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Lunde S, Nguyen HT, Petersen KK, Arendt-Nielsen L, Krarup HB, Søgaard-Andersen E. Chronic Postoperative Pain After Hysterectomy for Endometrial Cancer: A Metabolic Profiling Study. Mol Pain 2020; 16:1744806920923885. [PMID: 32375547 PMCID: PMC7227146 DOI: 10.1177/1744806920923885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION One out of seven women will develop a state of chronic postoperative pain following robot-assisted hysterectomy for endometrial cancer. Recently, metabolic studies have indicated that circulating lipids and lipoproteins could act as nociceptive modulators and thereby influence the induction and perpetuation of pain. The objectives of this explorative study were (1) to examine the preoperative serologic variations in concentrations of lipids, lipoproteins, and various low-molecular metabolites in patients with and without chronic postoperative pain after robot-assisted hysterectomy and (2) to explore if any of these serological biomarkers were predictive for development of chronic postoperative pain. MATERIALS AND METHODS The study was designed as a nested case-control study within a cohort of women treated for endometrial cancer with robot-assisted laparoscopic hysterectomy. Twenty-six women with chronic postoperative pain were matched on age and body mass index with fifty-two controls without chronic postoperative pain, and metabolic profiling of preoperatively drawn blood samples from a biobank was performed by means of nuclear magnetic resonance spectroscopy. RESULTS Nineteen metabolites, including cholesterol, cholesteryl ester, linoleic acid, phospholipids, lipids, and triglycerides had statistically significant higher concentrations in a subgroup of patients who would develop chronic postoperative pain on a later stage compared to the group of patients who would not develop chronic postoperative pain (p < 0.05). A sparse Partial Least Squares-Discriminant Analysis model explained 38.1% of the variance and had a predictive accuracy of 73.1%. CONCLUSIONS This explorative study substantiates the hypothesis that certain lipids, lipoproteins, and fatty acids are associated with chronic postoperative pain.
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Affiliation(s)
- Søren Lunde
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - Hien Tt Nguyen
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | - Kristian K Petersen
- Center for Sensory-Motor Interaction, Center for Neuroplasticity and Pain, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction, Center for Neuroplasticity and Pain, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Henrik B Krarup
- Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | - Erik Søgaard-Andersen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
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Huang Z, Liang L, Li L, Xu M, Li X, Sun H, He S, Lin L, Zhang Y, Song Y, Yang M, Luo Y, Loh HH, Law PY, Zheng D, Zheng H. Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels. Lipids Health Dis 2016; 15:47. [PMID: 26952011 PMCID: PMC4782347 DOI: 10.1186/s12944-016-0212-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/24/2016] [Indexed: 02/01/2023] Open
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. Electronic supplementary material The online version of this article (doi:10.1186/s12944-016-0212-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhenhua Huang
- Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China.
| | - Lining Liang
- 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.
| | - Lingyu Li
- 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. .,Anhui University, Hefei, 230601, China.
| | - Miao Xu
- 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.
| | - Xiang Li
- 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.
| | - Hao Sun
- 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.
| | - Songwei He
- 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.
| | - Lilong Lin
- 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.
| | - Yixin Zhang
- 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.
| | - Yancheng Song
- The third hospital, Southern Medical University, #183 Zhongshan Ave. E, Guangzhou, 510665, China.
| | - Man Yang
- Department of Neurology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China.
| | - Yuling Luo
- Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China.
| | - Horace H Loh
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, 6-120 Jackson Hall, 321 Church St. SE, Minneapolis, MN, 55455, USA.
| | - Ping-Yee Law
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, 6-120 Jackson Hall, 321 Church St. SE, Minneapolis, MN, 55455, USA.
| | - Dayong Zheng
- Department of Oncology, Nanfang Hospital, Southern Medical University, #1838 Guangzhou Ave. N, Guangzhou, 510515, China.
| | - Hui Zheng
- 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.
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