High Level of Irisin as a Marker of Malnutrition in Head and Neck Cancer Patients Subjected to Radiotherapy

Abstract

Background Head and neck cancers (HNC) are the 7 th most prevalent neoplasms in the world. In 50% of these patients, body weight loss and malnutrition are observed before the beginning of therapy. It is known that an important role in the pathomechanism of malnutrition and cachexia is played by the development of inflammation, degradation of muscle fibers, and browning of white adipose tissue (WAT). It was demonstrated that even a slight increase in irisin concentration leads to browning of WAT. Material/Methods The study group consisted of 50 patients with HNC. The nutritional status of the patients was assessed by the Nutritional Risk Score 2002 (NRS 2002) and Subjective Global Assessment (SGA) scales. Using bioelectrical impedance analysis (BIA), the parameters fat mass (FM) and fat-free mass (FFM) were obtained. Results Higher irisin values (1.57 vs 1.18 [ng/ml], P =0.0004) were observed in patients with higher nutritional risk (≥3) evaluated according to the NRS scale. In patients assessed as B or C on the SGA scale, higher values of irisin concentration (1.38 vs 1.07 [ng/ml], P =0.0139) were noted. It was also observed that the level of irisin before treatment was negatively correlated (rho=−0.30, p =0.0350) with FM% and was positively correlated (rho=0.30, p =0.0340) with FFM% in BIA measurements performed after the 7 th cycle of RTH. Conclusions Based on these results, we conclude that patients with malnutrition tend to have higher irisin values compared to normally nourished patients. A high level of irisin may be a useful marker of malnutrition in patients with HNC.

Impact of Nutritional Status of Patients with Head and Neck Squamous Cell Carcinoma on the Expression Profile of Ghrelin, Irisin, and Titin

“…However, Homa-Mlak et al also evaluated changes in irisin concentration in patients with head and neck cancers (HNCs) and connected it with the nutrition levels of patients. They noted a higher concentration of irisin in patients with a high risk of undernourishment (NRS > 3) in comparison to patients with a low or moderate risk as well as those who were well nourished [60]. These results are different from ours for several reasons.…”

“…Secondly, only patients with advanced cancer on the level of T3 and T4 took part in the study, and only one sort of therapy was used, different than in the study by Homa-Mlak et al Apart from that, in the study by Homa-Mlak et al a BMI < 18.5 was observed for only five patients (10%) [60], which is opposite of our study. Similar results to those obtained by Homa-Mlak et al [60], and therefore different from ours, were noted by Panagiotou et al [61], Shahidi et al [62], and Altay et al [63]. On the other hand, Quiñones et al, in an animal model, did not confirm the relationship between concentration of irisin and nutrition.…”