Department of Medicine, University Health Network, Toronto, Ontario, Canada.
Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2022 Oct 6;17(10):e0275782. doi: 10.1371/journal.pone.0275782. eCollection 2022.
Lactate dehydrogenase (LDH) reflects tumor burden and is a prognosticator of all-cause mortality in patients with cancer. Objective measures of physical function are associated with clinically relevant outcomes in older adults with cancer. However, whether physical function is associated with LDH in geriatric oncology is unknown. The objective of this study was to assess the relationship between objective measures of physical function and serum LDH in older adults with cancer prior to treatment.
Data from older adults with cancer prior to treatment were retrieved from an institutional database and medical records within a tertiary cancer centre. Physical function measures involved muscle strength and physical performance. Muscle strength and physical performance were assessed through grip strength and the Short Physical Performance Battery (SPPB), respectively. LDH was log transformed using the natural logarithm. Multivariable logistic regression was used to examine the relationship between objective measures of physical function and LDH prior to treatment in all participants. Stratified analyses were performed for participants with solid and hematological cancers.
A total of 257 participants (mean age: 80.2y) were included in the analysis. Most participants were females (50.6%) and were diagnosed with locally advanced (26.8%), gastrointestinal disease (35.0%). The multivariable analysis indicated that SPPB was inversely associated with LDH in all participants (B = -0.019, 95%CI = -0.036 to -0.002, p = 0.028). Notably, the inverse relationship between SPPB and LDH persisted only in patients with hematological malignancies in the multivariable model of the stratified analysis (B = -0.049, 95%CI = -0.087 to -0.011, p = 0.013). Neither grip strength alone nor the combination of low grip strength and/or SPPB were associated with LDH. Compared to participants with metastatic disease, those with localized or locally advanced disease had lower serum LDH.
Physical performance is inversely associated with serum LDH in older adults with hematological cancers prior to treatment.
乳酸脱氢酶（LDH）反映肿瘤负荷，是癌症患者全因死亡率的预后指标。身体功能的客观测量与老年癌症患者的临床相关结局相关。然而，在老年肿瘤学中，身体功能是否与 LDH 相关尚不清楚。本研究旨在评估治疗前老年癌症患者的身体功能客观测量与血清 LDH 之间的关系。
从一家三级癌症中心的机构数据库和病历中检索到治疗前老年癌症患者的数据。身体功能测量包括肌肉力量和身体表现。肌肉力量和身体表现分别通过握力和简短身体表现电池（SPPB）评估。使用自然对数对 LDH 进行对数转换。多变量逻辑回归用于检查所有参与者治疗前身体功能客观测量与 LDH 之间的关系。对实体瘤和血液系统癌症患者进行分层分析。
共纳入 257 名参与者（平均年龄：80.2 岁）进行分析。大多数参与者为女性（50.6%），诊断为局部晚期（26.8%）、胃肠道疾病（35.0%）。多变量分析表明，SPPB 与所有参与者的 LDH 呈负相关（B=-0.019，95%CI=-0.036 至-0.002，p=0.028）。值得注意的是，仅在血液系统恶性肿瘤的分层分析多变量模型中，SPPB 与 LDH 之间的负相关关系仍然存在（B=-0.049，95%CI=-0.087 至-0.011，p=0.013）。握力本身或低握力和/或 SPPB 的组合均与 LDH 无关。与患有转移性疾病的参与者相比，患有局限性或局部晚期疾病的参与者的血清 LDH 较低。
治疗前血液系统癌症老年患者的身体表现与血清 LDH 呈负相关。
