4.7 Article

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

Journal

CANCER
Volume 122, Issue 17, Pages 2646-2653

Publisher

WILEY
DOI: 10.1002/cncr.30104

Keywords

body composition; breast cancer; chemotherapy; glucose metabolism; metabolic syndrome

Categories

Funding

  1. National Institutes of Health [P30 CA33572, K05 CA136967]
  2. Carr-Baird Family Fund through the Women's Cancers Program at the City of Hope Comprehensive Cancer Center

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BACKGROUNDThe authors sought to determine the effect of chemotherapy on the development of metabolic syndrome (MetS) in premenopausal and postmenopausal women undergoing (neo)adjuvant therapy for early-stage breast cancer. METHODSA total of 86 women with early-stage (AJCC stage I-III) breast cancer who were free from clinically diagnosed MetS (defined as 3 of 5 components of MetS) were prospectively tested for the presence of the 5 components of MetS within 1 week before initiating and after completing (neo)adjuvant chemotherapy. The 5 components of MetS measured were waist circumference; blood pressure; and fasting levels of blood glucose, triglycerides, and high-density lipoprotein cholesterol. Anthropometrics (body weight, percentage body fat, fat mass), lipid profile (total cholesterol, low-density lipoprotein cholesterol), glucose metabolism (insulin, homeostatic model assessment of insulin resistance, glycated hemoglobin), and inflammation (C-reactive protein) also were examined before initiating and after completing treatment. RESULTSThe current study included 46 premenopausal and 40 postmenopausal women. All individual MetS components and the overall MetS score were found to be statistically significantly increased (P<.01) after chemotherapy. Body weight, percentage body fat, fat mass, lipids, glucose metabolism, and inflammation also were found to be statistically significantly increased (P<.01). CONCLUSIONSA 12-week to 18-week course of chemotherapy appears to statistically significantly increase MetS and related anthropometrics, biomarkers of glucose metabolism, and inflammation in patients with early-stage breast cancer with no preexisting MetS. Lifestyle interventions such as diet and exercise may be preventive approaches for use during chemotherapy to reduce the onset of MetS in patients with breast cancer. Cancer 2016. (c) 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Cancer 2016;122:2646-2653. (c) 2016 American Cancer Society. Patients with breast cancer who receive (neo)adjuvant chemotherapy experience an impaired metabolic presentation as noted by worsened components of metabolic syndrome, anthropometrics, and biomarkers of glucose metabolism. Lifestyle interventions such as diet and exercise may be preventive approaches for use during chemotherapy to reduce the onset of metabolic syndrome in patients with breast cancer.

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