Lactate dehydrogenase: relationship with the diagnostic GLIM criterion for cachexia in patients with advanced cancer

Background Although suggestive of dysregulated metabolism, the relationship between serum LDH level, phenotypic/aetiologic diagnostic Global Leadership Initiative on Malnutrition (GLIM) criteria and survival in patients with advanced cancer has yet to examined. Methods Prospectively collected data from patients with advanced cancer, undergoing anti-cancer therapy with palliative intent, across nine sites in the UK and Ireland between 2011–2016, was retrospectively analysed. LDH values were grouped as <250/250–500/>500 Units/L. Relationships were examined using χ 2 test for linear-by-linear association and binary logistics regression analysis. Results A total of 436 patients met the inclusion criteria. 46% ( n = 200) were male and 59% ( n = 259) were ≥65 years of age. The median serum LDH was 394 Units/L and 33.5% ( n = 146) had an LDH > 500 Units/L. LDH was significantly associated with ECOG-PS ( p < 0.001), NLR ( p < 0.05), mGPS ( p < 0.05) and 3-month survival ( p < 0.001). LDH was significantly associated with 3-month survival independent of weight loss ( p < 0.01), BMI ( p < 0.05), skeletal muscle mass ( p < 0.01), metastatic disease ( p < 0.05), NLR ( p < 0.05) and mGPS ( p < 0.01). Discussion LDH was associated with performance status, systemic inflammation and survival in patients with advanced cancer. LDH measurement may be considered as an aetiologic criteria and become a potential therapeutic target in the treatment of cancer cachexia.