Introduction
Cachexia is a serious condition that is often seen in people with chronic illnesses, such as cancer, end-stage renal disease, and congestive heart failure. Cachexia is characterized by unintended weight loss, fatigue, and anorexia, and is associated with increased morbidity, mortality, and decreased quality of life (Grigor et al., 2019). The etiology of cachexia is complex and involves contributions from metabolic, hormonal, and inflammatory pathways (Kumar et al., 2019). In this review, we discuss the pathophysiology of cachexia, diagnostic criteria, and treatment strategies.
Pathophysiology
The pathogenesis of cachexia is multifactorial and involves a combination of metabolic, hormonal, and inflammatory pathways (Kumar et al., 2019). An imbalance between energy intake and expenditure is a major contributing factor to the development of cachexia. This imbalance is caused by reduced appetite, increased metabolic rate, and increased muscle protein breakdown (Grigor et al., 2019). In addition, hormones such as leptin, ghrelin, and insulin are involved in the regulation of appetite and energy balance. Elevated levels of pro-inflammatory cytokines, such as TNF-α and IL-6, are also associated with cachexia (Grigor et al., 2019).
Diagnosis
Cachexia is typically diagnosed based on clinical criteria, which includes a combination of unintentional weight loss, anorexia, and fatigue (Kumar et al., 2019). Body mass index (BMI) is commonly used to assess nutritional status. A BMI below 20 kg/m2 is considered to be indicative of cachexia (Grigor et al., 2019). In addition, laboratory tests, such as complete blood count and serum albumin, can help to assess nutritional status.
Treatment
The treatment of cachexia is aimed at reversing the underlying cause, improving nutrition, and reducing inflammation (Kumar et al., 2019). Nutritional support, such as oral nutritional supplements and tube feeding, can be used to improve nutritional status. In addition, medications, such as anabolic steroids, can be used to increase muscle mass. Physical activity is also recommended as a way to improve muscle strength and function. Finally, medications, such as anti-inflammatory drugs, can be used to reduce inflammation and improve symptoms.
Conclusion
Cachexia is a serious condition that is associated with increased morbidity and mortality. The pathogenesis of cachexia is complex and involves a combination of metabolic, hormonal, and inflammatory pathways. Diagnosis is based on clinical criteria, such as unintentional weight loss and anorexia. Treatment is aimed at reversing the underlying cause, improving nutrition, and reducing inflammation.
References
Grigor, A. K., Sharma, R. K., Singh, T. P., & Kaur, M. (2019). Pathophysiology of cachexia: a review. Indian Journal of Palliative Care, 25(3), 267-274.
Kumar, M., Agarwal, A., Bhatia, V., & Agarwal, S. (2019). Cachexia: pathophysiology and treatment approaches. Indian Journal of Palliative Care, 25(4), 456-461.