Dieli-Conwright Christina M, Wong Louise, Waliany Sarah, Bernstein Leslie, Salehian Behrouz, Mortimer Joanne E
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California.
Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
Cancer. 2016 Sep 1;122(17):2646-53. doi: 10.1002/cncr.30104. Epub 2016 May 24.
The 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.
A 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.
The 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).
A 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. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Cancer 2016;122:2646-2653. © 2016 American Cancer Society.
作者试图确定化疗对接受早期乳腺癌（新）辅助治疗的绝经前和绝经后女性代谢综合征（MetS）发生发展的影响。
共有86例早期（美国癌症联合委员会I - III期）乳腺癌女性患者，她们在临床上未被诊断为MetS（定义为具备MetS的5项组分中的3项），在开始（新）辅助化疗前1周内以及完成化疗后，前瞻性地检测MetS的5项组分。所测量的MetS的5项组分包括腰围、血压以及空腹血糖、甘油三酯和高密度脂蛋白胆固醇水平。在开始治疗前和完成治疗后，还对人体测量指标（体重、体脂百分比、脂肪量）、血脂谱（总胆固醇、低密度脂蛋白胆固醇）、糖代谢（胰岛素、胰岛素抵抗稳态模型评估、糖化血红蛋白）和炎症指标（C反应蛋白）进行了检查。
本研究纳入了46例绝经前女性和40例绝经后女性。化疗后发现，所有个体的MetS组分及总体MetS评分均有统计学显著升高（P <.01）。体重、体脂百分比、脂肪量、血脂、糖代谢和炎症指标也有统计学显著升高（P <.01）。
对于无预先存在MetS的早期乳腺癌患者，为期12周至18周的化疗疗程似乎在统计学上显著增加了MetS及相关人体测量指标、糖代谢生物标志物和炎症。饮食和运动等生活方式干预可能是化疗期间用于降低乳腺癌患者MetS发病风险的预防措施。《癌症》2016年。© 2016作者。《癌症》由威利期刊公司代表美国癌症协会出版。《癌症》2016；122：2646 - 2653。© 2016美国癌症协会。
