatic cancer (PC) patients with and without PCDM (n = 88 each) with complete information were included. Cachexia was defined as weight loss >5% within 6 months or weight loss >2% and body mass index <20 kg/m2 or sarcopenia. Skeletal muscle mass was measured with lumbar skeletal muscle index (SMI) using computed tomography images. Cachexia-related parameters (prevalence of cachexia, weight loss, and SMI) were compared between patients with and without PCDM. Relations between cachexia-related parameters and fasting blood glucose or serum levels of galectin-3 and S100A9 were analysed by Spearman correlation and logistic regression analyses.

Results: One hundred two (58.0%) patients had cachexia at diagnosis. No significant differences existed between patients with and without PCDM in prevalence of cachexia (64.8% vs. 51.1%, P = 0.093), percentage of weight loss (median 6.8 vs. 4.0, P = 0.085), and SMI (median 45.8 vs. 45.3 cm2 /m2 in men, P = 0.119; 34.9 vs. 36.3 cm2 /m2 in women, P = 0.418). In patients with cachexia, the percentage of weight loss and SMI were also similar between patients with and without PCDM. In patients with PCDM, fasting blood glucose was comparable between patients with and without cachexia (P = 0.458) and did not correlate with the percentage of weight loss (P = 0.085) or SMI (P = 0.797 in men and 0.679 in women). Serum S100A9 level correlated with fasting blood glucose (correlation coefficient 0.213, P = 0.047) but not with the percentage of weight loss (P = 0.977) or SMI (P = 0.247 in men and 0.458 in women). Serum galectin-3 level also did not correlate with the percentage of weight loss (P = 0.226) and SMI (P = 0.201 in men and 0.826 in women). Primary tumour size was associated with cachexia (adjusted odds ratio per 1 cm increase 1.28, 95% confidence interval 1.02-1.60, P = 0.034), whereas PCDM, fasting blood glucose, and levels of galectin-3 and S100A9 were not predictors of cachexia.

Conclusions: Neither fasting blood glucose nor levels of galectin-3 and S100A9 were associated with cachexia-related parameters. Mediators of PCDM and hyperglycaemia do not directly mediate PC-induced cachexia.

Keywords: Cachexia; Diabetes; Pancreatic cancer; Sarcopenia.

PubMed Disclaimer

Conflict of interest statement

W.‐C.L., P.‐R.C., C.‐C.H., Y.‐T.C., B.‐S.H., C.‐C.C., M.‐S.W., and L.‐P.C. declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Weight loss (A) and muscle mass index (B) in patients with or without pancreatic cancer‐associated diabetes. PCDM, pancreatic cancer‐associated diabetes mellitus.
Figure 2
Figure 2
Fasting blood glucose (A), serum S100A9 (B), and serum galectin‐3 (C) levels in patients with pancreatic cancer‐associated diabetes.
Figure 3
Figure 3
Correlation between fasting blood glucose and weight loss (A) or skeletal muscle mass (B) in patients with pancreatic cancer‐associated diabetes.
Figure 4
Figure 4
Correlation between levels of S100A9 or galectin‐3 and fasting blood glucose (A), weight loss (B), and skeletal muscle mass (C) in patients with pancreatic cancer‐associated diabetes.
See this image and copyright information in PMC

References

    1. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res 2014;74:2913–2921. - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017;67:7–30. - PubMed
    1. Tan CR, Yaffee PM, Jamil LH, Lo SK, Nissen N, Pandol SJ, et al. Pancreatic cancer cachexia: a review of mechanisms and therapeutics. Front Physiol 2014;5:88. - PMC - PubMed
    1. Porporato PE. Understanding cachexia as a cancer metabolism syndrome. Oncogene 2016;5:e200. - PMC - PubMed
    1. Argiles JM, Busquets S, Stemmler B, Lopez‐Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer 2014;14:754–762. - PubMed

Publication types