Department of Preventive Medicine, Room 418D 2001 Soto Street, MC9239, Los Angeles, CA 90089, USA.
BMC Cancer. 2012 Aug 8;12:343. doi: 10.1186/1471-2407-12-343.
C-reactive protein (CRP) and Serum amyloid A protein (SAA) increases with systemic inflammation and are related to worse survival for breast cancer survivors. This study examines the association between percent body fat and SAA and CRP and the potential interaction with NSAID use and weight change.
Participants included 134 non-Hispanic white and Hispanic breast cancer survivors from the Health, Eating, Activity, and Lifestyle Study. Body fat percentage, measured with Dual Energy X-ray Absorptiometer (DEXA), and circulating levels of CRP and SAA were obtained 30 months after breast cancer diagnosis.
Circulating concentrations of CRP and SAA were associated with increased adiposity as measured by DEXA after adjustment for age at 24-months, race/ethnicity, dietary energy intake, weight change, and NSAID use. Survivors with higher body fat ≥35% had significantly higher concentrations of CRP (2.01 mg/l vs. 0.85 mg/l) and SAA (6.21 mg/l vs. 4.21 mg/l) compared to non-obese (body fat < 35%). Women who had gained more than 5% of their body weight since breast cancer diagnosis had non-statistically significant higher geometric mean levels of CRP and SAA. Mean levels of CRP and SAA were higher among obese women who were non-users of NSAIDs compared to current users; the association with SAA reached statistical significance (Mean SAA = 7.24, 95%CI 6.13-8.56 for non-NSAID; vs. 4.87; 95%CI 3.95-6.0 for NSAID users respectively).
Breast cancer survivors with higher body fat had higher mean concentrations of CRP and SAA than women with lower body fat. Further assessment of NSAID use and weight control in reducing circulating inflammatory markers among survivors may be worthwhile to investigate in randomized intervention trials as higher inflammatory markers are associated with worse survival.
C 反应蛋白（CRP）和血清淀粉样蛋白 A 蛋白（SAA）随着全身炎症的增加而升高，与乳腺癌幸存者的生存预后较差有关。本研究探讨了体脂肪百分比与 SAA 和 CRP 的关系，以及 NSAID 使用和体重变化的潜在相互作用。
参与者包括来自健康、饮食、活动和生活方式研究的 134 名非西班牙裔白人和西班牙裔乳腺癌幸存者。使用双能 X 射线吸收仪（DEXA）测量体脂肪百分比，在乳腺癌诊断后 30 个月测量循环 CRP 和 SAA 水平。
调整 24 个月时的年龄、种族/民族、膳食能量摄入、体重变化和 NSAID 使用后，循环 CRP 和 SAA 浓度与 DEXA 测量的肥胖程度增加相关。体脂≥35%的幸存者 CRP（2.01mg/L 比 0.85mg/L）和 SAA（6.21mg/L 比 4.21mg/L）浓度显著高于非肥胖者（体脂<35%）。自诊断为乳腺癌以来体重增加超过 5%的女性，CRP 和 SAA 的几何平均水平略有升高，但无统计学意义。与 NSAID 使用者相比，非 NSAID 使用者中肥胖女性的 CRP 和 SAA 平均水平更高，SAA 的相关性具有统计学意义（非 NSAID 使用者的平均 SAA=7.24，95%CI6.13-8.56；vs. NSAID 使用者的 4.87，95%CI3.95-6.0）。
体脂较高的乳腺癌幸存者 CRP 和 SAA 的平均浓度高于体脂较低的女性。进一步评估 NSAID 使用和体重控制是否可以降低幸存者的循环炎症标志物，这可能值得在随机干预试验中进行研究，因为较高的炎症标志物与生存预后较差有关。
