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Quality of life and stimulation of weight gain after treatment with megestrol acetate: correlation between cytokine levels and nutritional status, appetite in geriatric patients with wasting syndrome.
J Nutr Health Aging. 2000; 4(4):246-51.JN

Abstract

BACKGROUND

The geriatric wasting syndrome (GWS) has been associated with proinflammatory cytokines, depression and progressive decline in quality of life (QOL). The objective of this study was to evaluate the correlation between the changes in cytokine levels and appetite, nutritional markers, and QOL in geriatric patients with GWS following a randomized clinical trial of megestrol acetate (MA) versus placebo.

METHODS

This was a prospective, double-blind, placebo-controlled trial. We evaluated 69 predominantly male (3 females) nursing home residents with weight loss of > or =5% of their usual body weight over the past three months or body weight 20% below their ideal body weight. Patients were randomly assigned to receive either placebo or megestrol acetate (MA) oral suspension (O.S.) 800 mg/day for 12 weeks and were then followed for 13 weeks off treatment. Data on appetite, weight, nutritional status, QOL and cytokine levels were collected at baseline and week 12. The correlation between appetite, weight, nutritional status, sense of well being and cytokine level changes in response to MA treatment was examined at week 12.

RESULTS

Appetite, sense of well being, and QOL assessed by an "enjoyment list" significantly improved in the MA arm. Rising prealbumin showed a negative correlation with decreasing IL-6 (r = -0.51), TNFR-p 55 (r = -0.49) and sIL-2R (r = -0.38). There was also an improvement in prealbumin and a decrease in IL-6 and TNFR-p55 in the MA-arm (p < 0.01). A correlation between a decrease in the IL-6 levels and improvement in depression (r = 0.50) was seen in the MA arm as well. Improvement in appetite positively correlated with increased enjoyment of life (r = -0.41), less depression (r = -0.34), improved sense of well being (r = 0.36), prealbumin gain (r = 0.30), and weight gain (r = 0.38) by 12 weeks. Also, improvement in appetite positively correlated with improvement in nutritional parameters such as prealbumin, albumin, fat free mass and weight in the MA arm.

CONCLUSIONS

In a geriatric nursing home population with weight loss, reduction in cytokine levels after MA treatment correlates with improvement in appetite, prealbumin, albumin, and improvement in quality of life.

Authors+Show Affiliations

Geriatric Division, Department of Medicien, VAMC at Northport, New York 11768-2290, USA. Shing-shing.Yeh @med.VA.GOVNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11115810

Citation

Yeh, S, et al. "Quality of Life and Stimulation of Weight Gain After Treatment With Megestrol Acetate: Correlation Between Cytokine Levels and Nutritional Status, Appetite in Geriatric Patients With Wasting Syndrome." The Journal of Nutrition, Health & Aging, vol. 4, no. 4, 2000, pp. 246-51.
Yeh S, Wu SY, Levine DM, et al. Quality of life and stimulation of weight gain after treatment with megestrol acetate: correlation between cytokine levels and nutritional status, appetite in geriatric patients with wasting syndrome. J Nutr Health Aging. 2000;4(4):246-51.
Yeh, S., Wu, S. Y., Levine, D. M., Parker, T. S., Olson, J. S., Stevens, M. R., & Schuster, M. W. (2000). Quality of life and stimulation of weight gain after treatment with megestrol acetate: correlation between cytokine levels and nutritional status, appetite in geriatric patients with wasting syndrome. The Journal of Nutrition, Health & Aging, 4(4), 246-51.
Yeh S, et al. Quality of Life and Stimulation of Weight Gain After Treatment With Megestrol Acetate: Correlation Between Cytokine Levels and Nutritional Status, Appetite in Geriatric Patients With Wasting Syndrome. J Nutr Health Aging. 2000;4(4):246-51. PubMed PMID: 11115810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of life and stimulation of weight gain after treatment with megestrol acetate: correlation between cytokine levels and nutritional status, appetite in geriatric patients with wasting syndrome. AU - Yeh,S, AU - Wu,S Y, AU - Levine,D M, AU - Parker,T S, AU - Olson,J S, AU - Stevens,M R, AU - Schuster,M W, PY - 2000/12/15/pubmed PY - 2001/6/29/medline PY - 2000/12/15/entrez SP - 246 EP - 51 JF - The journal of nutrition, health & aging JO - J Nutr Health Aging VL - 4 IS - 4 N2 - BACKGROUND: The geriatric wasting syndrome (GWS) has been associated with proinflammatory cytokines, depression and progressive decline in quality of life (QOL). The objective of this study was to evaluate the correlation between the changes in cytokine levels and appetite, nutritional markers, and QOL in geriatric patients with GWS following a randomized clinical trial of megestrol acetate (MA) versus placebo. METHODS: This was a prospective, double-blind, placebo-controlled trial. We evaluated 69 predominantly male (3 females) nursing home residents with weight loss of > or =5% of their usual body weight over the past three months or body weight 20% below their ideal body weight. Patients were randomly assigned to receive either placebo or megestrol acetate (MA) oral suspension (O.S.) 800 mg/day for 12 weeks and were then followed for 13 weeks off treatment. Data on appetite, weight, nutritional status, QOL and cytokine levels were collected at baseline and week 12. The correlation between appetite, weight, nutritional status, sense of well being and cytokine level changes in response to MA treatment was examined at week 12. RESULTS: Appetite, sense of well being, and QOL assessed by an "enjoyment list" significantly improved in the MA arm. Rising prealbumin showed a negative correlation with decreasing IL-6 (r = -0.51), TNFR-p 55 (r = -0.49) and sIL-2R (r = -0.38). There was also an improvement in prealbumin and a decrease in IL-6 and TNFR-p55 in the MA-arm (p < 0.01). A correlation between a decrease in the IL-6 levels and improvement in depression (r = 0.50) was seen in the MA arm as well. Improvement in appetite positively correlated with increased enjoyment of life (r = -0.41), less depression (r = -0.34), improved sense of well being (r = 0.36), prealbumin gain (r = 0.30), and weight gain (r = 0.38) by 12 weeks. Also, improvement in appetite positively correlated with improvement in nutritional parameters such as prealbumin, albumin, fat free mass and weight in the MA arm. CONCLUSIONS: In a geriatric nursing home population with weight loss, reduction in cytokine levels after MA treatment correlates with improvement in appetite, prealbumin, albumin, and improvement in quality of life. SN - 1279-7707 UR - https://www.unboundmedicine.com/medline/citation/11115810/Quality_of_life_and_stimulation_of_weight_gain_after_treatment_with_megestrol_acetate:_correlation_between_cytokine_levels_and_nutritional_status_appetite_in_geriatric_patients_with_wasting_syndrome_ DB - PRIME DP - Unbound Medicine ER -