Larrad-Sáinz Angélica, Hernández Núñez María Gemma, Barabash Bustelo Ana, Gil Prados Inés, Valerio Johanna, Espadas Gil José Luis, Olivares Crespo María Eugenia, Herrera de la Muela María, Bernaldo Madrid Blanca, Serrano García Irene, Cristóbal García Ignacio, Rubio-Herrera Miguel Ángel, Calle-Pascual Alfonso Luis, Brenes Sánchez Juana María, Matía-Martín Pilar
Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Medicin II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Nutrients. 2025 Jul 30;17(15):2487. doi: 10.3390/nu17152487.
BACKGROUND/OBJECTIVES: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat redistribution or muscle loss. The objective of this exploratory study was to assess the evolution of body composition and muscle strength after one year of treatment, and their relationship with metabolic biomarkers.
Prospective observational study in newly diagnosed breast cancer patients. Body composition was assessed using bioelectrical impedance analysis (BIA) and ultrasound (US); muscle strength was measured by handgrip dynamometry. Biomarkers analyzed included glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), total cholesterol (and its fractions), triglycerides, C-reactive protein (CRP), 6-interleukin (IL-6), vitamin D, myostatin, and fibroblast growth factor 21 (FGF-21).
Sixty-one women (mean age 58 years) were included. After one year, fat mass and related parameters significantly increased, while skeletal muscle mass and muscle strength decreased. Sarcopenic obesity prevalence rose from 1.16% to 4.9%. No significant changes were found in biomarkers, but positive correlations were observed between fat parameters and insulin, HOMA-IR, and triglycerides, and negative correlations with HDL-cholesterol.
BIA and US can detect unfavorable changes in body composition that are not reflected in conventional measurements. At one year post-diagnosis, women showed increased fat accumulation, muscle loss, and reduced strength, even without significant metabolic biomarker changes. Further research is warranted to elucidate the long-term clinical implications of these findings and the external validity in larger cohorts.
背景/目的：乳腺癌女性在确诊后体重增加很常见，这与较差的临床结局相关。然而，体重、体重指数（BMI）和腰围等传统指标无法检测到身体成分的关键变化，如脂肪重新分布或肌肉流失。本探索性研究的目的是评估治疗一年后身体成分和肌肉力量的变化，以及它们与代谢生物标志物的关系。
对新诊断的乳腺癌患者进行前瞻性观察研究。使用生物电阻抗分析（BIA）和超声（US）评估身体成分；通过握力计测量肌肉力量。分析的生物标志物包括葡萄糖、胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、糖化血红蛋白（HbA1c）、总胆固醇（及其组分）、甘油三酯、C反应蛋白（CRP）、6-白细胞介素（IL-6）、维生素D、肌肉生长抑制素和成纤维细胞生长因子21（FGF-21）。
纳入61名女性（平均年龄58岁）。一年后，脂肪量及相关参数显著增加，而骨骼肌量和肌肉力量下降。肌少症肥胖患病率从1.16%升至4.9%。生物标志物未发现显著变化，但脂肪参数与胰岛素、HOMA-IR和甘油三酯之间存在正相关，与高密度脂蛋白胆固醇呈负相关。
BIA和US能够检测到常规测量未反映出的身体成分的不利变化。确诊一年后，女性表现出脂肪堆积增加、肌肉流失和力量下降，即使代谢生物标志物无显著变化。有必要进一步研究以阐明这些发现的长期临床意义以及在更大队列中的外部有效性。
