Klasson Caritha, Helde Frankling Maria, Warnqvist Anna, Sandberg Carina, Nordström Marie, Lundh-Hagelin Carina, Björkhem-Bergman Linda
Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo Floor 7, SE-141 83 Huddinge, Sweden.
Theme Cancer, Thoracic Oncology Center, Karolinska University Hospital, Solna, SE-171 64 Stockholm, Sweden.
Cancers (Basel). 2022 Jan 31;14(3):746. doi: 10.3390/cancers14030746.
In the randomized, placebo-controlled, double-blind trial 'Palliative-D', vitamin D treatment of 4000 IE/day for 12 weeks reduced opioid use and fatigue in vitamin-D-deficient cancer patients. In screening data from this trial, lower levels of vitamin D were associated with more fatigue in men but not in women. The aim of the present study was to investigate possible sex differences in the effect of vitamin D in patients with advanced cancer, with a specific focus on fatigue. A post hoc analysis of sex differences in patients completing the Palliative-D study ( = 150) was performed. Fatigue assessed with the Edmonton Symptom Assessment Scale (ESAS) was reduced in vitamin-D-treated men; -1.50 ESAS points (95%CI -2.57 to -0.43; = 0.007) but not in women; -0.75 (95%CI -1.85 to 0.36; = 0.18). Fatigue measured with EORTC QLQ-C15-PAL had a borderline significant effect in men (-0.33 (95%CI -0.67 to 0.03; = 0.05)) but not in women ( = 0.55). The effect on fatigue measured with ESAS in men remained the same after adjustment for opioid doses ( = 0.01). In conclusion, the positive effect of the correction of vitamin D deficiency on fatigue may be more pronounced in men than in women. However, studies focused on analyzing sex differences in this context must be performed before firm conclusions can be drawn.
在随机、安慰剂对照、双盲试验“Palliative-D”中，维生素D缺乏的癌症患者每日服用4000国际单位，持续12周，可减少阿片类药物的使用并缓解疲劳。在该试验的筛查数据中，维生素D水平较低与男性疲劳程度较高相关，而与女性无关。本研究的目的是调查晚期癌症患者中维生素D作用的可能性别差异，特别关注疲劳情况。对完成Palliative-D研究的患者（n = 150）进行了性别差异的事后分析。用埃德蒙顿症状评估量表（ESAS）评估的疲劳在接受维生素D治疗的男性中有所减轻；降低了1.50个ESAS评分点（95%CI -2.57至-0.43；P = 0.007），而在女性中未减轻；降低了0.75个评分点（95%CI -1.85至0.36；P = 0.18）。用欧洲癌症研究与治疗组织生活质量问卷C15-PAL评估的疲劳在男性中有临界显著效果（-0.33（95%CI -0.67至0.03；P = 0.05）），而在女性中无此效果（P = 0.55）。调整阿片类药物剂量后，男性中用ESAS测量的疲劳效果保持不变（P = 0.01）。总之，纠正维生素D缺乏对疲劳的积极作用在男性中可能比在女性中更明显。然而，在得出确切结论之前，必须进行专注于分析这种情况下性别差异 的研究。
