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There is no agreed definition for cachexia, and this hampers research and treatment. This Viewpoint emphasizes the importance of definitive cut-off limits for weight loss over time, and the need for straightforward diagnostic criteria. The authors suggest cut-off values for cardiac cachexia but acknowledge that the values might differ in other conditions.
According to the National Cholesterol Education Program, an optional LDL goal of less than 1.81 mmol/l might now be considered for patients at the highest risk of coronary heart disease. This Viewpoint discusses whether these LDL target levels are safe and describes which agents might help achieve this goal.
Many chronic diseases produce a condition called cachexia, which involves anorexia, decreased lean body mass and increased energy expenditure, worsening the prognosis for the underlying disease. This article describes a promising new approach to treating cachexia, targeting a key appetite-regulating center in the hypothalamus called the melanocortin system.
The level of insulin-like growth factor 1 (IGF-I) is influenced by many factors but, as detailed here, IGF-I measurements are useful to screen for growth hormone deficiencies in children and young adults. IGF-I levels are an excellent diagnostic test for acromegaly but are also useful to assess disease severity and the response to treatment.
This Review examines the biochemistry that underlies the behaviors of obesity, in particular the relationship between hyperinsulinemia and leptin resistance. Hyperinsulinemia promotes the behaviors of increased calorie intake, decreased exercise and altered hedonic reward responses to food that are associated with the current obesity epidemic.