Ayoub Nehad M, Jaradat Sara K, Alhusban Ahmed, Tahaineh Linda
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan.
Int J Womens Health. 2020 Mar 6;12:139-149. doi: 10.2147/IJWH.S234408. eCollection 2020.
To investigate the association between glycosylated hemoglobin A1c (HbA1c) with anthropometric measurements and clinicopathologic characteristics of breast cancer patients. Such data are lacking in Arabian countries.
A cross-sectional study was conducted at the Outpatient Oncology Unit at King Hussein Medical Center at the Royal Medical Services (RMS) and 223 breast cancer patients were included. Blood levels of HbA1c were measured and patients were classified into normal/non-diabetic (HbA1c <5.7%), prediabetic (HbA1c 5.7-6.4%), and diabetic (HbA1c ≥6.5%).
The average age of patients was 49.9±10.3 years. Most patients had waist circumference equal to or more than 80 cm (91.9%) and more than half (55.2%) had waist-hip ratio equal to or more than 0.85. Mean body mass index (BMI) was 29.9±5.7 kg/m. The mean level of HbA1c was 6.2±1.4% (range 4.7% to 12.6%). HbA1c levels revealed that most patients in this study classified as prediabetics (44.4%). There was a significant positive correlation between HbA1c levels and each of patient's age (r=0.267, p<0.001), waist circumference (r=0.180, p=0.008), and waist-hip ratio (r=0.278, p<0.001). Compared with premenopausal breast cancer patients, postmenopausal patients had significantly higher HbA1c blood levels (t=-3.542, p=0.003). HbA1c was significantly associated with stage (p=0.044) and grade (p=0.016) of carcinoma in premenopausal breast cancer patients. Among postmenopausal cases, HbA1c was significantly associated with molecular subtype of the disease (p=0.039).
The majority of Jordanian breast cancer patients in this study are prediabetic, obese, and had visceral obesity. HbA1c levels are increased among older patients and those who have greater waist circumference and waist-hip ratio. HbA1c is associated with advanced stage and grade of breast carcinoma in premenopausal patients and with molecular subtype in postmenopausal cases. These findings urge the need to screen breast cancer patients for glycemic status upon disease presentation and to further consider treatments to control hyperglycemia in order to reduce the impact of metabolic derangements on disease prognosis and outcomes.
探讨糖化血红蛋白A1c（HbA1c）与乳腺癌患者人体测量指标及临床病理特征之间的关联。阿拉伯国家缺乏此类数据。
在皇家医疗服务机构（RMS）的侯赛因国王医疗中心门诊肿瘤科进行了一项横断面研究，纳入了223例乳腺癌患者。测量了HbA1c的血液水平，并将患者分为正常/非糖尿病组（HbA1c<5.7%）、糖尿病前期组（HbA1c 5.7 - 6.4%）和糖尿病组（HbA1c≥6.5%）。
患者的平均年龄为49.9±10.3岁。大多数患者的腰围等于或大于80 cm（91.9%），超过半数（55.2%）的患者腰臀比等于或大于0.85。平均体重指数（BMI）为29.9±5.7 kg/m²。HbA1c的平均水平为6.2±1.4%（范围4.7%至12.6%）。HbA1c水平显示，本研究中的大多数患者被归类为糖尿病前期患者（44.4%）。HbA1c水平与患者的年龄（r = 0.267，p<0.001）、腰围（r = 0.180，p = 0.008）和腰臀比（r = 0.278，p<0.001）均呈显著正相关。与绝经前乳腺癌患者相比，绝经后患者的HbA1c血液水平显著更高（t = -3.542，p = 0.003）。在绝经前乳腺癌患者中，HbA1c与癌症分期（p = 0.044）和分级（p = 0.016）显著相关。在绝经后病例中，HbA1c与疾病的分子亚型显著相关（p = 0.039）。
本研究中大多数约旦乳腺癌患者处于糖尿病前期、肥胖且存在内脏肥胖。老年患者以及腰围和腰臀比更大的患者中HbA1c水平升高。在绝经前患者中，HbA1c与乳腺癌的晚期和分级相关，在绝经后病例中与分子亚型相关。这些发现促使有必要在乳腺癌患者就诊时筛查其血糖状态，并进一步考虑控制高血糖的治疗方法，以减少代谢紊乱对疾病预后和结局的影响。
