Effects of Serum Albumin, Calcium Levels, Cancer Stage and Performance Status on Weight Loss in Parathyroid Hormone-Related Peptide Positive or Negative Patients with Cancer

BACKGROUND: A recent animal study showed that parathyroid hormone-related peptide (PTHrP) is associated with cancer cachexia by promoting adipose tissue browning, and we previously demonstrated that PTHrP predicts weight loss (WL) in patients with cancer. In this study, we investigated whether prediction of WL by PTHrP is influenced by clinical factors such as serum albumin, corrected calcium levels, cancer stage, and performance status (PS). METHODS: A cohort of 219 patients with cancer whose PTHrP level was measured was enrolled and followed for body weight (BW) changes. Subjects were divided into two groups by serum albumin (cutoff value, 3.7 g/dL), corrected calcium (cutoff value, 10.5 mg/dL), cancer stage (stage 1 to 3 or 4), or PS (Eastern Cooperative Oncology Group 0 to 1 or 2 to 4), respectively. Clinically significant WL was defined as either percent of BW change (% BW) <−5% or % BW <−2% plus body mass index (BMI) < 20 kg/m². RESULTS: After a median follow-up of 327 days, 74 patients (33.8%) experienced clinically significant WL. A positive PTHrP level was associated with a 2-fold increased risk of WL after adjusting for age, baseline BMI, serum albumin, corrected calcium level, cancer stage, and PS. The effect of PTHrP on WL remained significant in patients with low serum albumin, stage 4 cancer, and good PS. Regardless of calcium level, the effect of PTHrP on WL was maintained, although there was an additive effect of higher calcium and PTHrP levels. CONCLUSION: Early recognition of patients with advanced cancer who are PTHrP positive with hypercalcemia or hypoalbuminemia is needed for their clinical management.

Hypercalcemia as Initial Presentation of Metastatic Adenocarcinoma of Gastric Origin: A Case Report and Review of the Literature

Hypercalcemia of malignancy due to metastatic gastric adenocarcinoma is extremely rare; in fact, to the best of our knowledge, only three case reports of hypercalcemia associated with metastatic gastric adenocarcinoma have been published in the literature to date. Herein, we report a rare case involving a 61-year-old African-American female who had hypercalcemia at initial presentation and who was later diagnosed with poorly differentiated gastric adenocarcinoma with extensive liver metastases, without bone involvement. She was found to have elevated parathyroid hormone-related peptide and normal parathyroid hormone levels. Despite aggressive treatment, she died within a few months of diagnosis.

Comparative Study of Serum Calcium and Magnesium in Pre-eclamptic Pregnancies in Third Trimester and its Comparison with Healthy Normotensive Nonpregnant and Pregnant Women and to Evaluate their role in Pregnancy-induced Hypertension.

Background: Despite numerous studies, the etiology of preeclampsia has not been fully elucidated. The study of serum calcium and serum magnesium is gaining ground in the pathophysiology of hypertension. Objective: A comparative study of serum calcium and serum magnesium in women with pre-eclamptic pregnancy and its comparison with healthy normotensive nonpregnant women and healthy normotensive pregnant women in third trimester. Materials and methods: Serum calcium and serum magnesium were measured in 52 women with pre-eclampsia in their trimester of pregnancy as patients group, and in 73 healthy normotensive nonpregnant women and 65 healthy normotensive pregnant women as control groups with similar maternal and gestational ages. Pre-eclamptic group was further divided into two subgroups mild (n = 36) and severe pre-eclampsia (n = 16). This is the case-control hospital based study carried in the Department of Biochemistry, MGM Medical College and associated MY Hospital, Indore, Madhya Pradesh. Results There were no significant differences among the three groups in age and body mass index (BMI) (p > 0.05) but significantly higher differences in gestational age, systolic and diastolic blood pressure was observed (p < 0.001). When comparison of serum calcium and serum magnesium between healthy normotensive nonpregnant women (9.87 ± 0.6 mg/dl, 2.60 ± 0.3 mg/dl) and healthy normotensive pregnant women was done, the levels were lower in the healthy normotensive pregnant women (9.34 ± 0.49 mg/dl, 2.36 ± 0.13 mg/dl) with statistically higher significant difference (p < 0.001). Lower mean values of serum calcium and serum magnesium were found in pre-eclamptic women (8.82 ± 0.93 mg/dl, 1.74 ± 0.24 mg/dl) than those of healthy normotensive nonpregnant women (9.87 ± 0.6 mg/dl, 2.60 ± 0.3 mg/dl) and healthy normotensive pregnant women (9.34 ± 0.49 mg/dl, 2.36 ± 0.13 mg/dl) in third trimester with statistically higher significant differences (p < 0.001). As compare to mild pre-eclamptic pregnant women (9.07 ± 0.8 mg/ dl, 1.77 ± 0.24 mg/dl), the levels of serum calcium and serum magnesium in severe pre-eclamptic pregnant women (8.25 ± 0.97 mg/dl 1.65 ± 0.24 mg/dl) was lower and the difference was significantly higher (p < 0.001). Conclusion: These findings support the hypothesis that hypocalcemia and hypomagnesemia are possible etiologies of pre-eclampsia and levels of calcium may be more important than magnesium.

The research progress of parathyroid hormone and parathry oid hormone-related peptide in skin dies ase / 药学实践杂志

Parathyroid hormone/parathyroid hormone-related peptides are polypeptide hormones. They have similar gene struc-ture and same membrane receptor .They play great roles in regulating the calcium and phosphorus metabolism in vivo.PTH/PTHrP and their receptors are expressed in tissues of tumor ,skin, hair follicle and other normal tissues .Because of their physiological action on the proliferation and differentiation of epidermis and hair growth ,they may be a potential therapeutic target for some skin diseases including psoriasis.

Parathyroid hormone related peptide and tumor / 国际肿瘤学杂志

The parathyroid hormone related peptide (PTHrP) participates in regulating calcium and phosphorus metabolism and multiple organ growth,and plays an important role in the processes of malignant tumor bone metastasis and hypercalcemia.Currently,more and more researches have confirmed that PTHrP can be secreted by a variety of types of tumor cells.PTHrP participates in regulating tumor cell proliferation and invasion,and it is closely related to the prognosis of patients,which provides a new target of cancer treatment.

Role of parathyroid hormone-related peptide in transdifferentiation of NRK-52E cells induced by high glucose / 第三军医大学学报

Objective To study the role of parathyroid hormone-related peptide ( PTHrP) in transdif-ferentiation of NRK-52E cells induced by high glucose. Methods Expression of PTHrP and its receptor 1 in NRK-52E cells incubated with 0 ( control group) ,5 ( normal glucose group) and 16. 7mmol/L glucose ( high glucose group) ,respectively,was detected by RT-PCR and Western blotting,respectively. Expression of TGF-?1,MMP2,type Ⅰ collagen and ?-SMA in NRK-52E cells of normal and high glucose groups was detected by Western blotting and ROS was detected by CM2H2DCFDA after 72 h. Results The expression levels of PTHrP,PTHrP receptor 1 ( PTH1R) ,and PTHrP mRNA were higher in high glucose group than in control and normal glucose groups ( P

Effect of simvastatin on PTHrP stimulated osteoclastic resorption and anabolism of murine calvarium / 实用口腔医学杂志

Objective:To study the effect of simvastatin on PTHrP stimulated osteoclastic resorption of murine calvarium and bone anabolism in vitro. Methods:Osteoclasts were isolated from bone marrow of Balb/C mice,cultured and identified.Calvaria of the new born Balb/C mice were cultured with PTHrP at 45 ng/ml and/or simvastatin at 10~ -7 -10~ -5 mol/L for 8 d.Ca~ 2+ and ALP in the culture supernatent were measured by atom spectrophotometer and automatic biochemical analyzer respectively.The bones were examined histologically.Results:Simvastatin at 10~ -7 -10~ -5 mol/L inhibited osteoclast formation and the osteoclastic bone resorption stimulated by PTHrP in vitro and reduced the release of Ca~ 2+ from the cultured osteoclasts in a dose-dependent manner. Simvastatin increased the ALP activities and bone mineralization of murines calvaria cultured in vitro. Conclusions:Simvastatin may inhibit the osteoclasric resorption stimulated by PTHrP and promote bone mineralization in vitro.