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

Namki Hong, Hye Jin Yoon, Yong Ho Lee, Hye Ryun Kim, Byung Wan Lee, Yumie Rhee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


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 <-5% or percentage WL <-2% plus BMI < 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 (<=-2.73), muscle (<=-1.85), and fat (<=-2.52) after controlling for age, sex, and BMI. Kaplan-Meier analysis demonstrated that subjects with higher PTHrP had increased WL risk compared with lower PTHrP or PTHrP-negative groups (52.0% vs 38.9% vs 29.7%, P <.001). Serum PTHrP was independently associated with an increased WL risk (hazard ratio [HR]1.23, P =.005) adjusted for potent predictors including serum levels of calcium, C-reactive protein, albumin, cancer stage, and performance status of patients. Consistent results were observed when BMIadjusted WL was applied. Conclusions: Serum PTHrP levels predicted cancer-associated WL independent of the presence of hypercalcemia, inflammation, tumor burden, and other comorbidities.

Original languageEnglish
Pages (from-to)1207-1214
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
Publication statusPublished - 2016 Mar

Bibliographical note

Publisher Copyright:
© 2016 by the Endocrine Society.

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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