Increased serum levels of ghrelin at diagnosis mediate body weight loss in non-small cell lung cancer (NSCLC) patients

Objective: Ghrelin is an orexigenic peptide implicated in body weight regulation, while cachexia is a multifactorial effect of non-small cell lung cancer (NSCLC) presented in patients with advanced disease. The aim of this study was to detect the role of ghrelin in cachexia and systemic inflammation of advanced NSCLC patients as well as its role as a diagnostic and prognostic tool. Methods: Ghrelin serum levels were measured in 101 inoperable NSCLC patients before receiving any therapy (75 patients with weight loss and 26 without weight loss) and 60 healthy control volunteers. Epidemiological, anthropometrical and laboratory data were assessed for all participants (patients and healthy volunteers). Results: NSCLC patients presented significantly higher ghrelin serum levels than healthy individuals, adjusted for sex, age and BMI (0.5 +/- 0.4 ng/ml vs. 0.4 +/- 0.3 ng/ml, P<0.001). NSCLC patients with weight loss presented significantly increased ghrelin serum levels (0.56 +/- 0.24 ng/ml vs. 0.52 +/- 0.44 ng/ml, P= 0.017), compared to NSCLC patients without weight loss. Conclusions: Ghrelin serum levels are significantly increased in NSCLC patients, mainly in the subgroup of patients diagnosed with cachexia, indicating a possible implication in the pathogenesis of lung cancer. Further studies are needed to determine its potential role as predictive and prognostic marker. (C) 2009 Elsevier Ireland Ltd. All rights reserved.