Table 3.
Baseline characteristics of cachectic and non-cachectic women (n = 159) and men (n = 148) (wasting syndrome with unintentional weight loss defined as weight loss ≥ 5% in the last 12 months and BMI < 24 kg/m2)
| Measurement | All patients n = 307 |
Women with wasting syndrome with unintentional weight loss n = 85 |
Women without wasting syndrome with unintentional weight loss n = 74 |
p-value | Men with wasting syndrome with unintentional weight loss n = 67 |
Men without wasting syndrome with unintentional weight loss n = 81 |
p-value |
|---|---|---|---|---|---|---|---|
| Clinical variables | |||||||
| Age (years) | 62 ± 0.8 | 61 ± 1.6 | 63 ± 1.6 | 0.43 | 62 ± 1.9 | 63 ± 1.4 | 0.92 |
| Body mass index, BMI (kg/m2) | 24.6 ± 0.3 | 20.5 ± 0.3 | 28.3 ± 0.5 | < 0.001 | 21.3 ± 0.3 | 28.3 ± 0.4 | < 0.001 |
| Cancer and anti-cancer therapy details | |||||||
| Cancer stage III/IV, n (%) | 254 (83) | 71 (84) | 56 (76) | 0.24 | 58 (87) | 69 (85) | 0.82 |
| Solid cancer, n (%) | 170 (55) | 54 (64) | 44 (60) | 0.63 | 41 (61) | 31 (38) | 0.008 |
| ECOG Performance Scale points | 1.73 ± 0.07 | 2.18 ± 0.13 | 1.70 ± 0.12 | 0.008 | 1.81 ± 0.16 | 1.22 ± 0.11 | 0.002 |
| Karnofsky Index (%) | 73.4 ± 1.1 | 66.6 ± 2.3 | 75.5 ± 1.9 | 0.005 | 70.3 ± 2.8 | 80.9 ± 1.7 | 0.001 |
| Systemic anti-cancer therapy naïve, n (%) | 41 (13) | 12 (14) | 13 (18) | 1.00 | 5 (8) | 11 (14) | 0.59 |
| Cancer drugs causing heart failure (ESC guidelines ‘22), n (%) | 138 (45) | 38 (45) | 28 (38) | 0.42 | 31 (46) | 41 (51) | 0.60 |
| Cancer therapies associated with cardiomyopathy (AHA ‘22), n (%) | 187 (61) | 52 (61) | 36 (49) | 0.11 | 45 (67) | 54 (67) | 0.95 |
| Laboratory variables | |||||||
| Growth hormone, GH (ng/mL) | 0.94 (0.27–2.42) | 1.45 (0.49–3.78) | 0.54 (0.25–1.63) | 0.029 | 1.79 (0.66–3.28) | 0.53 (0.17–1.88) | < 0.001 |
| Insulin-like growth factor-I, IGF-I (ng/mL) | 69.2 (44.3–100.3) | 63.6 (43.9–95.3) | 68.4 (37.4–98.2) | 0.56 | 69.0 (47.2–112.3) | 80.7 (50.6–107.1) | 0.37 |
| Log IGF-I/GH ratio | 1.89 ± 0.04 | 1.68 ± 0.08 | 2.00 ± 0.07 | 0.003 | 1.68 ± 0.09 | 2.15 ± 0.07 | < 0.001 |
| Growth hormone binding protein, GHBP (pmol/L) | 331 (128–668) | 444 (194–760) | 272 (64–640) | 0.038 | 431 (220–1455) | 216 (84–470) | < 0.001 |
| IGF-I binding protein 3, IGFBP3 (µg/mL) | 1.66 ± 0.04 | 1.85 ± 0.07 | 1.83 ± 0.08 | 0.86 | 1.45 ± 0.07 | 1.47 ± 0.06 | 0.87 |
| Side diagnosis | |||||||
| Anemia, n (%) | 222 (72) | 65 (77) | 44 (60) | 0.026 | 56 (84) | 57 (70) | 0.08 |
| Arterial hypertension, n (%) | 144 (47) | 31 (37) | 48 (65) | 0.001 | 24 (36) | 41 (51) | 0.09 |
| Hypercholesterolemia, n (%) | 72 (24) | 23 (27) | 26 (35) | 0.30 | 6 (9) | 17 (21) | 0.07 |
| Type II diabetes mellitus, n (%) | 43 (14) | 6 (7) | 14 (19) | 0.032 | 7 (10) | 16 (20) | 0.17 |
| Chronic kidney disease, n (%) | 21 (7) | 2 (2) | 7 (10) | 0.08 | 5 (8) | 7 (9) | 1.00 |
| Medication | |||||||
| ACE inhibitors/ARBs, n (%) | 78 (25) | 16 (19) | 25 (34) | 0.045 | 10 (15) | 27 (33) | 0.013 |
| Beta-blockers, n (%) | 53 (17) | 8 (9) | 20 (27) | 0.006 | 9 (13) | 16 (20) | 0.38 |
| Anticoagulants, n (%) | 12 (4) | 0 | 6 (8) | 0.009 | 3 (5) | 3 (4) | 1.00 |
| Diuretics, n (%) | 56 (18) | 9 (11) | 21 (28) | 0.005 | 8 (12) | 18 (22) | 0.13 |
| Antidepressants, n (%) | 42 (14) | 14 (17) | 11 (15) | 0.83 | 6 (9) | 11 (14) | 0.45 |
| Opioids, n (%) | 71 (23) | 23 (27) | 20 (27) | 1.00 | 16 (24) | 12 (15) | 0.21 |
| Corticosteroids, n (%) | 101 (33) | 20 (24) | 26 (35) | 0.12 | 23 (34) | 32 (40) | 0.61 |
| Echocardiographic variables | |||||||
| Left ventricular (LV) mass (g) | 183 ± 3 | 144 ± 5 | 169 ± 4 | < 0.001 | 195 ± 7 | 225 ± 5 | < 0.001 |
| LV mass adjusted to height2 (g/m2) | 62 ± 1 | 53 ± 2 | 62 ± 2 | < 0.001 | 62 ± 2 | 71 ± 2 | < 0.001 |
ACE, angiotensin-converting enzyme, ARB, angiotensin II receptor blocker; BSA, body surface area; ECOG, Eastern Co-operative of Oncology Group; ESC, European Society of Cardiology cardio-oncology guidelines 2022; AHA, American Heart Association 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure; t-test p-value/chi-squared (χ2) test for comparison between patients with wasting syndrome with unintentional weight loss vs. without. Normal distributed variables are presented as means ± SEM, non-normally distributed variables as median (interquartile range), and nominal variables as n (%), p-values <0.05 are bold