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早期乳腺癌幸存者的关键代谢参数显著变化:一项探索性 PILOT 研究。

Key metabolic parameters change significantly in early breast cancer survivors: an explorative PILOT study.

机构信息

Department of Oncology, Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark.

Department of Endocrinology and Internal Medicine MEA, Aarhus University Hospital, Palle Juul Jensens Blvd 99, 8200, Arhus N, Denmark.

出版信息

J Transl Med. 2019 Apr 1;17(1):105. doi: 10.1186/s12967-019-1850-2.

Abstract

BACKGROUND

With increasing number of breast cancer survivors, more attention is drawn to long-term consequences of curative cancer treatment. Adjuvant treatment of breast cancer patients is associated with several unfavorable medical conditions, including dyslipidemia, insulin resistance, and obesity, potentially leading to cardiovascular disease and/or the metabolic syndrome. The aim of this explorative study is to investigate metabolic side effects of adjuvant treatment in breast cancer patients.

METHODS

A cohort of 13 premenopausal and 20 postmenopausal women with early stage breast cancer were extensively examined prior to, immediately after and 1 year after ended adjuvant chemotherapy and compared with healthy controls (N = 36) matched by age and menopausal status. Repeated examinations included: anthropometric measures, DEXA scans, 24-h blood pressure measurements, and blood samples [high sensitivity CRP, lipid profile and glucose metabolism, including homeostatic model assessment (HOMA)].

RESULTS

At baseline, breast cancer patients were similar to healthy controls regarding all measures. From baseline to 1-year post-treatment specific components of the metabolic syndrome increased significantly in premenopausal breast cancer patients; body fat (P = 0.01), triglycerides (P = 0.03), waist circumference (P = 0.008) and diastolic blood pressure (P = 0.04). In postmenopausal patients, waist circumference also increased significantly (P = 0.03), and High density lipoprotein (HDL) cholesterol decreased significantly (P = 0.05).

CONCLUSIONS

Specific components of the metabolic syndrome changed significantly during chemotherapy in early stage breast cancer patients. After 1 year, several key parameters remained pathologically changed. Premenopausal breast cancer patients seemed to be especially prone to develop these unfavorable changes. Trial registration ClinicalTrial.gov, registration number NCT02652975. Registered 15 December 2015-Retrospectively registered, https://clinicaltrials.gov/ .

摘要

背景

随着乳腺癌幸存者人数的增加,人们越来越关注癌症治疗的长期后果。乳腺癌患者的辅助治疗与多种不良的医学状况有关,包括血脂异常、胰岛素抵抗和肥胖,这可能导致心血管疾病和/或代谢综合征。本探索性研究旨在调查乳腺癌患者辅助治疗的代谢副作用。

方法

在辅助化疗结束前、结束后立即和结束后 1 年,对 13 例绝经前和 20 例绝经后早期乳腺癌女性患者进行了广泛检查,并与年龄和绝经状态匹配的健康对照组(N=36)进行了比较。重复检查包括:人体测量学测量、DEXA 扫描、24 小时血压测量和血液样本[高敏 C 反应蛋白、血脂谱和葡萄糖代谢,包括稳态模型评估(HOMA)]。

结果

在基线时,乳腺癌患者在所有指标上与健康对照组相似。从基线到治疗后 1 年,绝经前乳腺癌患者的代谢综合征特定成分显著增加;体脂肪(P=0.01)、甘油三酯(P=0.03)、腰围(P=0.008)和舒张压(P=0.04)。在绝经后患者中,腰围也显著增加(P=0.03),高密度脂蛋白(HDL)胆固醇显著降低(P=0.05)。

结论

早期乳腺癌患者在化疗过程中代谢综合征的特定成分发生了显著变化。1 年后,一些关键参数仍然存在病理变化。绝经前乳腺癌患者似乎更容易出现这些不利变化。试验注册临床Trials.gov,注册号 NCT02652975。2015 年 12 月 15 日注册-回顾性注册,https://clinicaltrials.gov/。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62c8/6444586/ef4df5cc799b/12967_2019_1850_Fig1_HTML.jpg

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