Abstract | CONTEXT: Recent animal studies showed that tumor-derived PTHrP induced cancer cachexia by fat browning with increased energy expenditure; however, clinical evidence from human data is insufficient. OBJECTIVE: DESIGN, SETTING, AND PATIENTS: From a longitudinal observational cohort, body mass index (BMI) of patients with measured serum PTHrP levels (n = 624) was assessed (median follow-up of 327 d). MAIN OUTCOME MEASURES: Cox hazard models were used to examine the predictive value of PTHrP for WL defined by consensus definition (WL [consensus], percentage WL < -5% or percentage WL < -2% plus BMI < 20 kg/m(2)) and by BMI-adjusted grades (WL [BMI adjusted]). RESULTS: The overall risk of WL (consensus) was 34.4%. Compared with PTHrP-negative subjects, patients with higher PTHrP levels ( PTHrP ≥ median 5.7 pmol/L) had more WL (percentage WL, -6.9% vs -1.1%, P = .010) at follow-up. A higher PTHrP level was associated with an increased loss of body weight (β = -2.73), muscle (β = -1.85), and fat (β = -2.52) after controlling for age, sex, and BMI. Kaplan-Meier analysis demonstrated that subjects with higher PTHrP had increased WL risk compared with lower PTHrP or PTHrP-negative groups (52.0% vs 38.9% vs 29.7%, P < .001). Serum PTHrP was independently associated with an increased WL risk (hazard ratio [HR]1.23, P = .005) adjusted for potent predictors including serum levels of calcium, C-reactive protein, albumin, cancer stage, and performance status of patients. Consistent results were observed when BMI-adjusted WL was applied. CONCLUSIONS:
|
Authors | Namki Hong, Hye-Jin Yoon, Yong-Ho Lee, Hye Ryun Kim, Byung Wan Lee, Yumie Rhee, Eun Seok Kang, Bong-Soo Cha, Hyun Chul Lee |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 101
Issue 3
Pg. 1207-14
(Mar 2016)
ISSN: 1945-7197 [Electronic] United States |
PMID | 26765580
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Parathyroid Hormone-Related Protein
|
Topics |
- Aged
- Cachexia
(blood, diagnosis, etiology)
- Female
- Humans
- Hypercalcemia
(blood, complications)
- Inflammation
(blood, complications)
- Longitudinal Studies
- Male
- Middle Aged
- Neoplasms
(blood, complications, diagnosis)
- Parathyroid Hormone-Related Protein
(blood)
- Prognosis
- Tumor Burden
(physiology)
- Weight Loss
|