Serum PTHrP predicts weight loss in cancer patients independent of hypercalcemia, inflammation, and tumor burden

Abstract

Context: Recent animal studies showed that tumor-derived PTHrP induced cancer cachexia by fat browning with increased energy expenditure; however, clinical evidence from human data is insufficient. Objective: We investigated whether serum PTHrP levels independently predicts weight loss (WL) in cancer patients. Design, Setting, and Patients: From a longitudinal observational cohort, body mass index (BMI) of patients with measured serum PTHrP levels (n = 624) was assessed (median follow-up of 327 d). Main Outcome Measures: Cox hazard models were used to examine the predictive value of PTHrP for WL defined by consensus definition (WL [consensus], percentage WL < 20 kg/m2) and by BMI-adjusted grades (WL [BMI adjusted]). Results: The overall risk of WL (consensus) was 34.4%. Compared with PTHrP-negative subjects, patients with higher PTHrP levels (PTHrP = median 5.7 pmol/L) had more WL (percentage WL,-6.9% vs-1.1%, P=.010) at follow-up.Ahigher PTHrP level was associated with an increased loss of body weight (