Disturbance of the growth hormone-insulin-like growth factor-1 axis associated with poor performance status in patients with solid tumors

Objective: Hormonal imbalance characterized by excessive production of growth hormone (GH) and a low circulating concentration of insulin-like growth factor (IGF)-1 has been demonstrated in individuals with various serious conditions. However, little is known about changes in the GH–IGF-1 axis in cancer patients. Methods: We prospectively examined the circulating levels of several hormones in 58 patients with solid tumors who were classified according to Eastern Cooperative Oncology Group performance status (PS): PS 0–1, n ¼ 15; PS 2, n ¼ 15; PS 3, n ¼ 15; and PS 4, n ¼ 13. The relations of hormone concentrations, with a focus on the GH –I GF-1 system, to PS were evaluated by Spearman’s rank correlation test and regression analysis. Results: The circulating levels of IGF-1, IGF-binding protein-3 and thyroid hormones (total T3 and T4) were inversely correlated with PS score. The concentration of GH was increased irrespective of PS but not statistically significant. The ratio of IGF-I to GH was inversely correlated with PS. The levels of GH and IGF-1 in all patients were also inversely correlated. Conclusions: The present study suggests that the GH –I GF-1 axis is disturbed in patients with cancer.