Fuoco Domenico, di Tomasso Jonathan, Boulos Caroline, Kilgour Robert D, Morais Jose A, Borod Manuel, Vigano Antonio
McGill Nutrition and Performance Laboratory, McGill University Health Centre, Montreal H4A 3S5, Canada ; Division of Supportive and Palliative Care Medicine, McGill University Health Centre, Montreal H4A 3S5, Canada.
Division of Supportive and Palliative Care Medicine, McGill University Health Centre, Montreal H4A 3S5, Canada.
Ecancermedicalscience. 2015 Aug 4;9:561. doi: 10.3332/ecancer.2015.561. eCollection 2015.
With the availability of a potential treatment to reverse male hypogonadism (MH), the primary aim of this case series study was to determine independent relationships between this condition and the nutritional, functional, and quality of life characteristics of advanced cancer patients (ACP). Free testosterone levels were measured in 100 male patients with advanced lung and gastrointestinal (GI) cancer. Routine blood markers of nutrition and inflammation, self-reporting questionnaires for symptom, nutrition, and functional status along with handgrip dynamometry were assessed for all patients at bedside. Almost half of this cohort underwent further assessments (body composition, lower body strength, in depth quality of life and fatigue questionnaires) at the McGill Nutrition and Performance Laboratory (mnupal.mcgill.ca). Multiple regression analyses were performed to identify independent correlations between free testosterone and the above measures. Seventy-six percent of patients were diagnosed with MH. Using multiple linear regression, low free testosterone (31.2 pmol/L) was independently associated with lower albumin (B = -3.8 g/L; 95% confidence interval CI -6.8:-0.8), muscle strength (-11.7 lbs; -20.4: -3.0) and mass in upper limbs (-0.8 kg; -1.4: -0.1), overall performance status (Eastern Cooperative Oncology Group Performance Scale, ECOG PS 0.6; 0.1:1.1), cancer-related fatigue (Brief Fatigue Inventory, BFI 16.7; 2.0: 31.3), and overall quality of life (MQoL total score -1.42; -2.5: -0.3). Thus MH seems to be highly prevalent in ACP, and it is independently associated with important nutritional, functional, and quality of life characteristics in this patient population.
随着一种可逆转男性性腺功能减退（MH）的潜在治疗方法的出现，本病例系列研究的主要目的是确定这种病症与晚期癌症患者（ACP）的营养、功能及生活质量特征之间的独立关系。对100例晚期肺癌和胃肠道（GI）癌男性患者测定了游离睾酮水平。在床边对所有患者评估了营养和炎症的常规血液指标、症状、营养及功能状态的自我报告问卷以及握力测定。该队列中近一半患者在麦吉尔营养与性能实验室（mnupal.mcgill.ca）接受了进一步评估（身体成分、下肢力量、深入的生活质量和疲劳问卷）。进行多元回归分析以确定游离睾酮与上述指标之间的独立相关性。76%的患者被诊断为MH。使用多元线性回归分析发现，低游离睾酮水平（31.2 pmol/L）与较低的白蛋白水平（B = -3.8 g/L；95%置信区间CI -6.8:-0.8）、肌肉力量（-11.7磅；-20.4: -3.0）、上肢肌肉量（-0.8千克；-1.4: -0.1）、总体表现状态（东部肿瘤协作组表现量表，ECOG PS 0.6；0.1:1.1）、癌症相关疲劳（简明疲劳量表，BFI 16.7；2.0: 31.3）以及总体生活质量（MQoL总分 -1.42；-2.5: -0.3）独立相关。因此，MH在ACP中似乎非常普遍，并且与该患者群体重要的营养、功能及生活质量特征独立相关。
