TY - JOUR
T1 - Serum PTHrP predicts weight loss in cancer patients independent of hypercalcemia, inflammation, and tumor burden
AU - Hong, Namki
AU - Yoon, Hye Jin
AU - Lee, Yong Ho
AU - Kim, Hye Ryun
AU - Lee, Byung Wan
AU - Rhee, Yumie
AU - Kang, Eun Seok
AU - Cha, Bong Soo
AU - Lee, Hyun Chul
N1 - Publisher Copyright:
© 2016 by the Endocrine Society.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2016/3
Y1 - 2016/3
N2 - 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: We investigated whether serum PTHrP levels independently predicts weight loss (WL) in cancer patients. 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/m2) 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.Ahigher PTHrP level was associated with an increased loss of body weight (<=-2.73), muscle (<=-1.85), and fat (<=-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 BMIadjusted WL was applied. Conclusions: Serum PTHrP levels predicted cancer-associated WL independent of the presence of hypercalcemia, inflammation, tumor burden, and other comorbidities.
AB - 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: We investigated whether serum PTHrP levels independently predicts weight loss (WL) in cancer patients. 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/m2) 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.Ahigher PTHrP level was associated with an increased loss of body weight (<=-2.73), muscle (<=-1.85), and fat (<=-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 BMIadjusted WL was applied. Conclusions: Serum PTHrP levels predicted cancer-associated WL independent of the presence of hypercalcemia, inflammation, tumor burden, and other comorbidities.
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U2 - 10.1210/jc.2015-3785
DO - 10.1210/jc.2015-3785
M3 - Article
C2 - 26765580
AN - SCOPUS:84960910492
VL - 101
SP - 1207
EP - 1214
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 3
ER -