Low Testosterone Levels and Increased Inflammatory Markers in Patients with Cancer and Relationship with Cachexia
Low Testosterone Levels and Increased Inflammatory Markers in Patients with Cancer and Relationship with Cachexia
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DOI：
10.1210/jc.2011-2387
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发表时间：
2012-05-01
影响因子：
5.8
通讯作者：
Garcia, Jose M.
中科院分区：
文献类型：
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作者：
Burney, Basil O.;Hayes, Teresa G.;Garcia, Jose M.
背景：男性癌症患者患有疲劳、性功能障碍、功能表现和肌肉质量下降。这些症状常见于患有性腺功能减退和/或炎症的男性。然而，睾酮和炎症对癌症症状负担的相对贡献尚未明确。目的：本研究的目的是测量男性癌症患者的睾酮水平，并确定睾酮、炎症和症状负担之间的关系。设计/背景：这项横断面研究招募了来自三级医疗中心的患者。受试者/结果测量：受试者包括患有癌症恶病质的男性 （CC；n = 45）和无恶病质的癌症（CNC；n = 50），以及非癌症对照（CO；n = 45）。测量血浆中的总睾酮 (TT)、生物可利用睾酮、C 反应蛋白 (CRP) 和 IL-6。功能表现通过ECOG（东部肿瘤合作组）和KPS（卡诺夫斯基性能量表）进行评估，性功能通过IIEF（国际勃起功能指数）进行评估。结果：70%以上的CC病例中睾酮水平较低。 CC 中的 TT 低于 CNC（P < 0.05）。此外，与对照组相比，CC 的生物可利用睾酮、握力、IIEF 评分、四肢去脂体重和脂肪量较低，而 IL-6 和 CRP 较高（P
Context: Male cancer patients suffer from fatigue, sexual dysfunction, and decreased functional performance and muscle mass. These symptoms are seen in men with hypogonadism and/or inflammatory conditions. However, the relative contribution of testosterone and inflammation to symptom burden in cancer has not been well-established.Objective: The aim of this study was to measure testosterone levels in male cancer patients and determine the relationship between testosterone, inflammation, and symptom burden.Design/Setting: This cross-sectional study enrolled patients from a tertiary-care center.Subjects/Outcome Measures: Subjects included males with cancer-cachexia (CC; n = 45) and cancer without cachexia (CNC; n = 50), as well as noncancer controls (CO; n = 45). Total testosterone (TT), bioavailable testosterone, C-reactive protein (CRP), and IL-6 were measured in plasma. Functional performance was assessed by the ECOG (Eastern Cooperative Oncology Group) and KPS (Karnofsky Performance Scales), and sexual function was assessed by the IIEF (International Index of Erectile Function).Results: Low testosterone levels were seen in more than 70% of CC cases. TT was lower in CC compared to CNC(P < 0.05). Also, CC had lower bioavailable testosterone, grip strength, IIEF scores, appendicular lean body mass, and fat mass and higher IL-6 and CRP compared to controls (P