Cachexy

Cachexy (also known as cachexia) is a complex syndrome associated with an underlying illness, characterized by loss of muscle with or without loss of fat mass. It is a multifactorial condition that involves metabolic abnormalities, inflammation, and muscle wasting. Cachexy is commonly seen in patients with chronic diseases such as cancer, chronic obstructive pulmonary disease (COPD), chronic heart failure, and chronic kidney disease.

Etiology

Cachexy is primarily caused by an imbalance between protein synthesis and degradation, leading to muscle wasting. The condition is often driven by pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6). These cytokines can induce muscle protein breakdown and inhibit muscle protein synthesis. Additionally, metabolic changes such as increased energy expenditure and reduced appetite contribute to the development of cachexy.

Clinical Features

Patients with cachexy typically present with significant weight loss, muscle atrophy, fatigue, and weakness. Unlike simple starvation, cachexy is characterized by a disproportionate loss of muscle mass relative to fat mass. Other symptoms may include anemia, hypoalbuminemia, and increased levels of inflammatory markers.

Diagnosis

The diagnosis of cachexy is primarily clinical and involves the assessment of weight loss, muscle mass, and functional status. Criteria for diagnosing cachexy include:

• Unintentional weight loss of more than 5% over 6-12 months
• Body mass index (BMI) less than 20 kg/m² in the presence of chronic illness
• Reduced muscle strength and fatigue

Management

The management of cachexy involves a multidisciplinary approach aimed at addressing the underlying disease, improving nutritional intake, and reducing inflammation. Treatment strategies may include:

• Nutritional support with high-protein and high-calorie diets
• Pharmacological interventions such as appetite stimulants, anti-inflammatory agents, and anabolic steroids
• Physical exercise to improve muscle mass and strength

Prognosis

Cachexy is associated with poor prognosis and increased mortality, particularly in patients with advanced cancer and chronic heart failure. Early recognition and intervention are crucial to improving outcomes and quality of life for affected individuals.

Related Pages

• Cancer
• Chronic obstructive pulmonary disease
• Chronic heart failure
• Chronic kidney disease
• Tumor necrosis factor-alpha
• Interleukin-1
• Interleukin-6

Resources

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Source: Data courtesy of the U.S. National Library of Medicine. Since the data might have changed, please query MeSH on Cachexy for any updates.

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