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预防乳腺癌患者的他莫昔芬相关性非酒精性脂肪性肝病。

Prevention of Tamoxifen-related Nonalcoholic Fatty Liver Disease in Breast Cancer Patients.

机构信息

Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

出版信息

Clin Breast Cancer. 2018 Aug;18(4):e677-e685. doi: 10.1016/j.clbc.2017.11.010. Epub 2017 Nov 23.

Abstract

BACKGROUND

Tamoxifen is commonly used to prevent breast cancer recurrence. Studies have confirmed the association between tamoxifen and nonalcoholic fatty liver disease (NAFLD), with the results indicating the need for aggressive management of this side effect. We assessed the potential risk factors for and identified the possible protective factors of tamoxifen-related fatty liver.

MATERIALS AND METHODS

We enrolled patients with a history of breast cancer, aged 20 to 70 years, who had received with tamoxifen treatment within the past 5 years. We obtained the initial data and performed a follow-up blood test and ultrasound examination to compare the differences before and after tamoxifen treatment. The patients were divided into relatively normal and fatty liver groups.

RESULTS

Of the 266 enrolled tamoxifen-treated patients, 143 (53.8%) and 123 (46.2%) were in the relatively normal and fatty liver groups, respectively. The initial body weight (57.6 ± 9.3 kg vs. 60.9 ± 10.3 kg; P = .006) and body mass index (BMI; 23.4 ± 3.8 kg/m vs. 25.0 ± 4.2 kg/m; P < .001) were lower in the relatively normal group. An initial BMI of ≥ 22 kg/m was a potential risk factor for tamoxifen-related NAFLD (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.00-2.48; P = .048). In contrast, a weekly exercise duration of ≥ 150 minutes reduced the risk (HR, 0.47; 95% CI, 0.31-0.69; P < .001).

CONCLUSION

The results from our study suggest that a BMI of ≥ 22 kg/m is a potential risk factor for tamoxifen-related fatty liver and exercise is a possible protective factor.

摘要

背景

他莫昔芬常用于预防乳腺癌复发。研究证实他莫昔芬与非酒精性脂肪性肝病(NAFLD)之间存在关联,结果表明需要积极管理这种副作用。我们评估了他莫昔芬相关脂肪肝的潜在危险因素,并确定了可能的保护因素。

材料与方法

我们招募了年龄在 20 至 70 岁之间、过去 5 年内接受过他莫昔芬治疗的乳腺癌病史患者。我们获得了初始数据,并进行了随访血液检查和超声检查,以比较他莫昔芬治疗前后的差异。患者分为相对正常和脂肪肝组。

结果

在 266 名接受他莫昔芬治疗的患者中,143 名(53.8%)和 123 名(46.2%)分别在相对正常和脂肪肝组。初始体重(57.6 ± 9.3 kg 与 60.9 ± 10.3 kg;P =.006)和体重指数(BMI;23.4 ± 3.8 kg/m 与 25.0 ± 4.2 kg/m;P <.001)在相对正常组中较低。初始 BMI 大于等于 22 kg/m 是他莫昔芬相关 NAFLD 的潜在危险因素(危险比[HR],1.58;95%置信区间[CI],1.00-2.48;P =.048)。相比之下,每周运动时间大于等于 150 分钟可降低风险(HR,0.47;95% CI,0.31-0.69;P <.001)。

结论

我们的研究结果表明,BMI 大于等于 22 kg/m 是他莫昔芬相关脂肪肝的潜在危险因素,而运动可能是一种保护因素。

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