{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:35:19Z","timestamp":1787927719584,"version":"build-2784847793"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","award":["XX"],"award-info":[{"award-number":["XX"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["XX"],"award-info":[{"award-number":["XX"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stockholms Sjukhem Foundation","award":["XX"],"award-info":[{"award-number":["XX"]}]},{"DOI":"10.13039\/501100018713","name":"CIMED","doi-asserted-by":"publisher","award":["XX"],"award-info":[{"award-number":["XX"]}],"id":[{"id":"10.13039\/501100018713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>In the randomized, placebo-controlled, double-blind trial \u2018Palliative-D\u2019, vitamin D treatment of 4000 IE\/day for 12 weeks reduced opioid use and fatigue in vitamin-D-deficient cancer patients. In screening data from this trial, lower levels of vitamin D were associated with more fatigue in men but not in women. The aim of the present study was to investigate possible sex differences in the effect of vitamin D in patients with advanced cancer, with a specific focus on fatigue. A post hoc analysis of sex differences in patients completing the Palliative-D study (n = 150) was performed. Fatigue assessed with the Edmonton Symptom Assessment Scale (ESAS) was reduced in vitamin-D-treated men; \u22121.50 ESAS points (95%CI \u22122.57 to \u22120.43; p = 0.007) but not in women; \u22120.75 (95%CI \u22121.85 to 0.36; p = 0.18). Fatigue measured with EORTC QLQ-C15-PAL had a borderline significant effect in men (\u22120.33 (95%CI \u22120.67 to 0.03; p = 0.05)) but not in women (p = 0.55). The effect on fatigue measured with ESAS in men remained the same after adjustment for opioid doses (p = 0.01). In conclusion, the positive effect of the correction of vitamin D deficiency on fatigue may be more pronounced in men than in women. However, studies focused on analyzing sex differences in this context must be performed before firm conclusions can be drawn.<\/jats:p>","DOI":"10.3390\/cancers14030746","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T09:59:21Z","timestamp":1643709561000},"page":"746","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sex Differences in the Effect of Vitamin D on Fatigue in Palliative Cancer Care\u2014A Post Hoc Analysis of the Randomized, Controlled Trial \u2018Palliative-D\u2019"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0843-5493","authenticated-orcid":false,"given":"Caritha","family":"Klasson","sequence":"first","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickag\u00e5ngen 16, Neo Floor 7, SE-141 83 Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8444-3623","authenticated-orcid":false,"given":"Maria","family":"Helde Frankling","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickag\u00e5ngen 16, Neo Floor 7, SE-141 83 Huddinge, Sweden"},{"name":"Theme Cancer, Thoracic Oncology Center, Karolinska University Hospital, Solna, SE-171 64 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5691-2127","authenticated-orcid":false,"given":"Anna","family":"Warnqvist","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Division of Biostatistics, Karolinska Institutet, Nobels v\u00e4g 13, SE-171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Sandberg","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Stockholms Sjukhem, Mariebergsgatan 22, SE-112 19 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Stockholms Sjukhem, Mariebergsgatan 22, SE-112 19 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-9121","authenticated-orcid":false,"given":"Carina","family":"Lundh-Hagelin","sequence":"additional","affiliation":[{"name":"Department of Health Care Sciences, Ersta Sk\u00f6ndal Br\u00e4cke University College, SE-100 61 Stockholm, Sweden"},{"name":"Department of Neurobiology, Care Sciences and Society (NVS), Division of Care Science, Karolinska Institutet, Alfred Nobels Alle 23, SE-141 83 Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3505-9283","authenticated-orcid":false,"given":"Linda","family":"Bj\u00f6rkhem-Bergman","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickag\u00e5ngen 16, Neo Floor 7, SE-141 83 Huddinge, Sweden"},{"name":"Palliative Medicine, Stockholms Sjukhem, Mariebergsgatan 22, SE-112 19 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/nrclinonc.2014.127","article-title":"Cancer-related fatigue-mechanisms, risk factors, and treatments","volume":"11","author":"Bower","year":"2014","journal-title":"Nat. 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