Department of Obstetrics & Gynecology, Division of Gynecological Oncology, University Hospitals Leuven, Belgium.
Ann Oncol. 2011 Aug;22(8):1763-9. doi: 10.1093/annonc/mdq699. Epub 2011 Jan 27.
Our preliminary results showed that tenosynovial changes and decrease in grip strength are associated with the aromatase inhibitor-induced musculoskeletal syndrome (AIMSS). Here, we report the final results and assess the relationship between grip strength and body mass index (BMI).
We conducted a prospective study including postmenopausal early breast cancer patients receiving either an aromatase inhibitor (AI) or tamoxifen. Primary end point was change from baseline in tenosynovial abnormalities. Secondary end points were changes from baseline in morning stiffness, intra-articular fluid and grip strength and its association with BMI.
After 6 months of therapy, 74% [95% confidence interval (CI) 51% to 89%] of AI-treated patients had worsened tenosynovial abnormalities, 56% (95% CI 34% to 75%) had increased intra-articular fluid, and 22% (95% CI 9% to 45%) had increased morning stiffness. Grip strength decreased 8% for the left hand (95% CI 2% to 21%) and 11% for the right (95% CI 4% to 17%). Regression analysis suggested that grip strength decreased more for subjects with high or with low BMI.
AIMSS is characterized by tenosynovial changes, intra-articular fluid and morning stiffness. We hypothesize that the quadratic association between BMI and loss of grip strength reflects AI-induced changes on the endocrine control of the growth hormone insulin-like growth factor-I pathway.
我们的初步研究结果表明，滑液囊改变和握力下降与芳香化酶抑制剂诱导的肌肉骨骼综合征（AIMSS）有关。在此，我们报告最终结果，并评估握力与体重指数（BMI）之间的关系。
我们进行了一项前瞻性研究，包括接受芳香化酶抑制剂（AI）或他莫昔芬治疗的绝经后早期乳腺癌患者。主要终点是滑液囊异常从基线的变化。次要终点是晨僵、关节内积液和握力的变化及其与 BMI 的关系。
治疗 6 个月后，74%（95%置信区间 51%至 89%）的 AI 治疗患者滑液囊异常恶化，56%（95%置信区间 34%至 75%）关节内积液增加，22%（95%置信区间 9%至 45%）晨僵增加。左手握力下降 8%（95%置信区间 2%至 21%），右手握力下降 11%（95%置信区间 4%至 17%）。回归分析表明，BMI 较高或较低的患者握力下降幅度更大。
AIMSS 的特征是滑液囊改变、关节内积液和晨僵。我们假设 BMI 与握力丧失之间的二次关联反映了 AI 对生长激素胰岛素样生长因子-I 通路内分泌控制的改变。
