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. 2016 Mar 8:15:47.
doi: 10.1186/s12944-016-0212-9.

Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels

Affiliations

Opioid doses required for pain management in lung cancer patients with different cholesterol levels: negative correlation between opioid doses and cholesterol levels

Zhenhua Huang et al. Lipids Health Dis. .

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.

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Figures

Fig. 1
Fig. 1
There is correlation between BMI and serum cholesterol level. a The distribution of ages of current 282 patients. The percentages of patients in each age range were plotted. b The distribution of serum total cholesterol levels of current 282 patients. The percentages of patients in each cholesterol range were plotted. c-d The correlation between serum cholesterol levels (y-axis) and ages (x-axis) was calculated with Pearson test in female (a) and male (b). e-f The correlation between BMIs (y-axis) and ages (x-axis) was calculated with Pearson test in female (c) and male (d). g-h The correlation between BMIs (y-axis) and serum cholesterol levels (x-axis) was calculated with Pearson test in female (e) and male (f)
Fig. 2
Fig. 2
Low cholesterol patients are more likely to require higher doses of opioids. a-b Patients were classified into three groups, low, medium and high cholesterol groups, depending on serum total cholesterol levels. The average of serum total cholesterol levels and patients number were listed below x-axis. There were significant differences between high and low cholesterol groups in both female (a) and male (b). (c-f) The final doses of morphine and fentanyl used for patients were converted into oxycodone doses, and were plotted with serum cholesterol level (c-d) and age (e-f). Data for female and male were plotted in (c & e) and (d & f)

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