Simultaneous measurements of serum insulin-like growth factor-I and leptin reflect the postoperative nutrition status of oral tumor patients

Perspectives of lipid metabolism reprogramming in head and neck squamous cell carcinoma: An overview

Recent studies showed that lipid metabolism reprogramming contributes to tumorigenicity and malignancy by interfering energy production, membrane formation, and signal transduction in cancers. HNSCCs are highly reliant on aerobic glycolysis and glutamine metabolism. However, the mechanisms underlying lipid metabolism reprogramming in HNSCCs remains obscure. The present review summarizes and discusses the "vital" cellular signaling roles of the lipid metabolism reprogramming in HNSCCs. We also address the differences between HNSCCs regions caused by anatomical heterogeneity. We enumerate these recent findings into our current understanding of lipid metabolism reprogramming in HNSCCs and introduce the new and exciting therapeutic implications of targeting the lipid metabolism.

Obesity: An emerging driver of head and neck cancer

Obesity has become pandemic and emerged as one of the most critical global health care problems worldwide since last century. Recent studies have demonstrated that there may be a causal link between obesity and higher risks and mortality of cancers, including prostate, breast, colon, and thyroid cancers, head and neck cancer (HNC). This review focuses on the relationship between obesity and HNC, and the molecular mechanism of abnormal lipid metabolism in HNC. Elucidating the mechanism may open up new possibilities for strategies to reduce risk and mortality of HNC in an increasingly obese population.

The Role of Adipokines in the Establishment and Progression of Head and Neck Neoplasms

Adipokines constitute a family of protein factors secreted by white adipose tissue (WAT), that regulate the functions of WAT and other sites. Leptin, adiponectin and resistin, are the main adipokines present in serum and saliva, targeting several tissues and organs, including vessels, muscles, liver and pancreas. Besides body mass regulation, adipokines affect glucose homeostasis, inflammation, angiogenesis, cell proliferation and apoptosis, and other crucial cell procedures. Their involvement in tumor formation and growth is well established and deregulation of adipokine and adipokine receptors' expression is observed in several malignancies including those located in the head and neck region. Intracellular effects of adipokines are mediated by a plethora of receptors that activate several signaling cascades including Janus kinase/ Signal transducer and activator of transcription (JAK/ STAT pathway), Phospatidylinositol kinase (PI3/ Akt/ mTOR) and Peroxisome proliferator-activated receptor (PPAR). The present review summarizes the current knowledge on the role of adipokines family members in carcinogenesis of the head and neck region. The diagnostic and prognostic significance of adipokines and their potential role as serum and saliva biomarkers are also discussed.

Leptin is better than any other biological parameter for monitoring the efficacy of renutrition in hospitalized malnourished elderly patients

OBJECTIVE

Despite malnutrition being a major problem in hospitalized elderly patients, there is a lack of studies focusing on the comparative value of biological parameters for monitoring renutrition. The aim of this study was to determine which biological parameter(s) could best monitor successful renutrition in hospitalized malnourished elderly patients.

DESIGN

The objective of the study was to explore the impact of a 6-week renutrition process on anthropometric and biological parameters in elderly patients and to define the biological parameters associated with weight regain.

PATIENTS

A total of 72 hospitalized malnourished elderly patients admitted to a hospital-based geriatric rehabilitation unit.

MEASUREMENTS

Patients were evaluated at admission and at 6 weeks for anthropometric measurements of weight, sum of the four subcutaneous skinfold thicknesses, calf circumference and biological serum parameters including albumin, transthyretin, leptin, IGF-1, IGFBP-1 and IGFBP-3. Renutrition was considered successful if a patient gained at least 5% of body weight over 6 weeks.

RESULTS

Leptin was the only biological parameter that increased at 6 weeks in successful renutrition. Leptin variations were not influenced by C-reactive protein variations, in contrast to transthyretin which can be modified by the inflammatory states frequently encountered in geriatric patients.

CONCLUSIONS

Serum leptin is a more appropriate parameter than transthyretin for monitoring renutrition.

Use of serum leptin levels for determination of nutritional status and the effects of different enteral nutrients on intestinal mucosa after minor surgery: an experimental study

BACKGROUND

We planned to evaluate the effects of different enteral nutrients on the levels of serum leptin, protein and albumin changes and also to compare their effects on mucosal morphology of small intestine.

METHODS

Rats were randomly divided into 5 groups each including 10 animals. Group I rats were given rat chow and water. Group II rats were fed with standard enteral nutrient. Group III rats were fed with calorie enriched enteral nutrient. Group IV rats were given enteral nutrition supplemented with fiber. Group V rats were fed with immunonutrient. Serum albumin, protein, leptin levels were measured. Terminal ileum of each rat was scored.

RESULTS

We found no difference in serum leptin, protein and albumin levels. The average mucosal atrophy of rats fed with standard chow was significantly different than that of rats fed with standard and calorie enriched nutrients. Feeding with nutrients supplemented with fiber and immunonutrient did not cause significant distortion in mucosal integrity when compared with feeding with standard chow.

CONCLUSION

Low levels of leptin may show malnutrition but for determination of nutritional status of a patient receiving enteral nutrition, studies with long duration are required.

Leptin a new biological marker for evaluating malnutrition in elderly patients

BACKGROUND

There is no single universally accepted biochemical marker of nutritional status in the elderly. Many markers are affected by non-nutritional factors.

OBJECTIVE

The purpose of this study was to determine the biological parameters best related to anthropometric markers of malnutrition in an elderly polypathological population, and determine cutoff values for these potential parameters to diagnose malnutrition.

DESIGN

This prospective study enrolled 116 elderly hospitalized patients and 76 elderly outpatients. Nutritional status (albumin, transthyretin, body mass index (BMI), skinfold thickness) and biological parameters (leptin, insulin-like growth factor-1 (IGF-1), IGF binding protein-1 (IGFBP-1), IGFBP-3, C-reactive protein (CRP), orosomucoid) were assessed. We defined malnutrition according to the lowest quartile of BMI and skinfold thickness measured in a large healthy elderly French sample population.

RESULTS

In this sample of elderly patients (age: 85+/-7 years old), leptin concentration was the only biological parameter significantly related to nutrition status. Independent correlations were found between leptin concentration and BMI, skinfold thickness and sex. The relationship between nutritional status and leptin concentration is significantly different in each sex: the more the patients are undernourished, the lower the leptin concentration in both sexes. The optimal leptin cutoff value for the diagnosis of malnutrition in this population was 4 microg/l in men (sensitivity 0.89, specificity 0.82) and 6.48 microg/l in women (sensitivity 0.90, specificity 0.83).

CONCLUSION

Leptin concentration is highly correlated with anthropometric data whereas albumin or transthyretin are known to be also influenced by morbidity and inflammatory conditions. Serum leptin concentration could be used for nutritional assessment in elderly patients with acute diseases.