Lei Yuan-Yuan, Ho Suzanne C, Kwok Carol, Cheng Ashley, Cheung Ka Li, Lee Roselle, Mo Frankie, Yeo Winnie
Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China.
Division of Epidemiology, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, New Territories, Hong Kong, SAR, China.
BMC Cancer. 2021 Jul 20;21(1):839. doi: 10.1186/s12885-021-08554-5.
Body weight management was an important component in breast cancer survivorship care. The present study described the change patterns of body weight and waist-to-hip ratio (WHR) during the first 5 years of survival, and investigated potential factors associated with very substantial changes.
Based on a longitudinal cohort with 1462 Chinese women with breast cancer, anthropometric measurements including body weight, height, waist and hip circumferences were measured by trained interviewers following standard protocol at four time-points: baseline at study entry, 18-, 36- and 60-months follow up assessments (termed as T0, T1, T2 and T3, respectively). Body height was measured at baseline and body weight at cancer diagnosis were retrieved from medical record.
Compared to weight at breast cancer diagnosis, the median weight change was - 0.5 kg, 0 kg, + 0.5 kg, and + 1 kg at T0, T1, T2 and T3, respectively. During the first 5 years of survival, the proportion of women who were obese have slightly increased. At 60-months after diagnosis, only 14.3% of women had weight gain by > 5 kg; and the percentage of women who had weight gain by > 10% was 10.7%. Nearly half of patients had abdominal obesity at study entry, and this proportion were gradually increased to nearly 70% at 60-months follow-up. Multivariate analysis indicated that older age, and frequent sports participation during the first 5 years of survival were related to lower risk of very substantial weight gain (> 10%) at 60-month follow-up; patients aged 40-49 years, having ≥2 comorbidities and ER negative were associated with less likelihood of very substantial WHR substantial increase (> 10%) at 60-month follow-up.
Weight gain was modest in Chinese breast cancer survivors during the first 5 years of survival, while central adiposity has become a contemporary public health issue. The incorporation of healthy weight and abdominal circumference patient education and management has a potential to improve cancer survivorship.
体重管理是乳腺癌生存护理的重要组成部分。本研究描述了生存头5年期间体重和腰臀比(WHR)的变化模式,并调查了与显著变化相关的潜在因素。
基于一个包含1462名中国乳腺癌女性的纵向队列,由经过培训的访员按照标准方案在四个时间点测量人体测量学指标,包括体重、身高、腰围和臀围:研究入组时的基线、18个月、36个月和60个月的随访评估(分别称为T0、T1、T2和T3)。在基线时测量身高,并从病历中获取癌症诊断时的体重。
与乳腺癌诊断时的体重相比,T0、T1、T2和T3时的体重变化中位数分别为-0.5kg、0kg、+0.5kg和+1kg。在生存的头5年中,肥胖女性的比例略有增加。诊断后60个月时,只有14.3%的女性体重增加超过5kg;体重增加超过10%的女性比例为10.7%。近一半的患者在研究入组时存在腹型肥胖,这一比例在60个月随访时逐渐增加到近70%。多变量分析表明,年龄较大以及在生存的头5年中经常参加体育活动与60个月随访时体重显著增加(>10%)的风险较低有关;40-49岁、患有≥2种合并症且雌激素受体阴性的患者在60个月随访时WHR显著增加(>10%)的可能性较小。
中国乳腺癌幸存者在生存的头5年中体重增加幅度较小,而中心性肥胖已成为一个当代公共卫生问题。纳入健康体重和腹围的患者教育与管理有可能改善癌症生存情况。