Table 4.
Associations between cancer-related symptoms, health-related quality of life (HRQOL) and c-reactive protein (CRP)
| CRP, mg/L | |||||
|---|---|---|---|---|---|
| Overall | Lowest tertile | Middle tertile | Highest tertile | ||
| N=661 | N=223 | N=220 | N=218 | ||
| Cancer-related symptoms | Mean (SD) | P trend1 | |||
| Chest wall symptom (Scored 0–4) | |||||
| Unadjusted mean | 0.97 (0.82) | 0.92 (0.76) | 0.92 (0.82) | 1.08 (0.88) | |
| Adjusted mean (Model 1) | 0.98 | 1.02 | 1.16 a | 0.03 | |
| Adjusted mean (Model 1 + BMI) | 0.99 | 1.02 | 1.15 | 0.06 | |
| Arm symptom (scored 0–4) | |||||
| Unadjusted mean | 0.82 (0.87) | 0.74 (0.78) | 0.78 (0.83) | 0.91 (1.04) | |
| Adjusted mean (Model 1) | 0.93 | 0.97 | 1.09 | 0.053 | |
| Adjusted mean (Model 1 + BMI) | 0.96 | 0.98 | 1.06 | 0.27 | |
| Urinary incontinence (scored 0–4) | |||||
| Unadjusted mean | 0.90 (1.03) | 0.77 (0.92) | 0.91 (1.04) | 1.03 (1.12) | |
| Adjusted mean (Model 1) | 1.07 | 1.14 | 1.31 a | 0.02 | |
| Adjusted mean (Model 1 + BMI) | 1.12 | 1.15 | 1.27 | 0.19 | |
| Vasomotor symptoms | |||||
| Unadjusted mean | 1.63 (1.11) | 1.62 (1.05) | 1.65 (1.16) | 1.61 (1.12) | |
| Adjusted mean (Model 1) | 1.79 | 1.84 | 1.81 | 0.84 | |
| Adjusted mean (Model 1 + BMI) | 1.77 | 1.84 | 1.83 | 0.59 | |
| Vaginal symptoms (scored 0–4) | |||||
| Unadjusted mean | 0.55 (0.74) | 0.51 (0.70) | 0.60 (0.77) | 0.56 (0.76) | |
| Adjusted mean (Model 2) | 0.62 | 0.71 | 0.69 | 0.32 | |
| Adjusted mean (Model 2 + BMI) | 0.59 | 0.71 | 0.71 | 0.13 | |
| Cognitive/mood problems (scored 0–4) | |||||
| Unadjusted mean | 1.07 (0.80) | 1.12 (0.78) | 0.99 (0.78) | 1.10 (0.85) | |
| Adjusted mean (Model 2) | 1.43 | 1.28 a | 1.35 | 0.33 | |
| Adjusted mean (Model 2 + BMI) | 1.45 | 1.28 a | 1.33 | 0.13 | |
| Sexual interest/function (Scored 0–3)* | |||||
| Unadjusted mean | 0.88 (0.79) | 0.93 (0.78) | 0.89 (0.79) | 0.80 (0.79) | |
| Adjusted mean (Model 2) | 0.91 | 0.90 | 0.80 | 0.31 | |
| Adjusted mean (Model 2 + BMI) | 0.88 | 0.90 | 0.84 | 0.79 | |
| Sleep hours | |||||
| Unadjusted mean | 6.94 (1.21) | 7.00 (1.12) | 7.04 (1.30) | 6.78 (1.19) | |
| Adjusted mean (Model 2) | 6.89 | 6.97 | 6.78 | 0.35 | |
| Adjusted mean (Model 2 + BMI) | 6.93 | 6.98 | 6.74 | 0.14 | |
| Interrupted sleep (Scored 0–4) | |||||
| Unadjusted mean | 1.67 (1.27) | 1.70 (1.22) | 1.69 (1.31) | 1.61 (1.28) | |
| Adjusted mean (Model 2) | 1.99 | 1.97 | 1.89 | 0.43 | |
| Adjusted mean (Model 2 + BMI) | 1.96 | 1.97 | 1.92 | 0.73 | |
| Tendency to nap (Scored 0–4) | |||||
| Unadjusted mean | 0.88 (1.05) | 0.82 (0.92) | 0.79 (1.03) | 1.03 (1.17) | |
| Adjusted mean (Model 2) | 1.21 | 1.12 | 1.32 | 0.27 | |
| Adjusted mean (Model 2 + BMI) | 1.27 | 1.12 | 1.27 | 0.97 | |
| Trouble getting to sleep (Scored 0–4) | |||||
| Unadjusted mean | 2.35 (1.03) | 2.40 (0.99) | 2.36 (1.07) | 2.29 (1.03) | |
| Adjusted mean (Model 2) | 2.51 | 2.48 | 2.52 | 0.66 | |
| Adjusted mean (Model 2 + BMI) | 2.46 | 2.48 | 2.50 | 0.69 | |
| Feeling awake (Scored 0–10) | |||||
| Unadjusted mean | 3.73 (2.66) | 3.52 (2.60) | 3.54 (2.58) | 4.14 (2.77) | |
| Adjusted mean (Model 2) | 4.34 | 4.30 | 4.69 | 0.18 | |
| Adjusted mean (Model 2 + BMI) | 4.35 | 4.30 | 4.68 | 0.25 | |
|
HRQOL (Scored 0–100) | |||||
| Physical functioning | |||||
| Unadjusted mean | 74.7 (25.2) | 83.5 (21.7) | 75.4 (22.2) | 65.0 (27.9) | |
| Adjusted mean (Model 3) | 76.1 | 73.5 | 65.5 b | <0.0001 | |
| Adjusted mean (Model 3 + BMI) | 74.2 | 73.6 | 67.5 b | 0.005 | |
| Role-physical | |||||
| Unadjusted mean | 65.8 (39.8) | 75.6 (35.3) | 63.1 (39.9) | 58.5 (42.1) | |
| Adjusted mean (Model 3) | 66.2 | 59.3 | 56.6 b | 0.01 | |
| Adjusted mean (Model 3 + BMI) | 65.5 | 59.3 | 57.3 a | 0.048 | |
| Bodily pain | |||||
| Unadjusted mean | 71.1 (24.8) | 75.4 (23.2) | 71.6 (23.7) | 66.3 (26.6) | |
| Adjusted mean (Model 3) | 69.4 | 68.8 | 65.8 | 0.12 | |
| Adjusted mean (Model 3 + BMI) | 68.6 | 68.8 | 66.6 | 0.42 | |
| Vitality | |||||
| Unadjusted mean | 56.2 (22.0) | 59.7 (20.6) | 56.5 (22.1) | 52.4 (22.8) | |
| Adjusted mean (Model 3) | 54.8 | 53.0 | 50.0 a | 0.02 | |
| Adjusted mean (Model 3 + BMI) | 54.2 | 53.0 | 50.6 | 0.12 | |
| General health | |||||
| Unadjusted mean | 45.4 (9.7) | 46.3 (10.1) | 45.7 (9.2) | 44.1 (9.8) | |
| Adjusted mean (Model 3) | 44.6 | 44.9 | 44.3 | 0.74 | |
| Adjusted mean (Model 3 + BMI) | 44.4 | 44.9 | 44.5 | 0.98 | |
| Social functioning | |||||
| Unadjusted mean | 81.1 (23.2) | 84.3 (21.3) | 82.1 (22.2) | 76.9 (25.6) | |
| Adjusted mean (Model 3) | 78. | 78.5 | 75.5 | 0.20 | |
| Adjusted mean (Model 3 + BMI) | 3 78.1 | 78.5 | 75.6 | 0.30 | |
| Role-emotional | |||||
| Unadjusted mean | 71.8 (36.8) | 74.9 (35.2) | 71.7 (37.0) | 68.8 (38.2) | |
| Adjusted mean (Model 3) | 71.3 | 71.6 | 69.8 | 0.66 | |
| Adjusted mean (Model 3 + BMI) | 70.9 | 71.6 | 70.2 | 0.87 | |
| Mental health | |||||
| Unadjusted mean | 75.6 (16.9) | 74.7 (18.0) | 76.6 (15.2) | 75.4 (17.2) | |
| Adjusted mean (Model 3) | 71.8 | 74.1 | 73.6 | 0.26 | |
| Adjusted mean (Model 3 + BMI) | 71.5 | 74.1 | 73.8 | 0.20 | |
| Physical component summary score | |||||
| Unadjusted mean | 43.1 (9.7) | 46.4 (8.6) | 42.9 (8.9) | 39.9 (10.4) | |
| Adjusted mean (Model 3) | 43.5 | 41.9 | 39.9b | <0.0001 | |
| Adjusted mean (Model 3 + BMI) | 43.0 | 42.0 | 40.4 b | 0.005 | |
| Mental component summary score | |||||
| Unadjusted mean | 50.5 (9.0) | 49.7 (9.0) | 50.9 (8.8) | 51.0 (9.0) | |
| Adjusted mean (Model 3) | 49.0 | 50.2 | 50.5 | 0.08 | |
| Adjusted mean (Model 3 + BMI) | 49.1 | 50.2 | 50.4 | 0.19 | |
N=351 (lowest tertile N=138, middle tertile N=121, highest tertile=92). BMI: body mass index
Higher symptoms scores indicate scores indicate more frequent symptoms. Higher HRQOL scores indicate better HRQOL.
Model 1 was adjusted for race/study site, age (continuous), cancer treatment, hormone receptor status, tamoxifen use, number of comorbidities, and menopausal status.
Model 2 was adjusted for race/study site, age (continuous), cancer treatment, hormone receptor status, number of comorbidities, menopausal status, and tamoxifen and antidepressant/anxiolytic use.
Model 3 was adjusted for race/study site, age (continuous), cancer treatment, number of comorbidities, menopausal status, and antidepressant/anxiolytic use.
P trend tested a trend of scores across the subgroups determined by tertiles of CRP.
P values for direct comparisons between subgroups are indicated with symbols: p<0.05 vs. ‘lowest tertile’,
p<0.01 vs. ‘lowest tertile’.