Melatonin as a marker of severity of cardiac disorders in developing cachexia syndrome among cancer patients of different age groups

Abstract

We investigated 103 newly diagnosed stage II–IV cancer patients aged 28–78 years before the beginning of their anticancer therapy. The signs of cachexia syndrome were diagnosed and staged (precachexia or fully-fledged cachexia), including the age-related characteristics of subjects, based on the CASCO criteria (2011). It has been established that cardiovascular disorders with comorbid cancer pathologies were significantly more frequently recorded in patients with signs of cachexia syndrome already at its precachexia stage, while the cumulative index of cardiovascular disorders has been found to increase in cancer patients as cachexia progressed and its severity increased. The level of melatonin excretion evaluated by the excreted amount of 6-sulfatoximelatonin (aMT6s), the mean melatonin metabolite, was observed to decrease significantly in cancer patients as the CS manifestations became more advanced. The least changes in the aMT6s levels were observed in patients aged over 60 years who were included in the precachexia group, which might indicate the heterogeneity of the given sample due to the combined manifestation of geriatric syndromes and cancer pathologies. A false-positive precachexia diagnosis is also possible, especially, in elderly and old patients, due to a combination of polygenic metabolic and age-related changes, which are to meet, in sum, the current criteria for CS. Therefore, it is recommended to determine the melatonin excretion indicator as an additional marker in the diagnosis and differential diagnosis of CS with its progression, in particular, in geriatric patients. A significant correlation has been found between the emergence of cardiac pathology and/or a worsening in its course in cancer patients with cachexia symptoms and reduced aMT6s content.

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