vitamin-b-12 and Cachexia

A high frequency of hypogonadism has been reported in male patients with advanced cancer. The current study was performed to evaluate the association between low testosterone levels, symptom burden, and survival in male patients with cancer.. Of 131 consecutive male patients with cancer, 119 (91%) had an endocrine evaluation of total (TT), free (FT), and bioavailable testosterone (BT); high-sensitivity C-reactive protein (CRP); vitamin B12; thyroid-stimulating hormone; 25-hydroxy vitamin D; and cortisol levels when presenting with symptoms of fatigue and/or anorexia-cachexia. Symptoms were evaluated by the Edmonton Symptom Assessment Scale. The authors examined the correlation using the Spearman test and survival with the log-rank test and Cox regression analysis.. The median age of the patients was 64 years; the majority of patients were white (85 patients; 71%). The median TT level was 209 ng/dL (normal: ≥ 200 ng/dL), the median FT was 4.4 ng/dL (normal: ≥ 9 ng/dL), and the median BT was 22.0 ng/dL (normal: ≥ 61 ng/dL). Low TT, FT, and BT values were all associated with worse fatigue (P ≤ .04), poor Eastern Cooperative Oncology Group performance status (P ≤ .05), weight loss (P ≤ .01), and opioid use (P ≤ .005). Low TT and FT were associated with increased anxiety (P ≤ .04), a decreased feeling of well-being (P ≤ .04), and increased dyspnea (P ≤ .05), whereas low BT was only found to be associated with anorexia (P = .05). Decreased TT, FT, and BT values were all found to be significantly associated with elevated CRP and low albumin and hemoglobin. On multivariate analysis, decreased survival was associated with low TT (hazards ratio [HR], 1.66; P = .034), declining Eastern Cooperative Oncology Group performance status (HR, 1.55; P = .004), high CRP (HR, 3.28; P < .001), and decreased albumin (HR, 2.52; P < .001).. In male patients with cancer, low testosterone levels were associated with systemic inflammation, weight loss, increased symptom burden, and decreased survival. A high frequency of hypogonadism has been reported in male patients with advanced cancer. In the current study, an increased symptom burden, systemic inflammation, weight loss, opioid use, and poor survival were found to be associated with decreased testosterone levels in male patients with cancer. Cancer 2014;120:1586-1593. © 2014 American Cancer Society.

Topics: Adult; Aged; Aged, 80 and over; Analgesics, Opioid; Androgens; Anorexia; Biomarkers; C-Reactive Protein; Cachexia; Cost of Illness; Hemoglobins; Humans; Hydrocortisone; Hypogonadism; Inflammation; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasms; Quality of Life; Retrospective Studies; Serum Albumin; Testosterone; Texas; Thyrotropin; Vitamin B 12; Vitamin D; Weight Loss

To compare vitamin B6 levels in rheumatoid arthritis (RA) patients and healthy control subjects.. We measured levels of vitamin B6 in 23 adults with well-controlled RA, and in 23 healthy control subjects matched for age, sex, race, and weight.. Although plasma folate and vitamin B12 concentrations and erythrocyte B6 activity coefficients were similar in the patients and controls, plasma levels of pyridoxal-5'-phosphate (PLP) were lower in the RA patient group (mean +/- SD 46.1 +/- 48.1 versus 69.3 +/- 58.4 nmoles/liter; P < 0.004). In multivariate analyses, PLP was inversely associated with tumor necrosis factor alpha (TNF alpha) production by peripheral blood mononuclear cells (PBMC) (P < 0.001), after adjustment for age, pain score, erythrocyte sedimentation rate, and use of nonsteroidal antiinflammatory drugs.. PLP levels are reduced in patients with RA. This reduction is associated with TNF alpha production by PBMC.

Topics: Adult; Aged; Arthritis, Rheumatoid; Cachexia; Cross-Sectional Studies; Diet; Endotoxins; Female; Folic Acid; Humans; Male; Middle Aged; Pyridoxal Phosphate; Pyridoxine; Tumor Necrosis Factor-alpha; Vitamin B 12

Topics: Adult; Aged; Anemia; Asthenia; Body Weight; Cachexia; Chronic Disease; Cytidine; Diabetes Complications; Female; Heart Diseases; Humans; Hyperthyroidism; Liver Diseases; Liver Extracts; Male; Middle Aged; Nucleosides; Uridine; Vitamin B 12

Topics: Blood Proteins; Cachexia; Chronic Disease; Humans; Kidney Diseases; Liver Diseases; Liver Extracts; Neoplasms; Vitamin B 12