Effects of serum albumin, calcium levels, cancer stage and performance status on weight loss in parathyroid hormone-related peptide positive or negative patients with cancer

Ji Yeon Lee, Namki Hong, Hye Ryun Kim, byungwan lee, Eun Seok Kang, Bong Soo Cha, Yong Ho Lee

Research output: Contribution to journalArticle

Abstract

Background: A recent animal study showed that parathyroid hormone-related peptide (PTHrP) is associated with cancer cachexia by promoting adipose tissue browning, and we previously demonstrated that PTHrP predicts weight loss (WL) in patients with cancer. In this study, we investigated whether prediction of WL by PTHrP is influenced by clinical factors such as serum albumin, corrected calcium levels, cancer stage, and performance status (PS). Methods: A cohort of 219 patients with cancer whose PTHrP level was measured was enrolled and followed for body weight (BW) changes. Subjects were divided into two groups by serum albumin (cutoff value, 3.7 g/dL), corrected calcium (cutoff value, 10.5 mg/dL), cancer stage (stage 1 to 3 or 4), or PS (Eastern Cooperative Oncology Group 0 to 1 or 2 to 4), respectively. Clinically significant WL was defined as either percent of BW change (% BW) < -5% or % BW < -2% plus body mass index (BMI) < 20 kg/m 2 . Results: After a median follow-up of 327 days, 74 patients (33.8%) experienced clinically significant WL. A positive PTHrP level was associated with a 2-fold increased risk of WL after adjusting for age, baseline BMI, serum albumin, corrected calcium level, cancer stage, and PS. The effect of PTHrP on WL remained significant in patients with low serum albumin, stage 4 cancer, and good PS. Regardless of calcium level, the effect of PTHrP on WL was maintained, although there was an additive effect of higher calcium and PTHrP levels. Conclusion: Early recognition of patients with advanced cancer who are PTHrP positive with hypercalcemia or hypoalbuminemia is needed for their clinical management.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalEndocrinology and Metabolism
Volume33
Issue number1
DOIs
Publication statusPublished - 2018 Mar 1

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Parathyroid Hormone-Related Protein
Serum Albumin
Weight Loss
Calcium
Neoplasms
Parathyroid Neoplasms
Body Weight Changes
Body Mass Index
Body Weight
Hypoalbuminemia
Cachexia
Hypercalcemia
Adipose Tissue

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

@article{d957f01fbc674fad9139303db86bdadd,
title = "Effects of serum albumin, calcium levels, cancer stage and performance status on weight loss in parathyroid hormone-related peptide positive or negative patients with cancer",
abstract = "Background: A recent animal study showed that parathyroid hormone-related peptide (PTHrP) is associated with cancer cachexia by promoting adipose tissue browning, and we previously demonstrated that PTHrP predicts weight loss (WL) in patients with cancer. In this study, we investigated whether prediction of WL by PTHrP is influenced by clinical factors such as serum albumin, corrected calcium levels, cancer stage, and performance status (PS). Methods: A cohort of 219 patients with cancer whose PTHrP level was measured was enrolled and followed for body weight (BW) changes. Subjects were divided into two groups by serum albumin (cutoff value, 3.7 g/dL), corrected calcium (cutoff value, 10.5 mg/dL), cancer stage (stage 1 to 3 or 4), or PS (Eastern Cooperative Oncology Group 0 to 1 or 2 to 4), respectively. Clinically significant WL was defined as either percent of BW change ({\%} BW) < -5{\%} or {\%} BW < -2{\%} plus body mass index (BMI) < 20 kg/m 2 . Results: After a median follow-up of 327 days, 74 patients (33.8{\%}) experienced clinically significant WL. A positive PTHrP level was associated with a 2-fold increased risk of WL after adjusting for age, baseline BMI, serum albumin, corrected calcium level, cancer stage, and PS. The effect of PTHrP on WL remained significant in patients with low serum albumin, stage 4 cancer, and good PS. Regardless of calcium level, the effect of PTHrP on WL was maintained, although there was an additive effect of higher calcium and PTHrP levels. Conclusion: Early recognition of patients with advanced cancer who are PTHrP positive with hypercalcemia or hypoalbuminemia is needed for their clinical management.",
author = "Lee, {Ji Yeon} and Namki Hong and Kim, {Hye Ryun} and byungwan lee and Kang, {Eun Seok} and Cha, {Bong Soo} and Lee, {Yong Ho}",
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Effects of serum albumin, calcium levels, cancer stage and performance status on weight loss in parathyroid hormone-related peptide positive or negative patients with cancer. / Lee, Ji Yeon; Hong, Namki; Kim, Hye Ryun; lee, byungwan; Kang, Eun Seok; Cha, Bong Soo; Lee, Yong Ho.

In: Endocrinology and Metabolism, Vol. 33, No. 1, 01.03.2018, p. 97-104.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of serum albumin, calcium levels, cancer stage and performance status on weight loss in parathyroid hormone-related peptide positive or negative patients with cancer

AU - Lee, Ji Yeon

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AU - Kim, Hye Ryun

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AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lee, Yong Ho

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Y1 - 2018/3/1

N2 - Background: A recent animal study showed that parathyroid hormone-related peptide (PTHrP) is associated with cancer cachexia by promoting adipose tissue browning, and we previously demonstrated that PTHrP predicts weight loss (WL) in patients with cancer. In this study, we investigated whether prediction of WL by PTHrP is influenced by clinical factors such as serum albumin, corrected calcium levels, cancer stage, and performance status (PS). Methods: A cohort of 219 patients with cancer whose PTHrP level was measured was enrolled and followed for body weight (BW) changes. Subjects were divided into two groups by serum albumin (cutoff value, 3.7 g/dL), corrected calcium (cutoff value, 10.5 mg/dL), cancer stage (stage 1 to 3 or 4), or PS (Eastern Cooperative Oncology Group 0 to 1 or 2 to 4), respectively. Clinically significant WL was defined as either percent of BW change (% BW) < -5% or % BW < -2% plus body mass index (BMI) < 20 kg/m 2 . Results: After a median follow-up of 327 days, 74 patients (33.8%) experienced clinically significant WL. A positive PTHrP level was associated with a 2-fold increased risk of WL after adjusting for age, baseline BMI, serum albumin, corrected calcium level, cancer stage, and PS. The effect of PTHrP on WL remained significant in patients with low serum albumin, stage 4 cancer, and good PS. Regardless of calcium level, the effect of PTHrP on WL was maintained, although there was an additive effect of higher calcium and PTHrP levels. Conclusion: Early recognition of patients with advanced cancer who are PTHrP positive with hypercalcemia or hypoalbuminemia is needed for their clinical management.

AB - Background: A recent animal study showed that parathyroid hormone-related peptide (PTHrP) is associated with cancer cachexia by promoting adipose tissue browning, and we previously demonstrated that PTHrP predicts weight loss (WL) in patients with cancer. In this study, we investigated whether prediction of WL by PTHrP is influenced by clinical factors such as serum albumin, corrected calcium levels, cancer stage, and performance status (PS). Methods: A cohort of 219 patients with cancer whose PTHrP level was measured was enrolled and followed for body weight (BW) changes. Subjects were divided into two groups by serum albumin (cutoff value, 3.7 g/dL), corrected calcium (cutoff value, 10.5 mg/dL), cancer stage (stage 1 to 3 or 4), or PS (Eastern Cooperative Oncology Group 0 to 1 or 2 to 4), respectively. Clinically significant WL was defined as either percent of BW change (% BW) < -5% or % BW < -2% plus body mass index (BMI) < 20 kg/m 2 . Results: After a median follow-up of 327 days, 74 patients (33.8%) experienced clinically significant WL. A positive PTHrP level was associated with a 2-fold increased risk of WL after adjusting for age, baseline BMI, serum albumin, corrected calcium level, cancer stage, and PS. The effect of PTHrP on WL remained significant in patients with low serum albumin, stage 4 cancer, and good PS. Regardless of calcium level, the effect of PTHrP on WL was maintained, although there was an additive effect of higher calcium and PTHrP levels. Conclusion: Early recognition of patients with advanced cancer who are PTHrP positive with hypercalcemia or hypoalbuminemia is needed for their clinical management.

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