An Investigation of Insulin Resistance and Cachexia Relation in Patients with Metastatic Gastrointestinal Malignancies

Background: Insulin resistance has been suggested as one of the known metabolic disorders duringcachexia. This study hypothesized that cachexia in cancer patients might be related to insulinresistance as early as cachexia development. Methods: This study was performed on 46 patients with metastatic gastrointestinal cancer.Anthropometric characteristics and biochemical markers were assessed at baseline, second andthird month. Insulin resistance was assessed using the homeostasis model assessment-estimatedinsulin resistance (HOMA IR) method. SFQ-36 questions were used to assess the patients’ qualityof life at baseline, second and third months. Results: Anthropometric characteristic was significantly associated between pre-cachectic and non-pre-cachectic patients in third month. Cholesterol (P-value = 0.93), albumin (P-value: 0.82), andserum creatinine (P-value = 0.88) in pre-cachectic patients decreased over three months. There wasan increasing trend of insulin resistance between pre-cachectic and non-pre-cachectic patients in thirdmonth. Cholesterol had an upward trend with a significant relation in cachectic patients [(P-value =0.00), (P-value = 0.03), (P-value = 0.01)]. We detected a decreasing trend of insulin resistance betweencachectic and non-cachectic patients from second to third month (P-value = 0.04). SFQ evaluation hadno significant relation with cachectic status. Conclusion: Previous studies showed that the use of NSAIDs, progesterone’s, corticosteroids, COX-2inhibitors, anabolic agents and drugs targeting inflammatory cytokines may be beneficial for improvingof symptoms of cachexia. Significant relation between anthropometric variables with pre-cachexiaand cachectic conditions was concluded. Patients’ outcome and its relation with insulin resistancedemonstrated a significant relation between the cachectic and non-cachectic patients in the third month.We also detected the increased serum cholesterol level in cachectic patients, moreover, higher cholesterollevels in expired cachectic patients than in the living.