Effects of Tamoxifen vs. Toremifene on fatty liver development and lipid profiles in breast Cancer.
Effects of Tamoxifen vs. Toremifene on fatty liver development and lipid profiles in breast Cancer.
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DOI：
10.1186/s12885-021-08538-5
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发表时间：
2021-07-10
期刊：
影响因子：
3.8
通讯作者：
Hu X
中科院分区：
文献类型：
--
作者：
Song D;Hu Y;Diao B;Miao R;Zhang B;Cai Y;Zeng H;Zhang Y;Hu X
三苯氧胺（TAM）和托瑞米芬（TOR）是两种选择性雌激素受体调节剂（SERM），对乳腺癌患者具有同等疗效。然而，TAM已被证明会影响血脂谱并导致脂肪肝疾病。该研究旨在比较TAM和TOR对脂肪肝发展和血脂的影响。本研究对308例SERM治疗的早期乳腺癌患者进行了回顾性分析，这些患者根据倾向评分1：1匹配。随访3年。主要结果是超声或计算机断层扫描（CT）检测到的脂肪肝，纤维化指标的变化和血脂谱的变化。TAM组新发脂肪肝的累积发生率高于TOR组（113.2 vs. 67.2/1000人-年，p < 0.001），TAM组发生更严重的脂肪肝（25.5 vs. 7.5/1000人-年，p = 0.003）。根据Kaplan-Meier曲线，TAM显著增加新发脂肪肝（25.97% vs. 17.53%，p = 0.0243）和重度脂肪肝（5.84% vs. 1.95%，p = 0.0429）的风险。TOR使新发脂肪肝的风险降低了45%（风险比= 0.55，p = 0.020），并显示出较低的纤维化负担，与肥胖、脂质和肝酶水平无关。TOR增加甘油三酯的作用小于TAM，TOR增加高密度脂蛋白胆固醇，而TAM则相反。两组间总胆固醇和低密度脂蛋白胆固醇无显著差异。TAM治疗与更严重的脂肪肝疾病和肝纤维化显著相关，而TOR与脂质谱的整体改善相关，这支持在SERM治疗期间连续监测肝脏成像和血清脂质水平。
Tamoxifen (TAM) and Toremifene (TOR), two kinds of selective estrogen receptor modulators (SERMs), have equal efficacy in breast cancer patients. However, TAM has been proved to affect serum lipid profiles and cause fatty liver disease. The study aimed to compare the effects of TAM and TOR on fatty liver development and lipid profiles. This study performed a retrospective analysis of 308 SERMs-treated early breast cancer patients who were matched 1:1 based on propensity scores. The follow-up period was 3 years. The primary outcomes were fatty liver detected by ultrasonography or computed tomography (CT), variation in fibrosis indexes, and serum lipid profiles change. The cumulative incidence rate of new-onset fatty liver was higher in the TAM group than in the TOR group (113.2 vs. 67.2 per 1000 person-years, p < 0.001), and more severe fatty livers occurred in the TAM group (25.5 vs. 7.5 per 1000 person-years, p = 0.003). According to the Kaplan-Meier curves, TAM significantly increased the risk of new-onset fatty liver (25.97% vs. 17.53%, p = 0.0243) and the severe fatty liver (5.84% vs. 1.95%, p = 0.0429). TOR decreased the risk of new-onset fatty liver by 45% (hazard ratio = 0.55, p = 0.020) and showed lower fibrotic burden, independent of obesity, lipid, and liver enzyme levels. TOR increased triglycerides less than TAM, and TOR increased high-density lipoprotein cholesterol, while TAM did the opposite. No significant differences in total cholesterol and low-density lipoprotein cholesterol are observed between the two groups. TAM treatment is significantly associated with more severe fatty liver disease and liver fibrosis, while TOR is associated with an overall improvement in lipid profiles, which supports continuous monitoring of liver imaging and serum lipid levels during SERM treatment.
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影响因子：
45.3
作者：
Holli, K;Valavaara, R;Joensuu, H
通讯作者：
Joensuu, H
影响因子：
3.8
作者：
Kusama, M;Kaise, H;Aoki, T
通讯作者：
Aoki, T
影响因子：
2.3
作者：
Liu, Chien-Liang;Huang, Jon-Kway;Liu, Tsang-Pai
通讯作者：
Liu, Tsang-Pai
影响因子：
45.3
作者：
Borgquist, Signe;Giobbie-Hurder, Anita;Thurlimann, Beat
通讯作者：
Thurlimann, Beat
高密度脂蛋白功能，功能障碍和反向胆固醇转运。
DOI：
10.1161/atvbaha.112.300133
发表时间：
2012-12
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Fisher EA;Feig JE;Hewing B;Hazen SL;Smith JD
通讯作者：
Smith JD