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It is a condition that denotes excessive weight loss. It occurs due to the exhaustion of adipose tissue and muscle mass in people who are not trying to lose weight.
It is also known as ” wasting syndrome ” and causes disproportionate muscle wasting, weakness, fatigue and loss of appetite in affected people. The word “cachexia” comes from two Greek terms “kakos” which means “bad” and “hexis” which means “condition”.
Cachexia is observed in several patients with conditions such as:
- PAGE.
- Cancer.
- Celiac Disease.
- Rheumatoid arthritis .
- Multiple sclerosis
- Congestive heart failure.
- Tuberculosis.
- Mercury poisoning
- Severe sepsis
- Malabsorción.
It is usually established during the later stages of chronic diseases.
Cachexia affects approximately 16-42% of patients with heart failure , and almost 60% of patients with kidney disease. It affects more than 5 million people in the US UU
This condition remained ignored for several years, as doctors and researchers tended to focus on the main disease that had been diagnosed in patients.
The differentiation of cachexia from other syndromes that cause weight loss is crucial for the rapid diagnosis and effective treatment of this condition.
Cardiac caquexia
This is a common complication of chronic heart failure (CHF) that is associated with a poorer prognosis. It is defined as the involuntary loss of 5% of body mass in twelve months or less.
Myofibrillar proteins are degraded and there is also a reduction in protein synthesis. It is believed that endocrine factors play a regulatory role.
It has been shown that adipose tissue cells (adipocytes) release enzymes in congestive heart failure, which induce skeletal muscle wasting and reduce fat and bone mass.
Causes of Cachexia
Although the exact cause of cachexia is still not clearly known, several studies have shown that inflammatory cytokines such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and interferon gamma (IFN- γ) may play a role in the development of cachexia.
Studies that focused on the mechanism of weight loss in rabbits showed that the administration of TNF-α in laboratory rabbits induces cachexia, with anorexia and exhaustion of adipose tissue. It has also been shown that TNF-α triggers the degradation of muscle protein, although there is no evidence of direct action.
According to one study, the administration of TNF-α in healthy rats increases muscle protein degradation, although weight loss was not evident in the rats. Other studies have shown that TNF-α has the ability to cause catabolism of adipose tissue and human muscles.
Several studies in animals have shown that IL-6 has the potential to play a role in the development of cachexia, along with other factors.
In a particular study in mice, the infusion of IL-6 did not cause weight loss in mice harboring a tumor clone that does not induce weight loss. This was taken as an indication that IL-6 alone was not responsible for the induction of cachexia.
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Weight loss in cachexia is different from the weight loss that results from starvation. The latter is a direct result of inadequate caloric intake.
What happens with cachexia
We do not know exactly what happens in cachexia. Scientists think that cancer releases chemicals in the blood that contribute to the loss of fat and muscle.
These chemicals can speed up your metabolism so that you consume calories faster. Because your body is consuming energy faster than you are getting, you can have a serious weight loss even if you are eating normally.
symptom
Cachexia appears to be more common in people with lung cancer or with cancers anywhere in the digestive system. The main symptoms are:
- Severe weight loss, including loss of fat and muscle mass.
- Loss of appetite
- Feeling sick (nausea)
- Feeling full after eating small amounts.
- Anemia (low levels of red blood cells).
- Weakness and fatigue.
Risk factor’s
It is not common to have cachexia in the early stages of cancer. Up to 6 out of 10 people (60%) with advanced cancer develop a certain degree of cachexia. Cachexia in advanced cancer can be very annoying and make you feel very weak. However, it is not only associated with cancer.
It is common in the advanced stages of other diseases such as heart disease, HIV and kidney disease. Losing muscle and fat can make it look like you are “consuming” yourself. All of this may get worse because of the side effects of the cancer treatment you are having.
During the initial stages of starvation, the body supplies the brain and erythrocytes with glucose through two compensatory mechanisms:
- It decomposes glycogen reserves in liver and muscle.
- Increases the production of glucose in the liver, using gluconeogenic amino acids formed as a result of muscle catabolism.
However, in long-term starvation, the body begins to use fat as fuel. That is, it converts fatty acids from adipose tissue into ketone bodies, which provide the required energy to the brain and peripheral tissues. This results in the preservation of muscle mass.
Therefore, in prolonged starvation, most of the weight loss is due to the burning of fat and only a small portion comes from the muscle. Conversely, weight loss in cachexia involves the loss of the same amount of fat and muscle.
Therefore, for a given percentage of weight loss, a cachectic person loses more muscle than a hungry person. In addition, weight loss or change in body composition in the case of cachexia is not reversible by ensuring adequate caloric intake, unlike in cases of simple starvation.
This is due to the profound metabolic changes that take place in cachexia, which lead to a higher basal rate of energy expenditure, as well as to a greater degradation of fat and muscles.
The altered body composition of the patient in the presentation helps to differentiate cachexia from other syndromes such as anorexia that causes weight loss. However, anorexia may be a contributing factor to muscle wasting seen in patients with cachexia.
This is because the loss of appetite and the reduced intake of food interfere with the quality of the psychological and physical life of the patient. loss of appetite can also cause Hyporexia
