title: Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels.
abstract: BACKGROUND
  Pain management has been considered as significant contributor to broad quality-of-life improvement for cancer patients. Modulating serum cholesterol levels affects analgesia abilities of opioids, important pain killer for cancer patients, in mice system. Thus the correlation between opioids usages and cholesterol levels were investigated in human patients with lung cancer.
  
  
  METHODS
  Medical records of 282 patients were selected with following criteria, 1) signed inform consent, 2) full medical records on total serum cholesterol levels and opioid administration, 3) opioid-naïve, 4) not received/receiving cancer-related or cholesterol lowering treatment, 5) pain level at level 5-8. The patients were divided into different groups basing on their gender and cholesterol levels. Since different opioids, morphine, oxycodone, and fentanyl, were all administrated at fixed low dose initially and increased gradually only if pain was not controlled, the percentages of patients in each group who did not respond to the initial doses of opioids and required higher doses for pain management were determined and compared.
  
  
  RESULTS
  Patients with relative low cholesterol levels have larger percentage (11 out of 28 in female and 31 out of 71 in male) to not respond to the initial dose of opioids than those with high cholesterol levels (0 out of 258 in female and 8 out of 74 in male). Similar differences were obtained when patients with different opioids were analyzed separately. After converting the doses of different opioids to equivalent doses of oxycodone, significant correlation between opioid usages and cholesterol levels was also observed.
  
  
  CONCLUSIONS
  Therefore, more attention should be taken to those cancer patients with low cholesterol levels because they may require higher doses of opioids as pain killer.
authors.affiliation: Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China. welstan7@163.com.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Huang
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. Liang_lining@gibh.ac.cn.
authors.forename: Lining
authors.initials: L
authors.lastname: Liang
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. lingyuli2013@163.com.|Anhui University, Hefei, 230601, China. lingyuli2013@163.com.
authors.forename: Lingyu
authors.initials: L
authors.lastname: Li
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, #651 Dongfeng East Ave, Guangzhou, 510060, China. xumiao@sysucc.org.cn.
authors.forename: Miao
authors.initials: M
authors.lastname: Xu
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. Li_xiang@gibh.ac.cn.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. sun_hao@gibh.ac.cn.
authors.forename: Hao
authors.initials: H
authors.lastname: Sun
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. he_songwei@gibh.ac.cn.
authors.forename: Songwei
authors.initials: S
authors.lastname: He
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. Lin_lilong@gibh.ac.cn.
authors.forename: Lilong
authors.initials: L
authors.lastname: Lin
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. Zhang_yixin@gibh.ac.cn.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: The third hospital, Southern Medical University, #183 Zhongshan Ave. E, Guangzhou, 510665, China. songyancheng@21cn.com.
authors.forename: Yancheng
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Neurology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China. yangman80@163.com.
authors.forename: Man
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China. 791278620@qq.com.
authors.forename: Yuling
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, 6-120 Jackson Hall, 321 Church St. SE, Minneapolis, MN, 55455, USA. Lohxx001@umn.edu.
authors.forename: Horace H
authors.initials: HH
authors.lastname: Loh
authors.affiliation: Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, 6-120 Jackson Hall, 321 Church St. SE, Minneapolis, MN, 55455, USA. Lawxx001@umn.edu.
authors.forename: Ping-Yee
authors.initials: PY
authors.lastname: Law
authors.affiliation: Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China. zhengdayong@hotmail.com.
authors.forename: Dayong
authors.initials: D
authors.lastname: Zheng
authors.affiliation: CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, A-131, #190 Kaiyuan Ave, Guangzhou, 510530, China. zheng_hui@gibh.ac.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D002784:Cholesterol; D010098:Oxycodone; D005283:Fentanyl