Department of Psychology, University of Miami, Coral Gables, FL 33146, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Front Biosci (Landmark Ed). 2022 May 7;27(5):148. doi: 10.31083/j.fbl2705148.
Overweight and obese (OW/OB) body mass index (BMI) is associated with greater inflammation and poorer outcomes in breast cancer (BC). Stress management interventions using cognitive behavioral therapy (CBT) and relaxation training (RT) have reduced inflammation in BC patients but have not been tested specifically in OW/OB patients undergoing primary treatment. We developed brief CBT and RT-based group interventions and tested their effects (vs time-matched Health Education [HE] control) on serum inflammatory cytokines (IL-6, IL-1β and TNF-α) in OW/OB vs normal weight (NW) BC patients during primary treatment. We hypothesized OW/OB women would show higher levels of inflammatory cytokines, and that stress management would decrease these cytokines more in OW/OB women than in NW women.
Stage 0 - III BC patients were enrolled post-surgery and before initiating adjuvant therapy, were randomized to either 5 weeks of CBT, RT, or HE, and provided questionnaires and blood samples at baseline and 6-months. Serum cytokine levels were measured by ELISA. Repeated measures analysis of variance tested the interaction of condition by BMI by time in predicting cytokine levels over 6 months, controlling for age, stage, ethnicity, and income.
The sample (N = 153) majority was OW/OB (55.6%). We found differences in baseline IL-6 and IL-1β across BMI categories, with greater IL-6 ( < 0.005) and IL-1β ( < 0.04) in OW and OB vs NW women, but no difference between OW and OB women. There were no differences in baseline TNF-α among BMI groups. BMI category moderated the effect of brief stress management interventions on IL-6 changes over 6-months ( = 0.028): CBT/RT vs HE decreased IL-6 in OW/OB ( = 0.045) but not in NW patients ( = 0.664). There were no effects on IL-1β or TNF-α. Results could not be explained by differences in receipt of adjuvant therapy, prescription medications, or changes in physical activity.
OW/OB women with newly diagnosed BC had significantly greater serum IL-6 and IL-1β than NW women post-surgery. Brief stress management delivered with primary treatment among OW/OB patients may reduce the increases in inflammatory markers known to accompany adjuvant treatments and could thus promote better outcomes.
NCT02103387.
超重和肥胖（OW/OB）的体重指数（BMI）与乳腺癌（BC）的炎症反应增加和预后较差有关。使用认知行为疗法（CBT）和放松训练（RT）的压力管理干预措施已经降低了 BC 患者的炎症反应，但尚未在接受主要治疗的 OW/OB 患者中进行专门测试。我们开发了基于简短 CBT 和 RT 的小组干预措施，并测试了它们在主要治疗期间对 OW/OB 与正常体重（NW）BC 患者血清炎症细胞因子（IL-6、IL-1β 和 TNF-α）的影响（与时间匹配的健康教育[HE]对照组相比）。我们假设 OW/OB 女性的炎症细胞因子水平更高，并且压力管理会比 NW 女性更能降低 OW/OB 女性的这些细胞因子。
术后和开始辅助治疗前招募了 0 期-III 期 BC 患者，将他们随机分配到 5 周的 CBT、RT 或 HE，在基线和 6 个月时提供问卷和血液样本。通过 ELISA 测量血清细胞因子水平。重复测量方差分析测试了条件与 BMI 与时间的相互作用，以预测 6 个月内细胞因子水平的变化，同时控制年龄、分期、种族和收入。
样本（N=153）大部分为 OW/OB（55.6%）。我们发现 BMI 类别之间的基线 IL-6 和 IL-1β 存在差异，OW 和 OB 女性的 IL-6（<0.005）和 IL-1β（<0.04）更高，但 OW 和 OB 女性之间没有差异。BMI 组之间的基线 TNF-α 没有差异。BMI 类别调节了简短压力管理干预对 6 个月内 IL-6 变化的影响（=0.028）：CBT/RT 与 HE 降低了 OW/OB 的 IL-6（=0.045），而 NW 患者则没有（=0.664）。对 IL-1β 或 TNF-α 没有影响。这些结果不能用接受辅助治疗、处方药物或体力活动变化的差异来解释。
手术后新诊断为 BC 的 OW/OB 女性的血清 IL-6 和 IL-1β 明显高于 NW 女性。OW/OB 患者在接受主要治疗期间接受简短的压力管理可能会降低已知伴随辅助治疗而增加的炎症标志物，从而改善预后。
NCT02103387。
