Adiposity and sex hormones in postmenopausal breast cancer survivors
Adiposity and sex hormones in postmenopausal breast cancer survivors
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DOI：
10.1200/jco.2003.07.057
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发表时间：
2003-05-15
影响因子：
45.3
通讯作者：
Ballard-Barbash, R
中科院分区：
文献类型：
--
作者：
McTiernan, A;Rajan, KB;Ballard-Barbash, R
目的：超重和肥胖的乳腺癌妇女与较瘦的妇女相比，生存率较差。一个可能的原因是，肥胖程度较高的乳腺癌幸存者有较高浓度的促肿瘤激素。本研究以绝经后乳腺癌妇女为研究对象，探讨了肥胖与雌激素、雄激素和性激素结合球蛋白（SHBG）浓度之间的关系。方法：我们研究了体重指数（BMI）、体脂肪量和体脂肪百分比（通过双能X线吸收扫描测量）、腰围和腰臀比之间的关系，在华盛顿西部和新墨西哥州的505名绝经后0期至IIIA期乳腺癌患者中，测定雌酮、雌二醇、睾酮、SHBG、硫酸脱氢表雄酮、游离雌二醇和游离睾酮的浓度。结果：肥胖妇女（BMI大于或等于30）与体重较轻的妇女（BMI < 22.0; P = 0.005和0.002）相比，雌酮浓度高35%，雌二醇浓度高130%。在体脂量、体脂百分比和腰围方面也观察到类似的关联。睾酮浓度也随着肥胖水平的增加而增加（P = 0.0001）。游离雌二醇和游离睾酮的浓度是两到三倍，超重和肥胖的妇女相比，体重较轻的妇女（P = .0001）。结论：这些数据提供了有关潜在的激素解释肥胖和乳腺癌预后之间的关联信息。这些性激素可能是乳腺癌妇女减肥干预研究的有用生物标志物。(C)2003年，美国临床肿瘤学会。
Purpose: Overweight and obese women with breast cancer have poorer survival compared with thinner women. One possible reason is that breast cancer survivors with higher degrees of adiposity have higher concentrations of tumor-promoting hormones. This study examined the association between adiposity and concentrations of estrogens, androgens, and sex hormone-binding globulin (SHBG) in a population-based sample of postmenopausal women with breast cancer.Methods: We studied the associations between body mass index (BMI), body fat mass, and percent body fat, measured by dual-energy x-ray absorptiometry scan, waist circumference, and waist-to-hip circumference ratio, with concentrations of estrone, estradiol, testosterone, SHBG, dehydroepiandrosterone sulfate, free estradiol, and free testosterone in 505 postmenopausal women in western Washington and New Mexico with incident stage 0 to IIIA breast cancer. Blood and adiposity measurements were performed between 4 and 12 months after diagnosis.Results: Obese women (BMI greater than or equal to 30) had 35% higher concentrations of estrone and 130% higher concentrations of estradiol compared with lighter-weight women (BMI < 22.0; P = .005 and .002, respectively). Similar associations were observed for body fat mass, percent body fat, and waist circumference. Testosterone concentrations also increased with increasing levels of adiposity (P = .0001). Concentrations of free estradiol and free testosterone were two to three times greater in overweight and obese women compared with lighter-weight women (P = .0001).Conclusion: These data provide information about potential hormonal explanations for the association between adiposity and breast cancer prognosis. These sex hormones may be useful biomarkers for weight loss intervention studies in women with breast cancer. (C) 2003 by American Society of Clinical Oncology.