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Introduction

Due to the role of adipose tissue in mediating human metabolism, identification of prognostic biomarkers of fat loss in cancer cachexia are crucial to achieve better outcomes for cancer patients.

Aims & Methods

The aim of the study was to analyze the role of adipose-tissue derived adipokines in predicting cachexia in pancreatic cancer patients.We evaluated 71 patients with newly diagnosed pancreatic cancer. Serum adiponectin (ADP), leptin (L), ghrelin, tumor necrosis factor-alfa (TNF-alfa), and interleukin 6 (IL 6) were tested at baseline and after a follow-up period of 6 months. Our primary endpoint was 10% weight loss within 6 months. Receiver operating characteristics (ROC) analysis was employed to calculate the area under the curve (AUC).Survival analysis used the Kaplan-Meier curve and the Cox proportional hazards model.

Results

53 of 71 patients met the primary endpoint. ADP levels were inversely correlated with leptin levels (rho=-0.433,P<0.01) in patients showing weight loss (WL).Thus, ADP concentration were corrected by leptin values (A/L ratio).Ghrelin, TNF-alfa and IL-6 levels showed an overall increase in the WL group, but the difference was statistically not significant. High A/L ratio was the only independent predictor of cachexia (beta=0.655,P<0.001). At ROC analysis the diagnostic profile of A/L (AUC 0.932; sensitivity 82%;specificity 97%) in detecting cachexia was superior to that of leptin alone (AUC 0.698;sensitivity 70%;specificity 74%). Kaplan-Meier global survival analysis revealed a low A/L ratio was associated with an increased survival compared to patients with high A/L ratio (Cox F test= 2.260, P<0.05).

Conclusion

Our results support the hypothesis that the combined measurement of adiponectin and leptin (A/L ratio) might provide prognostic information in predicting cachexia and survival in pancreatic cancer patients.

ROLE OF ADIPOSE-DERIVED FACTORS IN PREDICITNG CACHEXIA IN PANCREATIC CANCER PATIETNS

Aida Saray 1, Nadja Zubcevic 1, Nerma Custovic 1, Amila Mehmedovic 1, Sanjin Glavaš 1, Vedad Papovic 1, Amina Valjevac 2

1 Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina

2 Faculty of Medicine University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Conference

UEG Week Vienna 2024

Topics

Pancreas

Submission format

Abstract

Session

Overview of pancreatic diseases (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Podcast Episode

New

UEG Podcast

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Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Topics

Small Intestine & Nutrition

Published

2026

UEG Podcast Episode

UEG Podcast

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Best of UEG Week 2024 Roberta Maselli on "Endoscopy"

Roberta Maselli, Egle Dieninyte - Misiune

Topics

Endoscopy

Published

2024

UEG Presentation

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Endoscopy

Pichamol Jirapinyo 1

1 Brigham and Women's Hospital, Boston, United States of America

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Hepatobiliary Small Intestine & Nutrition

Session

Best of DDW

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Presentation

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Early gastric cancer (Complete Session)

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Stomach & H. Pylori

Session

Early gastric cancer

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Interventional management of complications

Giuseppe Vanella 1

1 IRCCS San Raffaele Institute, Milan, Italy

Event

UEG Week Berlin 2025

Topics

Pancreas

Session

Acute pancreatitis

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Introduction

The threat of acute hepatitis A (AHA) to public health may be underestimated. We aimed to determine the frequency, clinical characteristics and outcomes of patients with AHA, and to compare them to those with acute hepatitis B (AHB).

Aims & Methods

This was a retrospective study of all patients diagnosed with AHA or AHB at a tertiary referral center between January 2013 and June 2024. Demographics, clinical presentation, laboratory findings, and outcomes were determined. AHA was defined by the presence of immunoglobulin M (IgM) antibodies to hepatitis A virus. AHB was defined by the presence of IgM antibodies to hepatitis B core antigen and positive hepatitis B surface antigen. Severe hepatitis was defined by serum bilirubin > 10 mg/dl, INR ≥ 1.5, serum creatinine > 2 mg/dl, and/or hepatic encephalopathy. Fulminant hepatitis (FH) was defined by the presence of hepatic encephalopathy.

Results

Over a period of 11 years, 398 patients were diagnosed with acute hepatitis, 367 (92%) with AHA and 31 (8%) with AHB. 336 patients (84.5%) were older than 18 years of age. Compared to patients with AHB, those with AHA were younger, were more likely to be females but were less likely to have an underlying immunocompromising illness (Table 1). There was no difference in the frequency of severe hepatitis, hospitalization rate, FH, and in hospital mortality between the two groups (Table 1). There were 115 patients (31%) with severe AHA, 89% of whom were older than 18 years of age. There was no difference in the mean age (33 ± 14 vs 31 ± 14 years, p=0.32), gender (37% vs 46% females, p=0.16), history of underlying liver disease (2.6% vs 0%, p=0.07) or having an underlying immunocompromising illness (4.2% vs 6.1%, p=0.47), between patients with severe AHA and patients with non-severe AHA. Furthermore, compared to patients with non-severe AHA, patients with severe AHA were more likely to require hospitalization (70% vs 43%, p=<0.001), ICU admission (8.7% vs 0.6%, p=<0.001), and to die during the index of hospitalization (4.3% vs 0%, p=0.01). Among patients with AHA who had a serum bilirubin > 10 mg/dl, INR ≥ 1.5, and/or serum creatinine > 2 mg/dl, 7% developed fulminant hepatitis while only 1% of patients with non-severe AHA developed fulminant hepatitis, p=0.003.

Table 1. Comparison of demographics, clinical characteristics, and outcomes between patients with acute hepatitis A (AHA) and patients with acute hepatitis B (AHB)

Characteristics	Total	Hepatitis A	Hepatitis B	P-value
Number of patients	398	367 (92)	31 (8)	-
Age at diagnosis (years)	31.3 ± 14.4	30.6 ± 14.3	40.2 ± 12.6	<0.001
Gender (female)	163 (41)	158 (43)	5 (16)	0.003
Underlying liver disease	4 (1)	4 (1.1)	0	1.0
Immunocompromising illness*	21 (5.3)	16 (4.4)	5 (16.7)	0.004
Severe hepatitis**	126 (41)	115 (41)	11 (44)	0.77
Hospitalization	168 (42)	159 (43)	9 (29)	0.12
Fulminant hepatitis	10 (2.5)	9 (2.5)	1 (3.2)	0.56
In hospital mortality	6 (1.5)	5 (1.4)	1 (3.2)	0.39

*Immunocompromising illness: organ transplantation, systemic cancer, being on chemotherapy, radiotherapy, and/or immunosuppressive therapy.
**Severe hepatitis: serum bilirubin > 10 mg/dl, INR ≥ 1.5, serum creatinine > 2 mg/dl, and/or hepatic encephalopathy.

Conclusion

AHA is far more common than AHB, but is associated with similar rates of hospitalization, severe hepatitis, and fulminant hepatitis. The high frequency of AHA among adults in low-income countries calls for renewed attention to prevention and vaccination to reduce the burden of this often-overlooked disease. Furthermore, further research may be needed to develop pharmacological treatment for patients with severe AHA and those with fulminant hepatitis, in view of unavailability of liver transplantation in most developing countries.

EMERGENCE OF SEVERE ACUTE HEPATITIS A IN ADULTS: AN 11-YEAR COHORT FROM A TERTIARY CARE CENTER

Reem Mansour 1, Rami Tabbikha 1, Fayrouz Hachicho 1, Ali ElHadi Zreik 1, Batoul Abdallah 1, George F. Araj 1, Kassem Barada 1

1 American University of Beirut Medical Center, Beirut, Lebanon

Conference

UEG Week Berlin 2025

Topics

Oesophagus

Submission format

Abstract

Session

OESOPHAGEAL, GASTRIC AND DUODENAL (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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