title: Preliminary report: vitamin D deficiency in advanced cancer patients with symptoms of fatigue or anorexia.
abstract: BACKGROUND
  Vitamin D deficiency in noncancer patients is associated with symptoms of fatigue, muscle weakness, and depression. These symptoms are common among advanced cancer patients. We investigated the prevalence of low serum vitamin D levels in cancer patients with fatigue or poor appetite and their association with symptom burden and other correctable endocrine abnormalities.
  
  
  METHODS
  This was a retrospective review of 100 consecutive cancer patients with appetite or fatigue scores of ≥4 of 10 referred to a supportive care clinic. We investigated serum levels of 25(OH) vitamin D, cortisol, thyroid-stimulating hormone, and bioavailable testosterone. Symptoms were measured by the Edmonton Symptom Assessment Scale. Serum 25(OH) vitamin D <20 ng/mL was considered deficient; ≥20 ng/mL and <30 ng/mL were considered insufficient.
  
  
  RESULTS
  Patients were predominantly male (68%) and white (66%), with a median age of 60 years (range, 27-91 years). Gastrointestinal (30%) and lung (22%) cancers were predominant. Forty-seven patients (47%) were vitamin D deficient and 70 (70%) were insufficient. Thirteen of 70 patients (19%) with vitamin D insufficiency were on supplementation. Vitamin D deficiency was more common among nonwhites (82% versus 36%) and females. No significant association was found between vitamin D and symptoms. Hypogonadic males had a significantly lower mean 25(OH) vitamin D level than eugonadic males.
  
  
  CONCLUSIONS
  Low vitamin D levels were highly prevalent among advanced cancer patients with cachexia or fatigue. Vitamin D deficiency was more frequent among nonwhite and female patients. Vitamin D levels were also significantly lower in male patients with hypogonadism.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. rdev@mdanderson.org
authors.forename: Rony
authors.initials: R
authors.lastname: Dev
authors.forename: Egidio
authors.initials: E
authors.lastname: Del Fabbro
authors.forename: Gary G
authors.initials: GG
authors.lastname: Schwartz
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.forename: Shana L
authors.initials: SL
authors.lastname: Palla
authors.forename: Noah
authors.initials: N
authors.lastname: Gutierrez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000097:blood* / Q000209:etiology; D005221:Fatigue / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000150:complications; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood / Q000378:metabolism; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism; D014807:Vitamin D / Q000097:blood* / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000097:blood*; D055815:Young Adult
chemical_list: D014807:Vitamin D; D013739:Testosterone; D013972:Thyrotropin; D006854:Hydrocortisone