Min Yul Ha, Lee Jong Won, Chung Il Yong, Ahn Sei Hyun
College of Nursing, Gachon University, Incheon, South Korea.
Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Support Care Cancer. 2017 Aug;25(8):2549-2558. doi: 10.1007/s00520-017-3664-1. Epub 2017 Apr 4.
This study aimed to describe longitudinal patterns of weight changes from diagnosis to within 5 years after diagnosis and investigate factors associated with short- and long-term weight changes among Korean breast cancer survivors with initially normal body mass index (BMI).
Body weights at diagnosis for 1546 breast cancer survivors were compared with those at 12, 24, 36, 48, and 60 months after diagnosis. Absolute weight change (kg) and relative weight changes (%) were analyzed. Logistic regression was used to identify factors associated with short-term (1 year) and long-term (5 years) weight changes.
A significant decrease in mean weight was predominant at 12 months postdiagnosis. In subgroup analysis, the younger age group showed significant weight gains after 36 months. The older age group and chemotherapy (CT) group showed significant weight losses after 24 months. About 40% of weight gainers and 60% of weight losers at 12 months returned to their initial weight by 60 months postdiagnosis. CT and lower educational levels were associated with short-term weight loss and gain, respectively. For long-term changes, age at diagnosis was the sole associated factor.
Korean breast cancer survivors treated with CT mainly experienced postdiagnosis weight loss rather than weight gain. Short-term weight change was independently associated with chemotherapy and educational level. However, long-term weight change was associated with age at diagnosis. Breast cancer survivors with normal BMI may be categorized according to the time-dependent risk for postdiagnosis weight change.
本研究旨在描述从诊断到诊断后5年内体重变化的纵向模式,并调查初诊时体重指数(BMI)正常的韩国乳腺癌幸存者短期和长期体重变化的相关因素。
比较了1546名乳腺癌幸存者诊断时的体重与诊断后12、24、36、48和60个月时的体重。分析了绝对体重变化(千克)和相对体重变化(%)。采用逻辑回归分析确定与短期(1年)和长期(5年)体重变化相关的因素。
诊断后12个月时,平均体重显著下降最为明显。在亚组分析中,较年轻年龄组在36个月后体重显著增加。较年长年龄组和化疗组在24个月后体重显著下降。诊断后12个月时约40%体重增加者和60%体重减轻者在60个月时恢复到初始体重。化疗和较低教育水平分别与短期体重减轻和增加有关。对于长期变化,诊断时的年龄是唯一相关因素。
接受化疗的韩国乳腺癌幸存者诊断后主要经历体重减轻而非体重增加。短期体重变化与化疗和教育水平独立相关。然而,长期体重变化与诊断时的年龄有关。BMI正常的乳腺癌幸存者可根据诊断后体重变化的时间依赖性风险进行分类。