Effect of cachexia on bone turnover in cancer patients: a case-control study

Autor:	Josef Seier, Martin Pecherstorfer, Hannes Zwickl, Klaus Hackner, Sonia Vallet, Elisabeth Zwickl-Traxler, Nico Jacobi, Klaus Podar, Michael Weber, Alexander Haushofer
Rok vydání:	2021
Předmět:	Male Cancer Research medicine.medical_specialty Bone turnover Cachexia 030209 endocrinology & metabolism Osteocalcin (Ocn) Gastroenterology Bone resorption Procollagen type I N-terminal propeptide (PINP) Bone remodeling 03 medical and health sciences 0302 clinical medicine N-terminal telopeptide Weight loss Internal medicine Neoplasms Genetics medicine Humans Hypoalbuminemia RC254-282 biology Carboxy terminal telopeptide of collagen type I (CTX) business.industry Research Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cancer Middle Aged medicine.disease Cross-Sectional Studies Oncology 030220 oncology & carcinogenesis Case-Control Studies Osteocalcin biology.protein Bone Remodeling medicine.symptom business CRP
Zdroj:	BMC Cancer BMC Cancer, Vol 21, Iss 1, Pp 1-9 (2021)
ISSN:	1471-2407
Popis:	Background Increased bone turnover is frequently observed in advanced cancer and predominantly related to bone metastases or therapy. Cachexia represents an important cause of morbidity and mortality in cancer patients. Key features are weight loss, muscle wasting and chronic inflammation, which induce profound metabolic changes in several organs, including the bone. However, whether cachexia contributes to abnormal bone metabolism in cancer patients is unknown. Aim of the present study was to determine the potential correlation of bone turnover markers with body composition and laboratory parameters in treatment-naïve cancer patients. Methods In this cross-sectional study we measured the levels of carboxy terminal telopeptide of collagen (CTX), an indicator of bone resorption, as well as osteocalcin (Ocn) and procollagen type I N-terminal propeptide (PINP), indicators of bone formation, in 52 cancer patients and correlated with body composition and laboratory parameters. Univariate and multivariate logistic analysis were performed to identify determinants of negative bone remodeling balance, estimated by CTX/Ocn and CTX/PINP ratio. Results Based on weight loss, body mass index and muscle mass, patients were divided into a cachectic (59.6%) and a control (40.4%) group. After correcting for the presence of bone metastases, our results showed a significant upregulation of CTX in cachectic patients compared to non-cachectic cancer patients (median 0.38 vs 0.27 ng/mL, p p = 0.2 and median 32 vs. 26 μg/L, p = 0.5, respectively). In addition, the CTX/Ocn and the CTX/PINP ratio were indicative of bone resorption in 68% and 60% of cachexia patients, respectively (vs. 20% and 31% in the control group, p = 0.002 and p = 0.06). The main determinants of the unbalanced bone turnover were hypoalbuminemia for the CTX/Ocn ratio (OR 19.8, p < 0.01) and high CRP for the CTX/PINP ratio (OR 5.3, p < 0.01) in the multivariate regression analysis. Conclusions CTX is substantially higher in cachectic patients compared to non-cachectic oncological patients and hypoalbuminemia as well as elevated CRP concentrations are independent predictors of a negative bone remodeling balance in cancer patients. These results strongly indicate that cachexia correlates with exacerbated bone turnover in cancer.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::83bd56f173bfb66a894ad61ccd9ccb65 https://pubmed.ncbi.nlm.nih.gov/34182958 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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