Effect of weight loss on bone health in overweight/obese postmenopausal breast cancer survivors.
Effect of weight loss on bone health in overweight/obese postmenopausal breast cancer survivors.
复制标题
减肥对超重/肥胖绝经后乳腺癌幸存者骨骼健康的影响。
DOI：
10.1007/s10549-015-3496-y
复制
发表时间：
2015
影响因子：
3.8
通讯作者：
Wolin,KathleenY
中科院分区：
文献类型：
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作者：
Toriola,AdetunjiT;Liu,Jingxia;Ganz,PatriciaA;Colditz,GrahamA;Yang,Lin;Izadi,Sonya;Naughton,MichaelJ;Schwartz,AnnaL;Wolin,KathleenY
目前的指南建议肥胖的癌症幸存者减肥。然而，减肥对未患癌症的肥胖个体的骨骼健康有不利影响，但尚未对乳腺癌幸存者进行评估。我们调查了超重/肥胖绝经后乳腺癌幸存者有意减肥与骨密度（BMD）和骨转换标志物的关系。参与者是超重/肥胖的I、II或IIIA期乳腺癌幸存者（N= 81），他们参加了一项多站点运动和营养促进恢复和健康（ENERGY）研究的圣路易斯站点；一项随机对照临床试验，旨在实现2年体重持续下降≥7%。减肥是通过调整饮食和增加体育活动来实现的。采用广义估计方程评估随访期与基线期平均值的差异。在基线、6个月随访和12个月随访期间，平均体重分别下降3%和2.3%。基线和12个月随访期间，骨钙素（10.6%，p值< 0.001）、PINP （14.5%，p值< 0.001）、NTx （19.2%，p值< 0.001）和RANK （48.5%，p值< 0.001）水平下降，但BALP和CTX-1水平未见下降。在基线和12个月的随访期间，平均t评分、骨盆和腰椎骨密度没有显著变化。患有早期乳腺癌的超重/肥胖妇女在12个月内体重减轻2.3%似乎对骨骼健康没有有害影响，甚至可能有有益影响。这些发现值得证实，特别是在体重减轻幅度较大的乳腺癌幸存者中。
Current guidelines recommend weight loss in obese cancer survivors. Weight loss, however, has adverse effects on bone health in obese individuals without cancer but this has not been evaluated in breast cancer survivors. We investigated the associations of intentional weight loss with bone mineral density (BMD) and bone turn-over markers in overweight/obese postmenopausal breast cancer survivors. Participants were overweight/obese breast cancer survivors (N= 81) with stage I, II or IIIA disease enrolled in the St. Louis site of a multi-site Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) study; a randomized-controlled clinical trial designed to achieve a sustained ≥7 % loss in body weight at 2 years. Weight loss was achieved through dietary modification with the addition of physical activity. Generalized estimating equations were used to assess differences in mean values between follow-up and baseline. Mean weight decreased by 3 and 2.3 % between baseline and 6-month follow-up, and 12-month follow-up, respectively. There were decreases in osteocalcin (10.6 %,pvalue < 0.001), PINP (14.5 %,pvalue < 0.001), NTx (19.2 %pvalue < 0.001), and RANK (48.5 %,pvalue < 0.001), but not BALP and CTX-1 levels between baseline and 12-month follow-up. No significant changes occurred in mean T-scores, pelvis and lumbar spine BMD between baseline and 12-month follow-up. A 2.3 % weight loss over 12 months among overweight/obese women with early-stage breast cancer does not appear to have deleterious effect on bone health, and might even have beneficial effect. These findings warrant confirmation, particularly among breast cancer survivors with a larger magnitude of weight loss.