Medicine, University of Pittsburgh, Kaufmann Medical Bldg, Pittsburgh, PA, 15213, USA.
Breast Cancer Res Treat. 2011 Jan;125(2):441-6. doi: 10.1007/s10549-010-1223-2. Epub 2010 Nov 3.
Aromatase inhibitors (AIs) have become the standard adjuvant therapy of postmenopausal breast cancer survivors. AIs induce a reduction of bioavailable estrogens by inhibiting aromatase, which would be expected to induce alterations in body composition, more extensive than induced by menopause. The objectives are to examine the impact of AIs on (1) DXA-scan derived body composition and (2) gonadal hormone levels. This is a sub-analysis of a 2-year double-blind, placebo-controlled, randomized trial of 82 women with nonmetastatic breast cancer, newly menopausal following chemotherapy, who were randomized to risedronate (35 mg once weekly) versus placebo, and stratified for their usage of AI versus no AI. Outcomes included DXA-scan derived body composition and gonadal hormone levels. As a group, total body mass increased in women over 24 months. Women on AIs gained a significant amount of lean body mass compared to baseline as well as to no-AI users (P < 0.05). Women not on an AI gained total body fat compared to baseline and AI users (P < 0.05). Free testosterone significantly increased and sex hormone binding globulin (SHBG) significantly decreased in women on AIs compared to no AIs at 24 months (P < 0.01) while total estradiol and testosterone levels remained stable. Independent of AI usage, chemotherapy-induced postmenopausal breast cancer patients demonstrated an increase of total body mass. AI users demonstrated maintenance of total body fat, an increase in lean body mass and free testosterone levels, and a decrease in SHBG levels compared to no-AI users. The mechanisms and implications of these changes need to be studied further.
芳香酶抑制剂 (AIs) 已成为绝经后乳腺癌幸存者的标准辅助治疗药物。AIs 通过抑制芳香酶来降低生物可利用的雌激素，这预计会引起身体成分的改变，比绝经引起的改变更广泛。目的是研究 AIs 对 (1) DXA 扫描得出的身体成分和 (2) 性腺激素水平的影响。这是一项为期 2 年的双盲、安慰剂对照、随机临床试验的子分析，该试验纳入了 82 名新诊断为非转移性乳腺癌且刚绝经的化疗后女性，这些患者被随机分为利塞膦酸盐（每周 35 毫克）组与安慰剂组，并根据是否使用 AI 进行分层。结果包括 DXA 扫描得出的身体成分和性腺激素水平。总体而言，女性在 24 个月内的总体体重增加。与基线相比，使用 AI 的女性获得了显著的瘦体重增加，与未使用 AI 的女性相比也是如此（P < 0.05）。未使用 AI 的女性获得的全身脂肪量比基线和 AI 用户多（P < 0.05）。与未使用 AI 的女性相比，使用 AI 的女性在 24 个月时游离睾酮显著增加，性激素结合球蛋白 (SHBG) 显著降低（P < 0.01），而总雌二醇和睾酮水平保持稳定。独立于 AI 使用，化疗诱导的绝经后乳腺癌患者的总体体重增加。与未使用 AI 的女性相比，AI 用户的总体脂肪保持稳定，瘦体重增加，游离睾酮水平升高，SHBG 水平降低。这些变化的机制和影响需要进一步研究。
