Department of Clinical Nutrition, St James's Hospital and Trinity College Dublin, Ireland.
Clin Oncol (R Coll Radiol). 2010 May;22(4):281-8. doi: 10.1016/j.clon.2010.02.001. Epub 2010 Feb 26.
Obesity is associated with both an increased risk of postmenopausal breast cancer and increased mortality rates. The mechanism is unclear, and central (visceral) obesity, insulin resistance, altered sex steroids and altered adipokines are mooted as possible factors. These features may cluster in the so-called metabolic syndrome. The relevance of metabolic syndrome to the biology of breast cancer is unknown, and this was the focus of the present study.
All postmenopausal women with newly diagnosed breast cancer (n=105) were recruited. A detailed clinical history was carried out, as well as a body composition analysis, metabolic screen and measurement of adipokines and inflammatory markers.
The median age was 68 years (40-94 years) and the mean body mass index was 28.3+/-5.2 kg/m2, with 87% of patients centrally obese. Metabolic syndrome was diagnosed in 39% of patients, and was significantly associated with central obesity (P<0.005) and increased inflammation, with C-reactive protein levels doubling in metabolic syndrome patients compared with non-metabolic syndrome patients (10.3 vs 5.8 mg/l; P=0.084). Patients with a later pathological stage (II-IV) were significantly more likely to be obese (P=0.007), centrally obese (P=0.009), hyperglycaemic (P=0.047) and hyperinsulinaemic (P=0.026); 51% had metabolic syndrome compared with 12% for early stage disease. Patients with node-positive disease were significantly more likely to be hyperinsulaemic (P=0.030) and have metabolic syndrome (P=0.028) than patients with node-negative disease.
The data suggest that metabolic syndrome and central obesity are common in postmenopausal breast cancer patients, and that metabolic syndrome may be associated with a more aggressive tumour biology.
肥胖与绝经后乳腺癌风险增加和死亡率升高均相关。其机制尚不清楚，而中心（内脏）性肥胖、胰岛素抵抗、性激素改变和脂肪因子改变被认为是可能的因素。这些特征可能集中在所谓的代谢综合征中。代谢综合征与乳腺癌生物学的相关性尚不清楚，这也是本研究的重点。
招募了所有新诊断为乳腺癌的绝经后女性（n=105）。进行了详细的临床病史采集，以及身体成分分析、代谢筛查以及脂肪因子和炎症标志物的测量。
中位年龄为 68 岁（40-94 岁），平均体重指数为 28.3+/-5.2 kg/m2，87%的患者为中心性肥胖。39%的患者诊断为代谢综合征，且与中心性肥胖显著相关（P<0.005），并伴有炎症增加，与非代谢综合征患者相比，代谢综合征患者的 C 反应蛋白水平增加了一倍（10.3 与 5.8 mg/l；P=0.084）。晚期（II-IV 期）病理阶段的患者明显更肥胖（P=0.007）、中心性肥胖（P=0.009）、血糖升高（P=0.047）和高胰岛素血症（P=0.026）；51%的患者患有代谢综合征，而早期疾病患者的这一比例为 12%。与淋巴结阴性疾病患者相比，淋巴结阳性疾病患者明显更可能出现高胰岛素血症（P=0.030）和患有代谢综合征（P=0.028）。
数据表明，代谢综合征和中心性肥胖在绝经后乳腺癌患者中很常见，代谢综合征可能与更具侵袭性的肿瘤生物学相关。
