Metabolic and anthropometric changes in early breast cancer patients receiving adjuvant therapy
Metabolic and anthropometric changes in early breast cancer patients receiving adjuvant therapy
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DOI：
10.1007/s10549-015-3586-x
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发表时间：
2015-11-01
影响因子：
3.8
通讯作者：
De Placido, Sabino
中科院分区：
文献类型：
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作者：
Arpino, Grazia;De Angelis, Carmine;De Placido, Sabino
体重增加和代谢变化与早期乳腺癌患者（EBC）的生存有关。然而，影响诊断后代谢的因素尚未完全了解。我们测量了433名绝经前和绝经后EBC女性在诊断时以及3、6、9、12和24个月后的人体测量[体重指数（BMI）、体重、腰围和臀围以及腰臀比]和代谢（胰岛素、葡萄糖、H1 Ac、总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、甘油三酯水平以及稳态模型评估评分[HOMA]）参数。在诊断时，与绝经后妇女相比，绝经前患者更可能更瘦，BMI更低，腰围和臀围更小，腰臀比更小。他们也有较低的葡萄糖，HbA 1c和甘油三酯水平和较低的HOMA评分。此外，他们更有可能患有雌激素和/或孕酮阳性肿瘤和更高的增殖性乳腺癌。在诊断后的前两年，所有女性的体重（+0.72 kg/年，P < 0.001）、腰围（+1.53 cm/年，P <0.001）、血浆LDL胆固醇（+5.4 mg/dl/年，P = 0.045）和甘油三酯（+10.73 mg/dl/年，P = 0.017）水平均显著增加。在仅接受化疗的患者中，臀围（+3.16 cm/年，P < 0.001）和血浆胆固醇水平（+21.26 mg/dl/年，P < 0.001）显著增加。我们发现接受辅助治疗的EBC患者的体重、体脂分布和血脂谱发生了变化。这些变化发生在诊断后的前2年，与化疗、绝经状态或初始体重无关。
Weight gain and metabolic changes have been related to survival of early breast cancer patients (EBC). ''However, factors influencing metabolism post-diagnosis are not fully understood. We measured anthropometric [body mass index (BMI), body weight, waist and hip circumferences, and waist-to-hip ratio] and metabolic (levels of insulin, glucose, H1Ac, total, HDL, and LDL cholesterol, triglycerides, and the homeostasis model assessment score [HOMA]) parameters in 433 pre- and post-menopausal women with EBC at diagnosis and 3, 6, 9, 12, and 24 months thereafter. At diagnosis, compared with post-menopausal women, pre-menopausal patients were more likely to be leaner and to have a lower BMI, smaller waist and hip circumferences, and waist-to-hip ratio. They had also lower glucose, HbA1c, and triglyceride levels and a lower HOMA score. Furthermore, they were more likely to have an estrogen- and/or progesterone-positive tumor and a higher proliferating breast cancer. During the first two post-diagnosis years, all women showed a significant increase of weight (+0.72 kg/year, P < 0.001), waist circumference (+1.53 cm/year, P < 0.001), and plasma levels of LDL cholesterol (+5.4 mg/dl per year, P = 0.045) and triglycerides (+10.73 mg/dl per year, P = 0.017). In patients receiving chemotherapy only, there was a significant increase in hip circumference (+3.16 cm/year, P < 0.001) and plasma cholesterol levels (+21.26 mg/dl per year, P < 0.001). We showed that weight, body fat distribution, and lipid profile changed in EBC patients receiving adjuvant therapy. These changes occurred during the first 2 years after diagnosis and were not specifically related to chemotherapy, menopausal status, or initial body weight.