51
|
Kim HJ, Kim HS, Kim HR, Yoo YS, Song BJ. Characterization of Metabolic Syndrome Risk Factors and Health-Related Behaviors in Korean Patients With Breast Cancer by Abdominal Obesity Status. J Nurs Res 2020; 28:e74. [PMID: 31599785 DOI: 10.1097/jnr.0000000000000345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Breast cancer is the second most prevalent malignancy among Korean women. Changes in lifestyle during and after remission of breast cancer tend to increase abdominal visceral fat, leading to increased risks of metabolic syndrome and chronic diseases. PURPOSE This cross-sectional study examined the differences in metabolic syndrome risk factors and health-related behaviors between abdominally obese and nonabdominally obese groups of Korean patients with breast cancer. METHODS The participants were assigned to nonabdominal obesity (waist circumference < 85 cm, n = 77) and abdominal obesity (waist circumference ≥ 85 cm, n = 59) groups, and a questionnaire was used to assess the prevalence of risk factors of metabolic syndrome and health-related behaviors in each. The chi-square test and t test were used to analyze the data. RESULTS The average age was 54.2 years in the abdominal obesity group and 51.3 years in the nonabdominal obesity group. The average blood pressure and fasting blood glucose levels were higher in the abdominal obesity than the nonabdominal obesity group (117.3/76.3 vs. 108.9/70.4 mmHg, respectively [p = .001]; 96.9 and 90.1 mg/dl, respectively [p = .007]). High-density lipoprotein cholesterol was lower in the abdominal obesity than the nonabdominal obesity group (55.4 and 62.5 mg/dl, respectively [p = .005]), whereas triglycerides were higher in the abdominal obesity than the nonabdominal obesity group (151.6 and 111.3 mg/dl, respectively [p = .006]). The prevalence of metabolic syndrome in the abdominal obesity and nonabdominal obesity groups were 42.4% and 9.1%, respectively (p = .001). Moreover, eating habits differed between the two groups, with the frequency of vegetable consumption lower in the abdominal obesity than the nonabdominal obesity group (p = .040) and the frequencies of salty and sweet food consumption and of overeating higher in the abdominal obesity than the nonabdominal obesity group. The percentage of participants who exercised for 30 minutes three times per week was 52.5% in the abdominal obesity group and 71.4% in the nonabdominal obesity group (p = .024). CONCLUSIONS/IMPLICATIONS FOR PRACTICE This observational study found more metabolic syndrome risk factors in the abdominal obesity group than the nonabdominal obesity group. Consumption of sweet foods and overeating were higher and the frequencies of vegetable intake and exercise were lower in the abdominal obesity group. These findings suggest that female abdominally obese patients with breast cancer exhibit health-related behaviors that require improvement and better management. Interventional programs should be developed based on the findings of this study to reduce cancer recurrence and mortality in patients with breast cancer.
Collapse
Affiliation(s)
- Hye-Jin Kim
- PhD, RN, Assistant Professor, Department of Nursing, University of Ulsan, Ulsan, ROK
| | - Hee-Seung Kim
- PhD, RN, Professor, College of Nursing, The Catholic University of Korea, Seoul, ROK
| | - Hye-Ryoung Kim
- PhD, RN, Assistant Professor, College of Nursing, Shinhan University, Dongducheon, ROK
| | - Yang-Sook Yoo
- PhD, RN, Professor, College of Nursing, The Catholic University of Korea, Seoul, ROK
| | - Byung Joo Song
- PhD, MD, Professor, Department of Surgery, College of Medicine, St. Mary's Hospital, The Catholic University of Korea, Bucheon, ROK
| |
Collapse
|
52
|
Li P, Wang T, Zeng C, Yang M, Li G, Han J, Wu W. Association between metabolic syndrome and prognosis of breast cancer: a meta-analysis of follow-up studies. Diabetol Metab Syndr 2020; 12:10. [PMID: 32015762 PMCID: PMC6990514 DOI: 10.1186/s13098-019-0514-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has been suggested to be a risk factor for many cancers, including breast cancer. However, it remains unclear whether MetS predicts poor prognosis in women with breast cancer. A meta-analysis was performed to summarize the association between MetS and clinical outcome in women with breast cancer. METHODS Cohort studies were identified by search of PubMed and Embase databases. A random-effect model incorporating the potential heterogeneity was applied to pool the results. Subgroup analyses according to the ethnicity and study design were performed. RESULTS Nine cohort studies with 17,892 women with breast cancer were included. Pooled results showed that MetS was significantly associated with an increased risk of breast cancer recurrence (adjusted risk ratio [RR] = 1.52, 95%, p = 0.02). Subgroup analyses showed that MetS was independently associated with increased recurrence of breast cancer in Caucasians (adjusted RR = 1.75, p = 0.02), but not in Asians (adjusted RR = 1.07, p = 0.81), and MetS was associated with a trend of increased risk of breast cancer recurrence in both the prospective and retrospective studies. Although we failed to show a significant association between MetS and breast cancer related deaths (adjusted RR = 1.24, p = 0.41), MetS was associated with increased risk of all-cause deaths in these patients (adjusted RR = 1.80, p < 0.001). CONCLUSIONS MetS may predict the risk of cancer recurrence and mortality in women with breast cancer, particularly in Caucasians.
Collapse
Affiliation(s)
- Peiting Li
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Tianying Wang
- Department of Hepatopancreatobiliary Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Chen Zeng
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Meng Yang
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Gang Li
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Jiang Han
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| | - Wei Wu
- Department of Breast Thyroid Surgery, The Third Xiangya Hospital of Central South University, No. 172 Tong Zi Po Road, Changsha, 410013 China
| |
Collapse
|
53
|
Knobf MT, Jeon S. Metabolic Syndrome, Exercise, and Cardiovascular Fitness in Breast Cancer Survivors. J Adv Pract Oncol 2020; 11:98-102. [PMID: 33542853 PMCID: PMC7517769 DOI: 10.6004/jadpro.2020.11.1.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Comorbid illness contributes to poorer cancer outcomes and higher mortality. Metabolic syndrome (MetS) includes a cluster of risk factors that are associated with an increased risk of comorbidities. Routine physical activity represents a risk reduction strategy for cancer survivors. From 148 participants in a 12-month randomized control trial (RCT) of a fitness center exercise intervention compared to home physical activity group, a subset analysis was conducted to explore the effect of exercise on MetS risk factors. There were 32 (21.6%) breast cancer survivors who met the criteria for MetS at baseline. Over the 12 months, there were significantly fewer participants who met the criteria for MetS (p < .01), and there was significant improvement in individual risk factors, specifically fasting blood sugar (p = .01), and high-density lipoprotein (HDL; p = .02). Cardiovascular fitness was evaluated and greater heart recovery rate (HRR) was negatively associated with waist circumference, triglycerides, systolic blood pressure, fasting blood sugar, and MetS risk (p < .02) and positively associated with HDL (p = .03). Oncology advanced practitioners are uniquely qualified to integrate risk reduction into the management of at-risk oncology patients.
Collapse
Affiliation(s)
- M Tish Knobf
- Yale University School of Nursing, Orange, Connecticut
| | | |
Collapse
|
54
|
Abstract
Patients with a current diagnosis of breast cancer are enjoying dramatic cure rates and survivorship secondary to an increase in awareness, earlier detection, and more effective therapies. Although strategies such as Breast Cancer Awareness Month in October focus on early detection, lifestyle changes are seldom discussed other than dietary concerns and physical activity. Lifestyle modifications centered on diet and exercise have been demonstrated to affect overall disease-free survival in breast cancer. Since the early 2000s, the role of the human gut microbiota and its relation to breast cancer has become a major area of interest in the scientific and medical community. We live and survive owing to the symbiotic relationship with the microorganisms within us: the human microbiota. Scientific advances have identified a subset of the gut microbiota: the estrobolome, those bacteria that have the genetic capability to metabolize estrogen, which plays a key role in most breast cancers. Recent research provides evidence that the gut microbiome plays a substantial role in estrogen regulation. Gut microbiota diversity appears to be an essential component of overall health, including breast health. Future research attention should include a more extensive focus on the role of the human gut microbiota in breast cancer.
Collapse
Affiliation(s)
- Balazs I Bodai
- The Breast Cancer Survivorship Institute, Kaiser Permanente, Sacramento, CA
| | - Therese E Nakata
- The Breast Cancer Survivorship Institute, Kaiser Permanente, Sacramento, CA
| |
Collapse
|
55
|
Kraus WE, Bhapkar M, Huffman KM, Pieper CF, Krupa Das S, Redman LM, Villareal DT, Rochon J, Roberts SB, Ravussin E, Holloszy JO, Fontana L. 2 years of calorie restriction and cardiometabolic risk (CALERIE): exploratory outcomes of a multicentre, phase 2, randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7:673-683. [PMID: 31303390 PMCID: PMC6707879 DOI: 10.1016/s2213-8587(19)30151-2] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND For several cardiometabolic risk factors, values considered within normal range are associated with an increased risk of cardiovascular morbidity and mortality. We aimed to investigate the short-term and long-term effects of calorie restriction with adequate nutrition on these risk factors in healthy, lean, or slightly overweight young and middle-aged individuals. METHODS CALERIE was a phase 2, multicentre, randomised controlled trial in young and middle-aged (21-50 years), healthy non-obese (BMI 22·0-27·9 kg/m2) men and women done in three clinical centres in the USA. Participants were randomly assigned (2:1) to a 25% calorie restriction diet or an ad libitum control diet. Exploratory cardiometabolic risk factor responses to a prescribed 25% calorie restriction diet for 2 years were evaluated (systolic, diastolic, and mean blood pressure; plasma lipids; high-sensitivity C-reactive protein; metabolic syndrome score; and glucose homoeostasis measures of fasting insulin, glucose, insulin resistance, and 2-h glucose, area-under-the curve for glucose, and insulin from an oral glucose tolerance test) analysed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT00427193. FINDINGS From May 8, 2007, to Feb 26, 2010, of 238 participants that were assessed, 218 were randomly assigned to and started a 25% calorie restriction diet (n=143, 66%) or an ad libitum control diet (n=75, 34%). Individuals in the calorie restriction group achieved a mean reduction in calorie intake of 11·9% (SE 0·7; from 2467 kcal to 2170 kcal) versus 0·8% (1·0) in the control group, and a sustained mean weight reduction of 7·5 kg (SE 0·4) versus an increase of 0·1 kg (0·5) in the control group, of which 71% (mean change in fat mass 5·3 kg [SE 0·3] divided by mean change in weight 7·5 kg [0·4]) was fat mass loss. Calorie restriction caused a persistent and significant reduction from baseline to 2 years of all measured conventional cardiometabolic risk factors, including change scores for LDL-cholesterol (p<0·0001), total cholesterol to HDL-cholesterol ratio (p<0·0001), and systolic (p<0·0011) and diastolic (p<0·0001) blood pressure. In addition, calorie restriction resulted in a significant improvement at 2 years in C-reactive protein (p=0·012), insulin sensitivity index (p<0·0001), and metabolic syndrome score (p<0·0001) relative to control. A sensitivity analysis revealed the responses to be robust after controlling for relative weight loss changes. INTERPRETATION 2 years of moderate calorie restriction significantly reduced multiple cardiometabolic risk factors in young, non-obese adults. These findings suggest the potential for a substantial advantage for cardiovascular health of practicing moderate calorie restriction in young and middle-aged healthy individuals, and they offer promise for pronounced long-term population health benefits. FUNDING National Institute on Aging and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
Collapse
Affiliation(s)
- William E Kraus
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - Manjushri Bhapkar
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Carl F Pieper
- Duke Center for Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
| | - Sai Krupa Das
- Jean Mayer, US Department of Agriculture, Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | | | - Dennis T Villareal
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA
| | | | - Susan B Roberts
- Jean Mayer, US Department of Agriculture, Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - John O Holloszy
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Luigi Fontana
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA; Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy; School of Medicine and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
56
|
Lee YS, Lee HS, Chang SW, Lee CU, Kim JS, Jung YK, Kim JH, Seo YS, Yim HJ, Lee CH, Woo SU, Seo JH, Yeon JE, Um SH, Byun KS. Underlying nonalcoholic fatty liver disease is a significant factor for breast cancer recurrence after curative surgery. Medicine (Baltimore) 2019; 98:e17277. [PMID: 31574842 PMCID: PMC6775430 DOI: 10.1097/md.0000000000017277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/15/2019] [Accepted: 08/28/2019] [Indexed: 02/07/2023] Open
Abstract
Breast cancer is the most common cancer among women worldwide, and it is a main cause of death in women. As with breast cancer, metabolic components are important risk factors for the development of nonalcoholic fatty liver disease (NAFLD). In this retrospective cohort study, we aimed to determine the prevalence of NAFLD in patients with breast cancer and the impact of NAFLD on the prognosis of breast cancer.Patients with breast cancer were enrolled in the study from January 2007 to June 2017. Hepatic steatosis was evaluated through non-enhanced computed tomography scan by measuring Hounsfield Units in the liver and spleen, respectively; 123 healthy controls who underwent non-enhanced computed tomography scan were also analyzed.The prevalence of NAFLD in patients with breast cancer was 15.8% (251/1587), which was significantly higher than in healthy controls (8.9%, 11/123) (P = .036). Overall survival did not significantly differ between the groups with and without NAFLD (P = .304). However, recurrence-free survival was significantly higher in patients without NAFLD than in those with NAFLD (P = .009). Among breast cancer patients receiving endocrine treatment, the NAFLD group showed a higher cumulative incidence of significant liver injury than the group without NAFLD (P < .001).The prevalence of NAFLD in patients with breast cancer is significantly higher than in healthy controls. Moreover, breast cancer patients with NAFLD showed poorer prognosis in terms of recurrence. Therefore, diagnostic evaluation for NALFD is important in managing patients with breast cancer.
Collapse
Affiliation(s)
- Young-Sun Lee
- Department of Internal Medicine, Korea University College of Medicine
| | - Ha Seok Lee
- Department of Internal Medicine, Korea University College of Medicine
| | - Sung Won Chang
- Department of Internal Medicine, Korea University College of Medicine
| | - Chan Uk Lee
- Department of Internal Medicine, Korea University College of Medicine
| | - Jung Sun Kim
- Division of Hematology/Oncology, Department of Internal medicine, Korea University Ansan Hospital
| | - Young Kul Jung
- Department of Internal Medicine, Korea University College of Medicine
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine
| | - Chang Hee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine
| | - Sang Uk Woo
- Department of Surgery, Korea University Guro Hospital
| | - Jae Hong Seo
- Division of Oncology/Hematology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine
| | - Soon Ho Um
- Department of Internal Medicine, Korea University College of Medicine
| | - Kwan Soo Byun
- Department of Internal Medicine, Korea University College of Medicine
| |
Collapse
|
57
|
|
58
|
Buss LA, Mandani A, Phillips E, Scott NJA, Currie MJ, Dachs GU. Characterisation of a Mouse Model of Breast Cancer with Metabolic Syndrome. In Vivo 2018; 32:1071-1080. [PMID: 30150428 DOI: 10.21873/invivo.11348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/03/2018] [Accepted: 07/12/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIM Patients with breast cancer and metabolic syndrome have poorer outcomes. We aimed to develop and characterise an apolipoprotein E-null/aromatase knockout (ApoE-/-/ArKO) mouse model of breast cancer with metabolic syndrome to aid research of the mechanisms behind poor prognosis. MATERIALS AND METHODS Wild-type, ApoE-/- and ApoE-/-/ArKO mice were orthotopically implanted with EO771 murine breast cancer cells. Tumour growth was monitored and tumours investigated for pathological features such as cancer-associated adipocytes, hypoxia and cancer cell proliferation. RESULTS Tumours from ApoE-/-/ArKO mice were significantly more proliferative than those from wild-type mice (p=0.003), and exhibited reduced expression of insulin-like growth factor binding protein-5 (p=0.002). However, ApoE-/-/ArKO mice also had a reduced rate of metastasis compared to wild-type and ApoE-/- mice. Tumour hypoxia and the number of cancer-associated adipocytes did not differ. CONCLUSION The ApoE-/-/ArKO model with EO771 breast cancer provides a novel mouse model to investigate the effects of metabolic syndrome on aspects of breast tumour biology.
Collapse
Affiliation(s)
- Linda A Buss
- Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Anishah Mandani
- Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Elisabeth Phillips
- Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Nicola J A Scott
- Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Margaret J Currie
- Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Gabi U Dachs
- Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand
| |
Collapse
|
59
|
Dibaba DT, Ogunsina K, Braithwaite D, Akinyemiju T. Metabolic syndrome and risk of breast cancer mortality by menopause, obesity, and subtype. Breast Cancer Res Treat 2018; 174:209-218. [PMID: 30465158 DOI: 10.1007/s10549-018-5056-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 11/16/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate the association between metabolic syndrome (MetS) and risk of breast cancer mortality by menopausal status, obesity, and subtype. METHODS Data from 94,555 women free of cancer at baseline in the National Institute of Health-American Association of Retired Persons Diet and Health Study cohort (NIH-AARP) were used to investigate the prospective associations of baseline MetS and components with risk of breast cancer mortality using Cox proportional hazard regression models adjusted for baseline behavioral and demographic covariates. RESULTS During a mean follow-up duration of 14 years, 607 women in the cohort died of breast cancer. Overall, MetS was associated with a 73% increased risk of breast cancer mortality (HR 1.73; 95% CI 1.09-2.75); the association remained significant among post-menopausal women overall (HR 2.07, 95% CI 1.32, 3.25), and among those with overweight/obesity (HR 1.15, 95% CI 0.81, 1.64). MetS was associated with increased risk of breast cancer mortality for ER+/PR+ (HR 1.28, 95% CI 0.52, 3.16) and lower risk for ER-/PR- (HR 0.44, 95% CI 0.11, 1.75) subtypes; however, the associations were not statistically significant. Of the individual MetS components, high waist circumference (HR 1.32, 95% CI 1.03, 1.70), high cholesterol (HR 1.24, 95% CI 1.05, 1.46), and hypertension (HR 1.24, 95% CI 1.05, 1.46) were independently associated with increased risk of breast cancer mortality. CONCLUSIONS MetS was associated with increased risk of breast cancer mortality, especially among post-menopausal women. Further studies with larger sample sizes are needed to definitively determine the extent to which these associations vary by breast cancer subtype.
Collapse
Affiliation(s)
- Daniel T Dibaba
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Kemi Ogunsina
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | | | - Tomi Akinyemiju
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA.
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
- College of Public Health and Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
| |
Collapse
|
60
|
A Dietary Intervention to Lower Serum Levels of IGF-I in BRCA Mutation Carriers. Cancers (Basel) 2018; 10:cancers10090309. [PMID: 30181513 PMCID: PMC6162406 DOI: 10.3390/cancers10090309] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/31/2018] [Accepted: 09/02/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Insulin-like growth factor I (IGF-I) and other markers of insulin resistance (IRm) might influence the penetrance of BRCA gene mutation. In a demonstration project on BRCA mutation carriers we tested the effect of the 'Mediterranean diet', with moderate protein restriction, on serum levels of IGF-I and IRm. METHODS BRCA mutation carriers, with or without breast cancer, aged 18⁻70 years and without metastases were eligible. After the baseline examinations, women were randomized to an active dietary intervention or to a control group. The intervention group attended six full days of life-style intervention activities (cookery classes followed by lunch, sessions of walking for 45 min and nutritional conferences) over the next six months. RESULTS 213 BRCA mutation carriers completed the six-month study. Women in the intervention group (110) showed major changes in all the parameters under study. They significantly lost weight (p < 0.001), fat mass (p = 0.002), with reduced hip circumference (p = 0.01), triglycerides (p = 0.02) and IGF-I (p = 0.02) compared with controls. They also had a significantly higher levels of insulin-like growth factor-binding protein 3 (IGFI-BP3) (p = 0.03) and a lower IGF-I/IGFI-BP3 ratio (p = 0.04). The reduction of serum levels of IGF-I was significantly associated with the reduction in the consumption of animal products (p = 0.04). CONCLUSIONS Women in the intervention group showed significant improvements in IGF-I and in other IRm that might influence the penetrance of BRCA mutations.
Collapse
|
61
|
Metabolic Syndrome and the Risk of Breast Cancer and Subtypes by Race, Menopause and BMI. Cancers (Basel) 2018; 10:cancers10090299. [PMID: 30200454 PMCID: PMC6162759 DOI: 10.3390/cancers10090299] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/24/2018] [Accepted: 08/29/2018] [Indexed: 01/08/2023] Open
Abstract
The objective of this study was to investigate the association of metabolic syndrome (MetS) with the risk of invasive breast cancer and molecular subtypes across race, menopause, and body mass index (BMI) groups. We examined the association of metabolic syndrome and its components with risk of invasive breast cancer among 94,555 female participants of the National Institute of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, accounting for ductal carcinoma in situ as a competing risk. Cox proportional hazard regression with the Fine and Gray method was used to generate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for baseline sociodemographic, behavioral, and clinical covariates. During a mean follow-up of 14 years, 5380 (5.7%) women developed breast cancer. Overall, MetS at baseline was associated with a 13% increased risk of breast cancer compared to women without MetS (HR: 1.13, 95% CI: 1.00, 1.27); similar estimates were obtained among postmenopausal women (HR: 1.14, 95% CI: 1.01, 1.29). MetS was associated with a slight but non-significantly increased risk of breast cancer among those with both normal weight and overweight/obesity, and those with estrogen receptor positive breast cancer subtype. In the NIH-AARP cohort, MetS was associated with an increased risk of breast cancer. Further studies are needed to definitively evaluate the association of MetS with triple negative breast cancer subtypes across all levels of BMI.
Collapse
|
62
|
Lee MK, Lee DH, Park S, Kim SI, Jeon JY. Relationship between resting heart rate and metabolic risk factors in breast cancer patients. Clin Chim Acta 2018; 486:104-109. [PMID: 30030991 DOI: 10.1016/j.cca.2018.07.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 07/05/2018] [Accepted: 07/17/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Higher resting heart rate (RHR) was associated with poor prognosis in breast cancer survivors, but the mechanism underlying such association has not been fully studied. We investigated the association between RHR and metabolic risk factors in stage I-III breast cancer survivors. METHODS Among 11,013 women diagnosed with breast cancer between 2005 and 2013 at the Severance hospital in Seoul, Korea, a total of 4980 patients met our inclusion criteria for the final analysis. Multivariable linear regressions were used to examine the association between RHR and metabolic risk factors, including systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, triglyceride (TG), total cholesterol, high density lipid cholesterol (HDLC), and low density lipid cholesterol. RESULTS The results showed that RHR had significant linear associations with SBP (p = .02), DBP (p < .001), TG (p < .001), glucose (p < .001), and HDL-C (p < .001). Compared to participants in the lowest quintile of RHR (<68 beat per min (bpm)), participants in the highest quintile (≥85 bpm) had higher DBP by 4 mmHg, TG by 13 mg/dl, and glucose by 5 mg/dl after adjusting for potential confounders. Further subgroup analyses showed that the association of RHR may differ by age and menopausal status for fasting glucose and cancer stage, chemotherapy, estrogen and progesterone receptor status for TG. CONCLUSIONS We observed a strong positive association of RHR with fasting glucose, TG, and DBP in breast cancer survivors, which may potentially explain the association between RHR and breast cancer prognosis.
Collapse
Affiliation(s)
- Mi Kyung Lee
- Department of Sport Industry Studies, Exercise Medicine and Rehabilitation Laboratory, Yonsei University, Seoul, Republic of Korea; Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University College of Medicine, Seoul, Republic of Korea; Cancer Prevention Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, Republic Korea.
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, Republic Korea
| | - Justin Y Jeon
- Department of Sport Industry Studies, Exercise Medicine and Rehabilitation Laboratory, Yonsei University, Seoul, Republic of Korea; Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University College of Medicine, Seoul, Republic of Korea; Cancer Prevention Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
63
|
Fang Q, Tong YW, Wang G, Zhang N, Chen WG, Li YF, Shen KW, Wu BW, Chen XS. Neutrophil-to-lymphocyte ratio, obesity, and breast cancer risk in Chinese population. Medicine (Baltimore) 2018; 97:e11692. [PMID: 30045325 PMCID: PMC6078664 DOI: 10.1097/md.0000000000011692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Breast cancer (BC), obesity, and metabolic syndrome (MetS) shared a common mechanism of dysregulated metabolism and inflammatory response in disease initiation. Neutrophil-to-lymphocyte ratio (NLR) is associated with adverse survival of BC patients. The aim of this study is to identify risk effect between NLR and BC in Chinese population with or without obesity and MetS. BC and age-matched breast benign disease (BBD) patients were retrospectively analyzed from Comprehensive Breast Health Center, Shanghai Ruijin Hospital. MetS was defined using AHA/NHLBI criteria. Individuals were classified into very low (0-1.30), low (1.31-1.67), intermediate (1.68-2.20), and high (>2.20) NLR subsets by each NLR quartile. In all, 1540 BC and 1540 BBD patients were included. Univariate and multivariate analysis found that NLR (OR: 1.27, 95% CI: 1.16-1.39, P < .001) and obesity (OR: 1.19, 95% CI: 1.00-1.42, P = .046) but not MetS (P = .060) were significantly associated with increased BC risk. Intermediate or high NLR substantially increased BC risk compared to very low NLR group (OR: 1.57, 95% CI: 1.29-1.92, P < .001; OR: 1.84, 95% CI: 1.50-2.25, P < .001; respectively) in whole population. Subgroup analysis found that the impact of higher NLR on BC risk was more obvious in patients without obesity (intermediate NLR, OR: 1.72, 95% CI: 1.37-2.16, P < .001; high NLR, OR: 1.92, 95% CI: 1.53-2.41, P < .001) or without MetS (intermediate NLR, OR: 1.70, 95% CI: 1.35-2.14, P < .001; high NLR, OR: 1.98, 95% CI: 1.57-2.51, P < .001). Higher preoperative NLR was found in BC patients compared with BBD patients. Intermediate to high NLR level substantially increased BC risk, which was more relevant for those without obesity or MetS.
Collapse
Affiliation(s)
- Qiong Fang
- School of Nursing, Shanghai Jiao Tong University
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yi-Wei Tong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Gen Wang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Nan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Guo Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Ya-Fen Li
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Kun-Wei Shen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Bei-Wen Wu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Song Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| |
Collapse
|
64
|
Travier N, Buckland G, Vendrell JJ, Fernandez-Veledo S, Peiró I, Del Barco S, Pernas S, Zamora E, Bellet M, Margeli M, Cirauqui B, Muñoz M, Tusquets I, Arcusa A, Javierre C, Moreno F, Rodriguez A, Agudo A. Changes in metabolic risk, insulin resistance, leptin and adiponectin following a lifestyle intervention in overweight and obese breast cancer survivors. Eur J Cancer Care (Engl) 2018; 27:e12861. [PMID: 29869823 DOI: 10.1111/ecc.12861] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 02/01/2018] [Accepted: 04/17/2018] [Indexed: 12/18/2022]
Abstract
Adiposity and physical activity are modifiable factors that could be important determinants of breast cancer (BC) prognosis through their effects on endogenous reproductive hormones, chronic inflammation and metabolic changes. Therefore, it is necessary to evaluate whether offering lifestyle interventions to BC survivors could affect the levels of certain biomarkers involved in these mechanisms. We designed a pre-post intervention study offering diet and exercise sessions over 12 weeks to 42 overweight/obese BC survivors. Before and after the intervention, we obtained dietary information, anthropometry and cardiorespiratory fitness (CRF) measurements and blood samples to measure metabolic risk, insulin resistance and adipokines biomarkers. Wilcoxon signed-rank tests and Spearman partial correlation coefficients were used to compare pre- and post-measurements and assess the correlations between changes in biomarkers and changes in anthropometry and CRF. Breast cancer survivors showed significant improvements in metabolic risk biomarkers and insulin resistance indicators along with a non-significant leptin decrease and a significant adiponectin decrease. The improvements in metabolic risk biomarkers, insulin resistance indicators and leptin were moderately correlated (0.32 ≤ |r| ≤ 0.55) with the decrease in body mass index and the increase in CRF. Diet and exercise interventions implemented in overweight/obese BC survivors may improve metabolic risk, insulin resistance and leptin biomarkers.
Collapse
Affiliation(s)
- Noemie Travier
- Cancer Prevention and Control Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Genevieve Buckland
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Joan J Vendrell
- Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain
| | - Sonia Fernandez-Veledo
- Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain
| | - Immaculada Peiró
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Sonia Del Barco
- Department of Medical Oncology-ICO, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - Sonia Pernas
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Esther Zamora
- Vall d'Hebron Institute of Oncology (VHIO), Breast Cancer Unit, Department of Medical Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Meritxell Bellet
- Vall d'Hebron Institute of Oncology (VHIO), Breast Cancer Unit, Department of Medical Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mireia Margeli
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Beatriz Cirauqui
- Department of Medical Oncology-ICO, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Montserrat Muñoz
- Department of Medical Oncology, Hospital Clínic, Barcelona, Spain
| | - Ignasi Tusquets
- Department of Medical Oncology, Hospital del Mar, Barcelona, Spain
| | - Angels Arcusa
- Department of Medical Oncology, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Casimiro Javierre
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ferran Moreno
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Ana Rodriguez
- Breast Cancer Functional Unit, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| |
Collapse
|
65
|
Nelson ER. The significance of cholesterol and its metabolite, 27-hydroxycholesterol in breast cancer. Mol Cell Endocrinol 2018; 466:73-80. [PMID: 28919300 PMCID: PMC5854519 DOI: 10.1016/j.mce.2017.09.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 12/12/2022]
Abstract
Although significant advances in the treatment of breast cancer have been made, in particular in the use of endocrine therapy, de novo and aquired resistance to therapy, and metastatic recurrence continue to be major clinical problems. Given the high prevalence of breast cancer, new life-style or chemotherapeutic approaches are required. In this regard, cholesterol has emerged as a risk factor for the onset of breast cancer, and elevated cholesterol is associated with a poor prognosis. While treatment with cholesterol lowering medication is not associated with breast cancer risk, it does appear to be protective against recurrence. Importantly, the cholesterol axis represents a potential target for both life-style and pharmacological intervention. This review will outline the clinical and preclinical data supporting a role for cholesterol in breast cancer pathophysiology. Specific focus is given to 27-hydroxycholesterol (27-OHC; (3β,25R)-Cholest-5-ene-3,26-diol)), a primary metabolite of cholesterol that has recently been defined as an endogenous Selective Estrogen Receptor Modulator. Future perspectives and directions are discussed.
Collapse
Affiliation(s)
- Erik R Nelson
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; University of Illinois Cancer Center, Chicago, IL, USA; Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Cancer Center at Illinois, University of Illinois at Urbana-Champaign, IL, USA.
| |
Collapse
|
66
|
Zhang ZP, Zhang XF, Li H, Liu TJ, Zhao QP, Huang LH, Cao ZJ, He LM, Hao DJ. Serum irisin associates with breast cancer to spinal metastasis. Medicine (Baltimore) 2018; 97:e0524. [PMID: 29703023 PMCID: PMC5944558 DOI: 10.1097/md.0000000000010524] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to determine whether the serum level of irisin can be a candidate to predict the spinal metastasis in patients with breast cancer.In a cross-sectional study, 148 patients were recruited. Of those, 53 (35.8%) had spinal metastasis. The baseline characteristics were compared by status of spinal metastasis. Multiple logistic regression analysis was used to determine whether the serum irisin can be a candidate for predicting breast cancer to spinal metastasis. The correlation coefficient analysis was used to confirm the correlation between the serum irisin and lipid metabolic parameters and body mass index (BMI), respectively.The serum irisin was higher in patients without spinal metastasis (7.60 ± 3.80). Multivariable analysis showed that the serum irisin was protective to the presence of spinal metastasis in patients with breast cancer after adjustments of age and BMI (odds ratio, 0.873; 95% confidence interval, 0.764-0.999). Furthermore, there was a positive correlation between the serum irisin and BMI (r = 0.263). The patients with metabolisc syndrome (MetS) had a higher level in serum irisin. In addition, the higher numbers of MetS components were associated with higher serum irisin.Higher serum irisin can be a protective factor of spinal metastasis in patients with breast cancer. The BMI is positively associated with the serum level of irisin. Furthermore, patients with MetS tended to have a higher level of serum irisin.
Collapse
|
67
|
Vernieri C, Nichetti F, Raimondi A, Pusceddu S, Platania M, Berrino F, de Braud F. Diet and supplements in cancer prevention and treatment: Clinical evidences and future perspectives. Crit Rev Oncol Hematol 2018; 123:57-73. [DOI: 10.1016/j.critrevonc.2018.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 01/11/2018] [Indexed: 12/14/2022] Open
|
68
|
Simon MS, Beebe-Dimmer JL, Hastert TA, Manson JE, Cespedes Feliciano EM, Neuhouser ML, Ho GYF, Freudenheim JL, Strickler H, Ruterbusch J, Barac A, Chlebowski R, Caan B. Cardiometabolic risk factors and survival after breast cancer in the Women's Health Initiative. Cancer 2018; 124:1798-1807. [PMID: 29338086 DOI: 10.1002/cncr.31230] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/01/2017] [Accepted: 12/18/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the relationship between cardiometabolic risk factors linked to metabolic syndrome and mortality among women with breast cancer. METHODS We used the Women's Health Initiative to evaluate the relationship between cardiometabolic risk factors, including waist circumference (WC), blood pressure, cholesterol level, and presence of type 2 diabetes, and their relation with death from breast cancer, cardiovascular disease (CVD), and other causes among 8641 women with local or regional stage invasive breast cancer. Cox proportional hazards models were used to estimate hazard ratios, and 95% confidence intervals, adjusted for important predictors of survival. RESULTS After a median of 11.3 years, there were 2181 total deaths, 619 (28.4%) of which were due to breast cancer. Most participants (55.7%) had at least 2 cardiometabolic risk factors, and 4.9% had 3 or 4. Having a larger number of risk factors was associated with higher risk of CVD and other-cause mortality (P trend < .001 for both), but not with breast cancer mortality (P trend = .86). Increased WC was associated with a higher risk of CVD (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.05-1.57) and other-cause mortality (HR, 1.32; 95% CI, 1.16-1.49) and only with a small and nonsignificant higher risk of breast cancer mortality (HR, 1.19; 95% CI, 0.93-1.52). The results did not differ in analyses stratified by race, hormone receptor status, or after an analysis of cases diagnosed within 5 years after baseline. CONCLUSIONS Among women with early stage breast cancer, cardiometabolic risk factors are significantly associated with cardiovascular and other-cause mortality, but not breast cancer mortality. Cancer 2018;124:1798-807. © 2018 American Cancer Society.
Collapse
Affiliation(s)
- Michael S Simon
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Jennifer L Beebe-Dimmer
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Theresa A Hastert
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine, Great Neck, New York
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - Howard Strickler
- Department of Epidemiology and Public Health, Albert Einstein, New York, New York
| | - Julie Ruterbusch
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Ana Barac
- MedStar Heart and Vascular Institute, Washington, DC
| | - Rowan Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, California
| |
Collapse
|
69
|
Chang H, Wei JW, Chen K, Zhang S, Han F, Lu LX, Xiao WW, Gao YH. Apolipoprotein A-I Is a Prognosticator of Nasopharyngeal Carcinoma in the Era of Intensity-modulated Radiotherapy. J Cancer 2018; 9:702-710. [PMID: 29556328 PMCID: PMC5858492 DOI: 10.7150/jca.22836] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/08/2017] [Indexed: 02/07/2023] Open
Abstract
Background: In the era of intensity-modulated radiotherapy (IMRT), distant metastasis remains the major cause of death from nasopharyngeal carcinoma (NPC). This study aimed to evaluate the clinical value of pretreatment serum lipid profiles in predicting clinical outcome of NPC. Methodology / Principal Findings: A total of 1927 consecutive patients who had untreated NPC and completed radical IMRT between Jan. 2010 and Dec. 2011 were retrospectively reviewed. Pretreatment serum lipid indexes including total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-I (apoAI) and apolipoprotein B were analyzed for their association with survivals, together with the clinical features (age, sex, pathological type, anemia, chemotherapy sequence and Epstein-Barr virus deoxyribonucleic acid). Hazard ratio (HR) and 95% confidence interval (CI) were calculated for each independent prognosticator. After univariate and multivariate survival analysis, low apoAI level (< 1.125 mmol/L) appeared to predict poor 5-year overall survival (OS), disease-free survival (DFS) and distant-metastasis-free survival (DMFS).The HRs were 1.549 (95% CI, 1.137-2.109), 1.293 (95% CI, 1.047-1.597) and 1.288 (95% CI, 1.022-1.623), respectively. Subgroup survival analysis showed that the apoAI maintained predicting independence for OS, DFS and DMFS in patients with locally advanced NPC, even in those treated with concurrent chemoradiotherapy. Conclusions / Significance: NPC patient with low serum level of pretreatment apoAI might be at risk of distant metastasis. Treatment aiming to eradicate distant metastasis might improve survival of these patients.
Collapse
Affiliation(s)
- Hui Chang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Jia-Wang Wei
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Kai Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Shu Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Fei Han
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Li-Xia Lu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Wei-Wei Xiao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| | - Yuan-Hong Gao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangzhou, Guangdong 510060, China
| |
Collapse
|
70
|
Akinyemiju T, Moore JX, Judd S, Lakoski S, Goodman M, Safford MM, Pisu M. Metabolic dysregulation and cancer mortality in a national cohort of blacks and whites. BMC Cancer 2017; 17:856. [PMID: 29246121 PMCID: PMC5731092 DOI: 10.1186/s12885-017-3807-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 11/21/2017] [Indexed: 12/13/2022] Open
Abstract
Background We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults. Methods A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models. Results About 46% of Black and 39% of White participants met the criteria for MetS. Overall, participants with MetS (HR: 1.22, 95% CI: 1.03–1.45) were at increased risk of cancer-related death. In race-stratified analysis, Black participants with MetS had significantly increased risk of cancer mortality compared with those without MetS (HR: 1.32, 95% CI: 1.01–1.72), increasing to more than a 2-fold risk of cancer mortality among those with five metabolic syndrome components (HR: 2.35, 95% CI: 1.01–5.51). Conclusions There are marked racial differences in the prevalence of metabolic dysregulation defined as MetS based on the harmonized criteria. The strong positive associations between MetS and cancer mortality suggests that efforts to improve cancer outcomes in general, and racial disparities in cancer outcomes specifically, may benefit from prevention and management of MetS and its components. Electronic supplementary material The online version of this article (10.1186/s12885-017-3807-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Tomi Akinyemiju
- Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. .,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. .,Department of Epidemiology, University of Kentucky, Lexington, KY, USA.
| | - Justin Xavier Moore
- Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Susan Lakoski
- Division of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Goodman
- Department of Epidemiology, Emory University School of Public Health, Atlanta, GA, USA
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA.,Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria Pisu
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.,Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
71
|
Denis GV, Sebastiani P, Andrieu G, Tran AH, Strissel KJ, Lombardi FL, Palmer JR. Relationships Among Obesity, Type 2 Diabetes, and Plasma Cytokines in African American Women. Obesity (Silver Spring) 2017; 25:1916-1920. [PMID: 28840653 PMCID: PMC5669048 DOI: 10.1002/oby.21943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The principal objective of this investigation was to identify novel cytokine associations with BMI and type 2 diabetes (T2D). METHODS Cytokines were profiled from African American women with obesity who donated plasma to the Komen Tissue Bank. Multiplex bead arrays of analytes were used to quantify 88 cytokines and chemokines in association with clinical diagnoses of metabolic health. Regression models were generated after elimination of outliers. RESULTS Among women with obesity, T2D was associated with breast adipocyte hypertrophy and with six plasma analytes, including four chemokines (chemokine [C-C motif] ligand 2, chemokine [C-C motif] ligand 16, chemokine [C-X-C motif] ligand 1, and chemokine [C-X-C motif] ligand 16) and two growth factors (interleukin 2 and epidermal growth factor). In addition, three analytes were associated with obesity independently of diabetes: interleukin 4, soluble CD40 ligand, and chemokine (C-C motif) ligand 3. CONCLUSIONS Profiling of inflammatory cytokines combined with measures of BMI may produce a more personalized risk assessment for obesity-associated disease in African American women.
Collapse
Affiliation(s)
- Gerald V Denis
- Department of Medicine, Cancer Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Paola Sebastiani
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Guillaume Andrieu
- Department of Medicine, Cancer Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Anna H Tran
- Department of Medicine, Cancer Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Katherine J Strissel
- Department of Medicine, Cancer Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Frank L Lombardi
- Department of Medicine, Cancer Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, USA
| |
Collapse
|
72
|
Hamer J, Warner E. Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health. CMAJ 2017; 189:E268-E274. [PMID: 28246240 DOI: 10.1503/cmaj.160464] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Julia Hamer
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Ellen Warner
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ont.
| |
Collapse
|
73
|
Luque RM, López-Sánchez LM, Villa-Osaba A, Luque IM, Santos-Romero AL, Yubero-Serrano EM, Cara-García M, Álvarez-Benito M, López-Mirand a J, Gahete MD, Castaño JP. Breast cancer is associated to impaired glucose/insulin homeostasis in premenopausal obese/overweight patients. Oncotarget 2017; 8:81462-81474. [PMID: 29113405 PMCID: PMC5655300 DOI: 10.18632/oncotarget.20399] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/25/2017] [Indexed: 01/04/2023] Open
Abstract
The association between breast cancer (BCa) presence and altered glucose/insulin metabolism is controversial likely due to an inaccurate insulin resistance (IR) assessment and inappropriate stratification of patients by body-mass index (BMI) and menopausal state. 148 women with suspect of sporadic BCa were stratified by BMI and menopause. Fasting levels of glucose, insulin, glycohemoglobin and selected IR-related and tumor-derived markers were measured. Glucose/insulin levels during OGTT were used to calculate insulin resistance/sensitivity indexes. Analysis of 77 BCa-bearing patients and 71 controls showed an association between BCa and IR as demonstrated by impaired glucose/insulin homeostasis (increased fasting- and OGTT-induced glucose levels) and deteriorated IR indexes, which was especially patent in premenopausal women. The association between BCa presence and IR was markedly influenced by BMI, being obese BCa patients significantly more insulin resistant than controls. BCa presence was associated to elevated levels of IR (glucose, triglycerides) and tumor-derived (VEGF) markers, especially in overweight/obese patients. BCa presence is associated to IR in overweight/obese premenopausal but not in premenopausal normal weight or postmenopausal women. Our data support a bidirectional relationship between dysregulated/imbalanced glucose/insulin metabolism and BCa, as tumor- and IR-markers are correlated with the impairment of glucose/insulin metabolism in overweight/obese premenopausal BCa patients.
Collapse
Affiliation(s)
- Raúl M. Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBERobn, Córdoba, Spain
- ceiA3, Córdoba, Spain
| | - Laura M. López-Sánchez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBERobn, Córdoba, Spain
- ceiA3, Córdoba, Spain
| | - Alicia Villa-Osaba
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBERobn, Córdoba, Spain
- ceiA3, Córdoba, Spain
| | - Isabel M. Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - Ana L. Santos-Romero
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- CIBERobn, Córdoba, Spain
- Mammary Gland Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Elena M. Yubero-Serrano
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- CIBERobn, Córdoba, Spain
- Lipids and Atherosclerosis Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - María Cara-García
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- CIBERobn, Córdoba, Spain
- Mammary Gland Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Marina Álvarez-Benito
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- CIBERobn, Córdoba, Spain
- Mammary Gland Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - José López-Mirand a
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- CIBERobn, Córdoba, Spain
- Lipids and Atherosclerosis Unit, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Manuel D. Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBERobn, Córdoba, Spain
- ceiA3, Córdoba, Spain
| | - Justo P. Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Córdoba, Spain
- Hospital Universitario Reina Sofia, Córdoba, Spain
- CIBERobn, Córdoba, Spain
- ceiA3, Córdoba, Spain
| |
Collapse
|
74
|
Bruno E, Manoukian S, Venturelli E, Oliverio A, Rovera F, Iula G, Morelli D, Peissel B, Azzolini J, Roveda E, Pasanisi P. Adherence to Mediterranean Diet and Metabolic Syndrome in BRCA Mutation Carriers. Integr Cancer Ther 2017; 17:153-160. [PMID: 28741383 PMCID: PMC5950953 DOI: 10.1177/1534735417721015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background. Insulin resistance is associated with higher breast
cancer (BC) penetrance in BRCA mutation carriers. Metabolic
syndrome (MetS), an insulin resistance syndrome, can be reversed by adhering to
the Mediterranean diet (MedDiet). In a dietary intervention trial on
BRCA mutation carriers, we evaluated adherence to the
MedDiet, and the association with the MetS, by analyzing data from the
Mediterranean Diet Adherence Screener (MEDAS). Methods. BRCA
mutation carriers, with or without BC, aged 18 to 70 years, were eligible for
the trial. After the baseline examinations, women were randomized to a dietary
intervention or to a control group. Both groups completed the MEDAS at baseline
and at the end of the dietary intervention. Results. A total of
163 women completed the 6 months of dietary intervention. Compared with
controls, the women in the intervention group significantly reduced their
consumption of red meat (P < .01) and commercial sweets
(P < .01) and their MEDAS score rose significantly (+1.3
vs +0.55, P = .02). The number of MetS parameters decreased
with increasing points of adherence to the MEDAS score (P =
.01). In the intervention group, there was a significant association with the
greater reduction of MetS. Conclusion. BRCA mutation carriers
in the intervention group experienced greater improvement in their MedDiet and
MetS parameters.
Collapse
Affiliation(s)
- Eleonora Bruno
- 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,2 University of Milan, Milan, Italy
| | | | | | | | | | | | - Daniele Morelli
- 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Bernard Peissel
- 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Jacopo Azzolini
- 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | |
Collapse
|
75
|
Vaysse C, Lømo J, Garred Ø, Fjeldheim F, Lofteroed T, Schlichting E, McTiernan A, Frydenberg H, Husøy A, Lundgren S, Fagerland MW, Richardsen E, Wist EA, Muller C, Thune I. Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer. NPJ Breast Cancer 2017. [PMID: 28649659 PMCID: PMC5460134 DOI: 10.1038/s41523-017-0015-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Growing evidence indicates that adiposity is associated with breast cancer risk and negatively affects breast cancer recurrence and survival, a paracrine role of mammary adipose tissue being very likely in this process. In contrast to other adipose depots, occurrence of a sub-inflammatory state of mammary adipose tissue defined by dying adipocytes surrounded by macrophages forming crown-like structures in overweight and obese subjects, remains only partially described. In a general population of breast cancer patients (107 patients) mostly undergoing breast-conserving surgery, we found a positive association between patient's body composition, breast adipocytes size, and presence of crown-like structures in mammary adipose tissue close to the tumor. Overweight (BMI: 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) patients have 3.2 and 6.9 times higher odds ratio of crown-like structures respectively, compared with normal weight patients. The relatively small increase in adipocyte size in crown-like structures positive vs. negative patients suggests that mammary adipose tissue inflammation might occur early during hypertrophy. Our results further highlight that body mass index is an adequate predictor of the presence of crown-like structures in mammary adipose tissue among postmenopausal women, whereas in premenopausal women truncal fat percentage might be more predictive, suggesting that mammary adipose tissue inflammation is more likely to occur in patients exhibiting visceral obesity. Finally, the presence of crown-like structures was positively associated with systemic markers such as the Triglyceride/High-density lipoprotein-cholesterol ratio serum C-reactive protein and glucose/(HbA1c) glycated Haemoglobin. These compelling results demonstrate that excess adiposity, even in overweight patients, is associated with mammary adipose tissue inflammation, an event that could contribute to breast cancer development and progression.
Collapse
Affiliation(s)
- Charlotte Vaysse
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Jon Lømo
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Øystein Garred
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Frøydis Fjeldheim
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trygve Lofteroed
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ellen Schlichting
- Department of Breast and Endocrine Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne McTiernan
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, Seattle, WA USA
| | | | - Anders Husøy
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Steinar Lundgren
- Department of Oncology, St. Olavs University Hospital, Trondheim, Norway
| | - Morten W Fagerland
- Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital Oslo, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Elin Richardsen
- Department of Medical Biology, Department of Clinical Pathology, UiT The Arctic University of Norway, University of North Norway, Tromsø, Norway
| | - Erik A Wist
- The Cancer Center, Oslo University Hospital, Oslo, Norway
| | - Catherine Muller
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Inger Thune
- The Cancer Center, Oslo University Hospital, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| |
Collapse
|
76
|
Melvin JC, Garmo H, Holmberg L, Hammar N, Walldius G, Jungner I, Lambe M, Van Hemelrijck M. Glucose and lipoprotein biomarkers and breast cancer severity using data from the Swedish AMORIS cohort. BMC Cancer 2017; 17:246. [PMID: 28376727 PMCID: PMC5381045 DOI: 10.1186/s12885-017-3232-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 03/24/2017] [Indexed: 12/27/2022] Open
Abstract
Background The lipid and glucose metabolisms are postulated as possible intermediary mechanisms in linking obesity and breast cancer (BC). Links between serum lipid and glucose biomarkers and BC risk has been observed in the Swedish Apolipoprotein MORtality RISk (AMORIS) cohort. We conducted a follow-up analysis including information on tumour characteristics. Methods One thousand eight hundred twenty-four women diagnosed with BC, with serum biomarker levels of glucose, triglycerides, cholesterol (total, HDL, and LDL), and apolipoproteins A-1 and B recorded in a routine health check at baseline were included. BC severity was split into categories (good, moderate, and poor prognosis) based on ER status, TNM stage, and age at diagnosis. Proportional odds models were used to obtain odds ratios (ORs) and 95% confidence intervals (CI), with the interval time between baseline measurement and BC diagnosis accounted for. Results Serum glucose and the ApoB/ApoA-1 ratio showed a non-statistically significant positive association with BC severity (proportional OR: 1.25 (95%CI: 0.92–1.70) for glucose (</≥ 5.60 mmol/L) and 1.31 (95%CI: 0.97–1.76) for ApoB/A-1 ratio (</≥ 1). The proportion of severe and moderate BC was modestly greater across all abnormal serum biomarker groups. Conclusions Despite the size and detail of data in AMORIS, we only found a modest positive association between serum levels of glucose, apoB/ApoA-1 and BC severity, suggesting that these factors are not the main players in linking obesity and BC aggressiveness. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3232-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jennifer C Melvin
- King's College London, Division of Cancer Studies, Translational Oncology and Urology Research (TOUR), Research Oncology, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK
| | - Hans Garmo
- King's College London, Division of Cancer Studies, Translational Oncology and Urology Research (TOUR), Research Oncology, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.,Regional Cancer Centre, Uppsala/Ӧrebro, Uppsala, Sweden
| | - Lars Holmberg
- King's College London, Division of Cancer Studies, Translational Oncology and Urology Research (TOUR), Research Oncology, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK
| | - Niklas Hammar
- Unit of Epidemiology, Insitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,AstraZeneca R&D, Mölndal, Sweden
| | - Göran Walldius
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala/Ӧrebro, Uppsala, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mieke Van Hemelrijck
- King's College London, Division of Cancer Studies, Translational Oncology and Urology Research (TOUR), Research Oncology, Guy's Hospital, 3rd Floor, Bermondsey Wing, London, SE1 9RT, UK.
| |
Collapse
|
77
|
Iyengar NM, Brown KA, Zhou XK, Gucalp A, Subbaramaiah K, Giri DD, Zahid H, Bhardwaj P, Wendel NK, Falcone DJ, Wang H, Williams S, Pollak M, Morrow M, Hudis CA, Dannenberg AJ. Metabolic Obesity, Adipose Inflammation and Elevated Breast Aromatase in Women with Normal Body Mass Index. Cancer Prev Res (Phila) 2017; 10:235-243. [PMID: 28270386 PMCID: PMC5380584 DOI: 10.1158/1940-6207.capr-16-0314] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/25/2017] [Accepted: 02/04/2017] [Indexed: 01/25/2023]
Abstract
Obesity is associated with breast white adipose tissue (WAT) inflammation, elevated levels of the estrogen biosynthetic enzyme, aromatase, and systemic changes that have been linked to the pathogenesis of breast cancer. Here, we determined whether metabolic obesity, including changes in breast biology and systemic effects, occurs in a subset of women with normal body mass index (BMI). Breast WAT and fasting blood were collected from 72 women with normal BMI (<25 kg/m2) undergoing mastectomy for breast cancer risk reduction or treatment. WAT inflammation was defined by the presence of crown-like structures of the breast (CLS-B) which are composed of dead or dying adipocytes surrounded by macrophages. Severity of inflammation was measured as CLS-B/cm2 The primary objective was to determine whether breast WAT inflammation is associated with aromatase expression and activity. Secondary objectives included assessment of circulating factors and breast adipocyte size. Breast WAT inflammation was present in 39% of women. Median BMI was 23.0 kg/m2 (range, 18.4-24.9 kg/m2) in women with breast WAT inflammation versus 21.8 kg/m2 (range, 17.3-24.6 kg/m2) in those without inflammation (P = 0.04). Breast WAT inflammation was associated with elevated aromatase expression and activity, which increased with severity of inflammation (P < 0.05). Breast WAT inflammation correlated with larger adipocytes (P = 0.01) and higher circulating levels of C-reactive protein, leptin, insulin, and triglycerides (P ≤ 0.05). A subclinical inflammatory state associated with elevated aromatase in the breast, adipocyte hypertrophy, and systemic metabolic dysfunction occurs in some normal BMI women and may contribute to the pathogenesis of breast cancer. Cancer Prev Res; 10(4); 235-43. ©2017 AACRSee related article by Berger, p. 223-25.
Collapse
Affiliation(s)
- Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Kristy A Brown
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Xi Kathy Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Ayca Gucalp
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Kotha Subbaramaiah
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Heba Zahid
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
- Faculty of Applied Medical Science, Taibah University, Medina, Saudi Arabia
| | - Priya Bhardwaj
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Nils K Wendel
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Domenick J Falcone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Samantha Williams
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael Pollak
- Department of Medicine and Oncology, McGill University, Montreal, Quebec, Canada
| | - Monica Morrow
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | | |
Collapse
|
78
|
Kallens V, Tobar N, Molina J, Bidegain A, Smith PC, Porras O, Martínez J. Glucose Promotes a Pro-Oxidant and Pro-Inflammatory Stromal Microenvironment Which Favors Motile Properties in Breast Tumor Cells. J Cell Biochem 2017; 118:994-1002. [DOI: 10.1002/jcb.25650] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/11/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Violeta Kallens
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| | - Nicolás Tobar
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| | - Jessica Molina
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| | - Arantzazú Bidegain
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| | - Patricio C. Smith
- Laboratorio de Fisiología Periodontal; Facultad de Medicina; Pontificia Universidad Católica de Chile; Santiago 8330024 Chile
| | - Omar Porras
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| | - Jorge Martínez
- Laboratorio de Biología Celular y Molecular, INTA; Universidad de Chile; Santiago 7830490 Chile
| |
Collapse
|
79
|
Bruno E, Roveda E, Vitale J, Montaruli A, Berrino F, Villarini A, Venturelli E, Gargano G, Galasso L, Caumo A, Carandente F, Pasanisi P. Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women. Eur J Cancer Care (Engl) 2016; 27:e12617. [DOI: 10.1111/ecc.12617] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 12/20/2022]
Affiliation(s)
- E. Bruno
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Roveda
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - J. Vitale
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - A. Montaruli
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - F. Berrino
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - A. Villarini
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Venturelli
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - G. Gargano
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - L. Galasso
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - A. Caumo
- Research Centre of Metabolism; IRCCS Policlinico San Donato Milanese; Milan Italy
| | - F. Carandente
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - P. Pasanisi
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| |
Collapse
|
80
|
Characteristics associated with nonadherence to medications for hypertension, diabetes, and dyslipidemia among breast cancer survivors. Breast Cancer Res Treat 2016; 161:161-172. [PMID: 27826756 DOI: 10.1007/s10549-016-4043-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/01/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Comorbidity among breast cancer survivors is prevalent, and adherence to medication management of comorbidities may be important for both chronic disease and cancer-related outcomes. Our objective was to determine characteristics associated with nonadherence to common chronic medications among breast cancer survivors. METHODS We conducted a retrospective cohort study of 4216 women in an integrated care system diagnosed with early-stage breast cancer between 1990 and 2008 and alive without recurrence or second primary breast cancer in the second-year following diagnosis. Adherence to antihypertensives, oral diabetes medications, and statins was measured during the second-year post-breast cancer diagnosis using medication possession ratios (MPR). Nonadherence was defined as MPR <0.80. We estimated odds ratios (OR) and 95% confidence intervals (CI) for nonadherence to antihypertensives, oral diabetes medications, and statins by various characteristics using multivariable logistic regression. RESULTS Among 2308 users of antihypertensives (n = 1779), diabetes medications (n = 499) and/or statins (n = 1072), 37% were nonadherent to antihypertensives; 75% were nonadherent to diabetes medications; 39% were nonadherent to statins. In adjusted models, younger age was associated with nonadherence to all three therapeutic classes. Certain cancer treatments were associated with nonadherence to antihypertensives (radiation: OR 1.21, 95% CI 1.01-1.47; endocrine therapy: OR 1.27, 95% CI 1.03-1.52) and diabetes medications (chemotherapy: OR 1.69, 95% CI 1.17-2.21). Less frequent primary care provider visits were associated with higher odds of nonadherence to antihypertensives (OR 1.70, 95% CI 1.19-2.22); and trends showed higher Charlson comorbidity scores associated with greater adherence to diabetes medications (P < 0.001) and statins (P = 0.032). CONCLUSIONS Nonadherence to medications is high among breast cancer survivors, particularly diabetes medications, and is associated with cancer treatments and other patient characteristics. Additional research is warranted to understand the needs of cancer patients taking chronic medications and explore patient and provider factors influencing adherence.
Collapse
|
81
|
Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and Cancer Mechanisms: Tumor Microenvironment and Inflammation. J Clin Oncol 2016; 34:4270-4276. [PMID: 27903155 DOI: 10.1200/jco.2016.67.4283] [Citation(s) in RCA: 534] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose There is growing evidence that inflammation is a central and reversible mechanism through which obesity promotes cancer risk and progression. Methods We review recent findings regarding obesity-associated alterations in the microenvironment and the local and systemic mechanisms through which these changes support tumor growth. Results Locally, hyperadiposity is associated with altered adipose tissue function, adipocyte death, and chronic low-grade inflammation. Most individuals who are obese harbor inflamed adipose tissue, which resembles chronically injured tissue, with immune cell infiltration and remodeling. Within this distinctly altered local environment, several pathophysiologic changes are found that may promote breast and other cancers. Consistently, adipose tissue inflammation is associated with a worse prognosis in patients with breast and tongue cancers. Systemically, the metabolic syndrome, including dyslipidemia and insulin resistance, occurs in the setting of adipose inflammation and operates in concert with local mechanisms to sustain the inflamed microenvironment and promote tumor growth. Importantly, adipose inflammation and its protumor consequences can be found in some individuals who are not considered to be obese or overweight by body mass index. Conclusion The tumor-promoting effects of obesity occur at the local level via adipose inflammation and associated alterations in the microenvironment, as well as systemically via circulating metabolic and inflammatory mediators associated with adipose inflammation. Accurately characterizing the obese state and identifying patients at increased risk for cancer development and progression will likely require more precise assessments than body mass index alone. Biomarkers of adipose tissue inflammation would help to identify high-risk populations. Moreover, adipose inflammation is a reversible process and represents a novel therapeutic target that warrants further study to break the obesity-cancer link.
Collapse
Affiliation(s)
- Neil M Iyengar
- Neil M. Iyengar, Ayca Gucalp, and Clifford A. Hudis, Memorial Sloan Kettering Cancer Center; Neil M. Iyengar, Ayca Gucalp, Andrew J. Dannenberg, and Clifford A. Hudis, Weill Cornell Medical College, New York, NY
| | - Ayca Gucalp
- Neil M. Iyengar, Ayca Gucalp, and Clifford A. Hudis, Memorial Sloan Kettering Cancer Center; Neil M. Iyengar, Ayca Gucalp, Andrew J. Dannenberg, and Clifford A. Hudis, Weill Cornell Medical College, New York, NY
| | - Andrew J Dannenberg
- Neil M. Iyengar, Ayca Gucalp, and Clifford A. Hudis, Memorial Sloan Kettering Cancer Center; Neil M. Iyengar, Ayca Gucalp, Andrew J. Dannenberg, and Clifford A. Hudis, Weill Cornell Medical College, New York, NY
| | - Clifford A Hudis
- Neil M. Iyengar, Ayca Gucalp, and Clifford A. Hudis, Memorial Sloan Kettering Cancer Center; Neil M. Iyengar, Ayca Gucalp, Andrew J. Dannenberg, and Clifford A. Hudis, Weill Cornell Medical College, New York, NY
| |
Collapse
|
82
|
Park B, Kong SY, Lee EK, Lee MH, Lee ES. Metabolic syndrome in breast cancer survivors with high carbohydrate consumption: The first report in community setting. Clin Nutr 2016; 36:1372-1377. [PMID: 27686692 DOI: 10.1016/j.clnu.2016.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/03/2016] [Accepted: 09/12/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS This study was conducted to examine the prevalence of and lifestyle factors associated with the metabolic syndrome in breast cancer survivors and to compare those factors with controls without cancer in a community setting. METHODS This study included 584 female breast cancer survivors ≥3 years after the initial diagnosis and 2336 age-matched cancer-free female controls from 39 community health examination centers located in 14 urban areas in Korea. The prevalence of the metabolic syndrome is shown. Factors associated with the metabolic syndrome were analyzed as odds ratios (ORs) in cancer survivors and controls; differences between the two groups in the ORs of associated factors were evaluated by calculating p-heterogeneity values. RESULTS The prevalence of metabolic syndrome in breast cancer survivors and age-matched controls were 26.8% and 26.9%, respectively. Higher percentage of caloric intake from carbohydrates was associated with increased metabolic syndrome only in the breast cancer survivors (OR for the highest vs. lowest quartile for survivors = 2.48 [95% CI = 1.20-5.14]; OR for controls = 1.11 [95% CI = 0.81-1.51]; P-heterogeneity = 0.046). Sweat-inducing exercise for ≥150 min/week was associated with a lower risk of metabolic syndrome only in controls (controls: OR = 0.72 [95% CI = 0.58-0.89]; survivors: OR = 0.88 [95% CI = 0.57-1.36]). Older age, higher body mass index, and a lower education level (≤12 years) was associated with an increased prevalence of metabolic syndrome in both groups. CONCLUSIONS Our results suggest that, in regions with excess carbohydrate intake, the association of the metabolic syndrome with percentage of caloric intake from carbohydrate might be more prominent than exercise in breast cancer survivors, compared with general population.
Collapse
Affiliation(s)
- Boyoung Park
- Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea.
| | - Sun-Young Kong
- Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Research Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea.
| | - Eun Kyung Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Research Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea.
| | - Moo Hyun Lee
- National Cancer Center Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea.
| | - Eun Sook Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Research Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea; National Cancer Center Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea.
| |
Collapse
|
83
|
Examining the prevalence of metabolic syndrome among overweight/obese African-American breast cancer survivors vs. matched non-cancer controls. J Cancer Surviv 2016; 11:102-110. [PMID: 27562474 DOI: 10.1007/s11764-016-0566-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/07/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Metabolic Syndrome (MetS) is more predominant in overweight, obese and minority populations. This study examined the prevalence of MetS in an exclusively African-American (AA) cohort of breast cancer (BC) survivors; an underrepresented group in previous studies demonstrating negative BC outcomes disparities for females with MetS. METHODS Using a case-control design, overweight/obese AA women with treated Stage I-IIIa BC were matched 1:1 on age, race, sex, and body mass index (BMI) category with non-cancer population controls (n = 444). Three of the following conditions were used to define MetS: HDL cholesterol <50 mg/dL (1.3 mmol/L), serum triglycerides ≥150 mg/dL (1.7 mmol/L), blood glucose ≥100 mg/dL (or on treatment), waist circumference ≥88 cm, or ≥130 mmHg systolic or ≥85 mmHg diastolic blood pressure (or on treatment). Matched-pairs analyses were conducted. RESULTS For BC cases, most women had self-reported Stage I (n = 76) or Stage II (n = 91) disease and were 6.9 (±5.2) years post-diagnosis. MetS was significantly lower in BC survivors vs. their non-cancer population controls (43.2 vs. 51.4 %, respectively; p < 0.05). The diagnosis of MetS did not differ by BMI stratification. A lower prevalence of ≥2 risk factors (80.2 vs. 85.6 %, p < 0.05) was observed for all cases vs. CONTROLS CONCLUSIONS While MetS occurred less frequently in our BC cases vs. non-cancer controls, our estimates are nearly two times those reported in other BC survivors, suggesting important racial/ethnic differences. IMPLICATIONS FOR CANCER SURVIVORS The prognostic implications of MetS among AA BC survivors remain unknown and warrant further investigation.
Collapse
|
84
|
Dai D, Chen B, Wang B, Tang H, Li X, Zhao Z, Li X, Xie X, Wei W. Pretreatment TG/HDL-C Ratio Is Superior to Triacylglycerol Level as an Independent Prognostic Factor for the Survival of Triple Negative Breast Cancer Patients. J Cancer 2016; 7:1747-1754. [PMID: 27698913 PMCID: PMC5039397 DOI: 10.7150/jca.15776] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/26/2016] [Indexed: 12/22/2022] Open
Abstract
Purpose: Previous studies have reported that the triacylglycerol (TG) level and high-density lipoprotein cholesterol (HDL-C) are connected with breast cancer. However, the prognostic utility of the TG level and the TG/HDL-C ratio (THR) as conventional biomarkers in patients with triple negative breast cancer (TNBC) has not been elucidated. In this research, we investigate and compare the predictive value of the pretreatment serum TG level and THR in TNBC patients. Methods: We evaluated 221 patients with TNBC who had pretreatment conventional blood biochemical examinations and calculated the THR. Univariate and multivariate logistic regression analyses were used to assess the effect of the TG level and the THR on overall survival (OS) and disease-free survival (DFS). Results: The optimal cutoff values of the TG level and the THR were determined to be 0.935 mmol/L and 0.600, respectively. As shown in a Kaplan-Meier analysis, TNBC patients with a high TG level and THR had shorter OS and DFS than patients in the low-level groups (p < 0.05). The multivariate analysis suggested that the pretreatment THR level is an independent prognostic factor of OS (HR: 1.935; 95%CI: 1.032-3.629; p = 0.040) in TNBC patients. Conclusions: In conclusion, our data indicate that a high THR is an independent predictor and is superior to the TG level for predicting poor clinical outcomes in TNBC patients.
Collapse
Affiliation(s)
- Danian Dai
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Bo Chen
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Bin Wang
- Institute of Life Science, Chongqing Medical University, Chongqing, China
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xing Li
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhiping Zhao
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xuan Li
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| |
Collapse
|
85
|
Villarini M, Lanari C, Nucci D, Gianfredi V, Marzulli T, Berrino F, Borgo A, Bruno E, Gargano G, Moretti M, Villarini A. Community-based participatory research to improve life quality and clinical outcomes of patients with breast cancer (DianaWeb in Umbria pilot study). BMJ Open 2016; 6:e009707. [PMID: 27251681 PMCID: PMC4893863 DOI: 10.1136/bmjopen-2015-009707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Breast cancer (BC) is the most frequent cancer in Europe and the International Agency for Research on Cancer (IARC) has estimated over 460 000 incident cases per year. Survival among patients with BC has increased in the past decades and EUROCARE-5 has estimated a 5-year relative survival rate of 82% for patients diagnosed in 2000-2007. There is growing evidence that lifestyle (such as a diet based on Mediterranean principles associated with moderate physical activity) may influence prognosis of BC; however, this information is not currently available to patients and is not considered in oncology protocols. Only a few epidemiological studies have investigated the role of diet in BC recurrence and metastasis. METHODS AND ANALYSIS DianaWeb is a community-based participatory research dedicated to patients with BC and represents a collaborative effort between participants and research institutions to determine if specified changes in lifestyle would result in improved outcomes in terms of quality of life or survival. The aim of the study is to recruit a large number of participants, to monitor their lifestyle and health status over time, to provide them tips to encourage sustainable lifestyle changes, to analyse clinical outcomes as a function of baseline risk factors and subsequent changes, and to share with patients methodologies and results. DianaWeb uses a specific interactive website (http://www.dianaweb.org/) and, with very few exceptions, all communications will be made through the web. In this paper we describe the pilot study, namely DianaWeb in Umbria. ETHICS AND DISSEMINATION DianaWeb does not interfere with prescribed oncological treatments; rather, it recommends that participants should follow the received prescriptions. The results will be used to plan guidelines for nutrition and physical activity for patients with BC. The pilot study was approved by the ethics committee of the University of Perugia (reference number 2015-002), and is supported by Fondazione Cassa di Risparmio di Perugia (2013.0185 021).
Collapse
Affiliation(s)
- Milena Villarini
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Chiara Lanari
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Daniele Nucci
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Vincenza Gianfredi
- School of Specialization in Hygiene and Preventive Medicine, University of Perugia, Perugia, Italy
| | - Tiziana Marzulli
- School of Specialization in Hygiene and Preventive Medicine, University of Perugia, Perugia, Italy
| | | | - Alessandra Borgo
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Eleonora Bruno
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giuliana Gargano
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Massimo Moretti
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Anna Villarini
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|
86
|
Metabolic syndrome contributes to an increased recurrence risk of non-metastatic colorectal cancer. Oncotarget 2016; 6:19880-90. [PMID: 26082438 PMCID: PMC4637327 DOI: 10.18632/oncotarget.4166] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/01/2015] [Indexed: 12/16/2022] Open
Abstract
Objectives Epidemiological data suggests a close link between metabolic syndrome (MetS) and non-metastatic colorectal cancer (NMCRC). However, the relationship between MetS and the outcome of NMCRC is less well understood. We aim to evaluate the impact of MetS on the prognosis in NMCRC patients. Methods We performed a large cohort study of 1069 NMCRC patients. The Kaplan-Meier method was used to calculate the cumulative survival rate. Cox proportional hazard regression models were used to analyze the prognosis associated with MetS adjusting for clinicopathologic variables. Results MetS was identified in 20.7% of NMCRC patients. Patients with MetS were more likely to be older, higher levels of blood glucose, triglycerides, high density lipoprotein, and uric acid than patients without MS (P < 0.05 for all). During a mean period of 59.6 months follow-up, patients with MetS had a statistically significantly lower rate of disease-free survival (DFS) than the patients without MetS (P = 0.014), especially local recurrence (P = 0.040). However, there was no difference in overall survival (P = 0.116). Multivariate analysis showed that the presence of MetS was an independent risk factor for DFS (HR = 0.733, 95%CI 0.545–0.987, P = 0.041), but not for OS (P = 0.118). Conclusions MetS is associated with an increased recurrence risk of NMCRC.
Collapse
|
87
|
Non-Alcoholic Fatty Liver Disease and Extra-Hepatic Cancers. Int J Mol Sci 2016; 17:ijms17050717. [PMID: 27187365 PMCID: PMC4881539 DOI: 10.3390/ijms17050717] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease but the second cause of death among NAFLD patients are attributed to malignancies at both gastrointestinal (liver, colon, esophagus, stomach, and pancreas) and extra-intestinal sites (kidney in men, and breast in women). Obesity and related metabolic abnormalities are associated with increased incidence or mortality for a number of cancers. NAFLD has an intertwined relationship with metabolic syndrome and significantly contributes to the risk of hepatocellular carcinoma (HCC), but recent evidence have fuelled concerns that NAFLD may be a new, and added, risk factor for extra-hepatic cancers, particularly in the gastrointestinal tract. In this review we critically appraise key studies on NAFLD-associated extra-hepatic cancers and speculate on how NAFLD may influence carcinogenesis at these sites.
Collapse
|
88
|
Iyengar NM, Zhou XK, Gucalp A, Morris PG, Howe LR, Giri DD, Morrow M, Wang H, Pollak M, Jones LW, Hudis CA, Dannenberg AJ. Systemic Correlates of White Adipose Tissue Inflammation in Early-Stage Breast Cancer. Clin Cancer Res 2016; 22:2283-9. [PMID: 26712688 PMCID: PMC4854755 DOI: 10.1158/1078-0432.ccr-15-2239] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/16/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE Obesity, insulin resistance, and elevated levels of circulating proinflammatory mediators are associated with poorer prognosis in early-stage breast cancer. To investigate whether white adipose tissue (WAT) inflammation represents a potential unifying mechanism, we examined the relationship between breast WAT inflammation and the metabolic syndrome and its prognostic importance. EXPERIMENTAL DESIGN WAT inflammation was defined by the presence of dead/dying adipocytes surrounded by macrophages forming crown-like structures (CLS) of the breast. Two independent groups were examined in cross-sectional (cohort 1) and retrospective (cohort 2) studies. Cohort 1 included 100 women undergoing mastectomy for breast cancer risk reduction (n = 10) or treatment (n = 90). Metabolic syndrome-associated circulating factors were compared by CLS-B status. The association between CLS of the breast and the metabolic syndrome was validated in cohort 2, which included 127 women who developed metastatic breast cancer. Distant recurrence-free survival (dRFS) was compared by CLS-B status. RESULTS In cohorts 1 and 2, breast WAT inflammation was detected in 52 of 100 (52%) and 52 of 127 (41%) patients, respectively. Patients with breast WAT inflammation had elevated insulin, glucose, leptin, triglycerides, C-reactive protein, and IL6 and lower high-density lipoprotein cholesterol and adiponectin (P < 0.05) in cohort 1. In cohort 2, breast WAT inflammation was associated with hyperlipidemia, hypertension, and diabetes (P < 0.05). Compared with patients without breast WAT inflammation, the adjusted HR for dRFS was 1.83 (95% CI, 1.07-3.13) for patients with inflammation. CONCLUSIONS WAT inflammation, a clinically occult process, helps to explain the relationship between metabolic syndrome and worse breast cancer prognosis. Clin Cancer Res; 22(9); 2283-9. ©2015 AACR.
Collapse
Affiliation(s)
- Neil M Iyengar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Xi Kathy Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Ayca Gucalp
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Patrick G Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Louise R Howe
- Department of Cell & Developmental Biology, Weill Cornell Medical College, New York, New York
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Monica Morrow
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Michael Pollak
- Departments of Medicine and Oncology, McGill University, Montreal, Quebec, Canada
| | - Lee W Jones
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Medicine, Weill Cornell Medical College, New York, New York
| | | |
Collapse
|
89
|
Agresti R, Meneghini E, Baili P, Minicozzi P, Turco A, Cavallo I, Funaro F, Amash H, Berrino F, Tagliabue E, Sant M. Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study. Breast Cancer Res Treat 2016; 157:179-89. [PMID: 27117160 DOI: 10.1007/s10549-016-3802-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/19/2016] [Indexed: 12/22/2022]
Abstract
Obesity and metabolic syndrome are risk and prognostic factors for breast cancer (BC) and are associated with chronic inflammation. We investigated the association between distinct BC subtypes and markers of adiposity, dysmetabolisms, and inflammation. We analyzed 1779 patients with primary invasive BC treated at a single institution, for whom anthropometric and clinical-pathological data were archived. BC subtypes were classified by immunohistochemical staining of ER, PR, HER2, and Ki67, and their relations with the study markers were assessed by multinomial logistic regression. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated taking luminal A as reference. All subtypes more aggressive than luminal A were significantly more frequent in younger (<45 years) than older women. Before menopause, luminal B HER2-negative tumors were positively associated with large waist (OR 2.55, 95 % CI 1.53-4.24) and insulin resistance (OR 1.90, 95 % CI 1.05-3.41); luminal B HER2-positive tumors with large waist (OR 2.11, 95 % CI 1.03-4.35) and triple-negative tumors with overweight (OR 3.04, 95 % CI 1.43-6.43) and high C-reactive protein (p trend = 0.026). In postmenopausal women aged <65, luminal B HER2-negative (OR 1.94, 95 % CI 1.16-3.24) and luminal B HER2-positive tumors (OR 2.48, 95 % CI 1.16-5.27) were positively related with metabolic syndrome. Dysmetabolisms and inflammation may be related to different BC subtypes. Before menopause, triple-negative cancers were related to obesity and chronic inflammation, and aggressive luminal subtypes to abdominal adiposity. After menopause, in women aged <65 these latter subtypes were related to metabolic syndrome. Control of adiposity and dysmetabolism can reduce the risk of aggressive BC subtypes, improving the prognosis.
Collapse
Affiliation(s)
- Roberto Agresti
- Breast Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Elisabetta Meneghini
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy.
| | - Paolo Baili
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Pamela Minicozzi
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Alberto Turco
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Ilaria Cavallo
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Francesco Funaro
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Hade Amash
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Franco Berrino
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Elda Tagliabue
- Molecular Targeting Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Milena Sant
- Analytic Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| |
Collapse
|
90
|
Raman Spectroscopic Measurements of Dermal Carotenoids in Breast Cancer Operated Patients Provide Evidence for the Positive Impact of a Dietary Regimen Rich in Fruit and Vegetables on Body Oxidative Stress and BC Prognostic Anthropometric Parameters: A Five-Year Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:2727403. [PMID: 27213029 PMCID: PMC4861805 DOI: 10.1155/2016/2727403] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/08/2015] [Accepted: 10/13/2015] [Indexed: 01/04/2023]
Abstract
Dermal carotenoids are a feasible marker of the body antioxidative network and may reveal a moderate to severe imbalance of the redox status, thereby providing indication of individual oxidative stress. In this work noninvasive Resonance Raman Spectroscopy (RRS) measurements of skin carotenoids (skin carotenoid score (SCS)) were used to provide indications of individual oxidative stress, each year for five years, in 71 breast cancer (BC) patients at high risk of recurrence. Patients' SCS has been correlated with parameters relevant to BC risk, waist circumference (WC), and body mass index (BMI), in the aim of monitoring the effect of a dietary regimen intended to positively affect BC risk factors. The RRS methodological approach in BC patients appeared from positive correlation between patients' SCS and blood level of lycopene. The level of skin carotenoids was inversely correlated with the patients' WC and BMI. At the end of the 5 y observation BC patients exhibited a significant reduction of WC and BMI and increase of SCS, when strictly adhering to the dietary regimen. In conclusion, noninvasive measurements of skin carotenoids can (i) reveal an oxidative stress condition correlated with parameters of BC risk and (ii) monitor dietary-related variations in BC patients.
Collapse
|
91
|
Baek AE, Nelson ER. The Contribution of Cholesterol and Its Metabolites to the Pathophysiology of Breast Cancer. Discov Oncol 2016; 7:219-28. [PMID: 27020054 DOI: 10.1007/s12672-016-0262-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 03/17/2016] [Indexed: 02/07/2023] Open
Abstract
As the most common cancer in women, one in eight will develop invasive breast cancer over their lifetime making it the second most common cause of cancer-related death among women. Of the many known risk factors for developing breast cancer, obesity stands out as prominent and modifiable. Interestingly, elevated cholesterol is highly associated with obesity and has emerged as an independent risk factor for breast cancer onset and recurrence. This indicates that cholesterol also contributes to the breast cancer pathogenicity of obesity. This review highlights our current understanding of the mechanisms by which cholesterol impacts breast cancer. Key preclinical studies have been highlighted, including the discussion of homeostatic control of cholesterol levels, signaling by cholesterol metabolites through the estrogen receptors, cholesterol formation of lipid rafts and subsequent signaling, and the potential roles of cholesterol in creating a pro-inflammatory tumor microenvironment. Future directions and avenues for therapeutic exploitation are also considered.
Collapse
Affiliation(s)
- Amy E Baek
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, 407 S. Goodwin Ave (MC-114), Urbana, IL, 61801, USA
| | - Erik R Nelson
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, 407 S. Goodwin Ave (MC-114), Urbana, IL, 61801, USA. .,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA. .,University of Illinois Cancer Center, Chicago, IL, USA.
| |
Collapse
|
92
|
Chen Y, Wen YY, Li ZR, Luo DL, Zhang XH. The molecular mechanisms between metabolic syndrome and breast cancer. Biochem Biophys Res Commun 2016; 471:391-5. [PMID: 26891869 DOI: 10.1016/j.bbrc.2016.02.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/10/2016] [Indexed: 12/17/2022]
Abstract
Metabolic syndrome, which is extremely common in developed and some developing countries, is a clustering of at least three of five of the following medical conditions: abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein levels. It has been proved that there is a strong association between metabolic syndrome and breast cancer. Metabolic syndrome could increase the risk of breast cancer and influence the prognosis of the breast cancer patients. Some characteristic of metabolic syndrome such as obesity and lack of physical exercise are all risk factors for developing breast cancer. The metabolic syndrome mainly include obesity, type 2 diabetes, hypercholesterolemia and nonalcoholic fatty liver disease, and each of them impacts the risk of breast cancer and the prognosis of the breast cancer patients in different ways. In this Review, we focus on recently uncovered aspects of the immunological and molecular mechanisms that are responsible for the development of this highly prevalent and serious disease. These studies bring new insight into the complex associations between metabolic syndrome and breast cancer and have led to the development of novel therapeutic strategies that might enable a personalized approach in the management of this disease.
Collapse
Affiliation(s)
- Yi Chen
- Department of General Surgery (Breast, Thyroid and Vascular Suerery), Daping Hospital of the Third Military Medical University, Chongqing, 400042, China
| | - Ya-yuan Wen
- Department of General Surgery (Breast, Thyroid and Vascular Suerery), Daping Hospital of the Third Military Medical University, Chongqing, 400042, China
| | - Zhi-rong Li
- Department of General Surgery (Breast, Thyroid and Vascular Suerery), Daping Hospital of the Third Military Medical University, Chongqing, 400042, China
| | - Dong-lin Luo
- Department of General Surgery (Breast, Thyroid and Vascular Suerery), Daping Hospital of the Third Military Medical University, Chongqing, 400042, China
| | - Xiao-hua Zhang
- Department of General Surgery (Breast, Thyroid and Vascular Suerery), Daping Hospital of the Third Military Medical University, Chongqing, 400042, China.
| |
Collapse
|
93
|
Abstract
It is considered that hypercholesterolemia is life-threatening and low cholesterol levels are a positive factor. However, taking into consideration the fact that cholesterol plays a key role in cell proliferation, it should be remembered that its low blood level may be linked to high cholesterol demands from neoplastic cells. The literature review analyzes the results of recent investigations of lipid metabolism in patients with hematologic cancers and their other types. All given investigations show a significant reduction in the serum levels of total cholesterol and high-density lipoproteins in patients with hematological disease at its onset. The data for other indicators of the lipid transport system are ambiguous. Such changes have been elucidated to be associated with the accumulation of cholesterol in the leukemia cells due to enhanced synthesis de novo, a more active absorption from circulation and blocked release of its surplus. If the disease runs a favorable course, lipid metabolic parameters become normalized and, in case of remission, correspond to those seen in healthy individuals. They continue to decline in patients with disease progression. This allows the consideration of cholesterol, its fractions, and apolipoproteins as biochemical prognostic markers in hematological cancer patients and as indicators for assessment of treatment results. In addition, there is evidence for the effect of chemotherapeutic agents on lipid metabolism. Recent attempts to elaborate new treatment strategies, by using the current knowledge on the role of lipid metabolism in cancers, are considered.
Collapse
Affiliation(s)
- S G Vladimirova
- Kirov Research Institute of Hematology and Blood Transfusion, Federal Biomedical Agency of Russia, Kirov, Russia
| | - L N Tarasova
- Kirov Research Institute of Hematology and Blood Transfusion, Federal Biomedical Agency of Russia, Kirov, Russia
| |
Collapse
|
94
|
Karimi N, Dabidi Roshan V, Fathi Bayatiyani Z. Individually and Combined Water-Based Exercise With Ginger Supplement, on Systemic Inflammation and Metabolic Syndrome Indices, Among the Obese Women With Breast Neoplasms. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 8:e3856. [PMID: 26855719 PMCID: PMC4736069 DOI: 10.17795/ijcp-3856] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 09/16/2015] [Accepted: 11/15/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Breast neoplasms has known as the most common cancer among the women worldwide, and relationship between obesity, metabolic syndrome, inflammation and cancer has been recognized since many years ago. OBJECTIVES The aim of this study was to determine the individual and concomitant effect of 6-weeks water-based exercise and oral ginger supplement on markers that have related to metabolic syndrome and systemic inflammation in obese women with breast neoplasms. PATIENTS AND METHODS Forty women whose have diagnosed with breast neoplasms have volunteered to participate in the study. Subjects have randomly assigned into four groups; placebo, exercise training, ginger supplement and exercise training+ ginger supplement groups. Subjects in the ginger supplement group and the exercise training+ ginger supplement group have orally received 4 capsules, 7 days a week and for 6 weeks. The water-based exercise training program have collected at a progressive intensity and time, have ranged from 50% to 75% of heart rate reserve, in a pool, 4 times a week for 6 weeks. Fasting blood sampling has collected at the pretest and post-test. RESULTS The ginger supplementation and the water-base exercise have resulted in a reduction of hs-CRP, IL-10, insulin, glucose, insulin resistance, LDL-C, TG; but an increase in HDL-C and HDL-C/LDL-C. The water-base exercise and ginger supplement group have significantly shown larger positive effect in all outcomes, in comparison with the water-base exercise or ginger supplement alone groups. CONCLUSIONS Findings have suggested that obese breast neoplasms survivors have commonly shown metabolic syndrome and elevated inflammation, which placed them at an increased risk for cardiovascular diseases. Moreover, data has indicated a protective effect of the nondrug strategies, such as water-base exercise and ginger supplementation have played an important role in pathogenesis of inflammatory and metabolic responses, among diagnosed breast neoplasms.
Collapse
Affiliation(s)
- Niloofar Karimi
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
| | - Valiollah Dabidi Roshan
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
| | - Zohreh Fathi Bayatiyani
- Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, IR Iran
| |
Collapse
|
95
|
Ruszczyk M, Zirpoli G, Kumar S, Bandera EV, Bovbjerg DH, Jandorf L, Khoury T, Hwang H, Ciupak G, Pawlish K, Schedin P, Masso-Welch P, Ambrosone CB, Hong CC. Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case-control and case-case analyses. Cancer Causes Control 2015; 27:183-98. [PMID: 26621543 DOI: 10.1007/s10552-015-0696-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 11/07/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Invasive ductal carcinoma (IDC) is diagnosed with or without a ductal carcinoma in situ (DCIS) component. Previous analyses have found significant differences in tumor characteristics between pure IDC lacking DCIS and mixed IDC with DCIS. We will test our hypothesis that pure IDC represents a form of breast cancer with etiology and risk factors distinct from mixed IDC/DCIS. METHODS We compared reproductive risk factors for breast cancer risk, as well as family and smoking history between 831 women with mixed IDC/DCIS (n = 650) or pure IDC (n = 181), and 1,620 controls, in the context of the Women's Circle of Health Study (WCHS), a case-control study of breast cancer in African-American and European-American women. Data on reproductive and lifestyle factors were collected during interviews, and tumor characteristics were abstracted from pathology reports. Case-control and case-case analyses were conducted using unconditional logistic regression. RESULTS Most risk factors were similarly associated with pure IDC and mixed IDC/DCIS. However, among postmenopausal women, risk of pure IDC was lower in women with body mass index (BMI) 25 to <30 [odds ratio (OR) 0.66; 95 % confidence interval (CI) 0.35-1.23] and BMI ≥ 30 (OR 0.33; 95 % CI 0.18-0.67) compared to women with BMI < 25, with no associations with mixed IDC/DCIS. In case-case analyses, women who breastfed up to 12 months (OR 0.55; 95 % CI 0.32-0.94) or longer (OR 0.47; 95 % CI 0.26-0.87) showed decreased odds of pure IDC than mixed IDC/DCIS compared to those who did not breastfeed. CONCLUSIONS Associations with some breast cancer risk factors differed between mixed IDC/DCIS and pure IDC, potentially suggesting differential developmental pathways. These findings, if confirmed in a larger study, will provide a better understanding of the developmental patterns of breast cancer and the influence of modifiable risk factors, which in turn could lead to better preventive measures for pure IDC, which have worse disease prognosis compared to mixed IDC/DCIS.
Collapse
Affiliation(s)
- Melanie Ruszczyk
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, 12 Capen Hall, Buffalo, NY, 14214, USA.
| | - Gary Zirpoli
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Shicha Kumar
- Department of Surgical Oncology, Roswell Park Cancer Institute, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Elisa V Bandera
- Population Science/Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA. .,Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ, 08854, USA.
| | - Dana H Bovbjerg
- Department of Psychiatry, University of Pittsburgh Cancer Institute, 5150 Centre Ave., Pittsburgh, PA, 15232, USA.
| | - Lina Jandorf
- Department of Oncology Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave., New York, NY, 10029, USA.
| | - Thaer Khoury
- Department of Pathology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, 14263, USA.
| | - Helena Hwang
- Department of Pathology, University of Texas, Southwestern Medical Center, 5325 Harry Hines Blvd., Dallas, TX, 75390, USA.
| | - Gregory Ciupak
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Karen Pawlish
- New Jersey State Cancer Registry, New Jersey Department of Health, 140 East Front Street, Trenton, NJ, 08625, USA.
| | - Pepper Schedin
- Department of Cell, Development and Cancer Biology, Oregon Health Sciences University, 3181 SW Sam Jackson Pkwy, Portland, OR, 97239, USA.
| | - Patricia Masso-Welch
- Department of Biotechnical and Clinical Laboratory Sciences, University at Buffalo, 12 Capen Hall, Buffalo, NY, 14214, USA.
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm & Carlton Sts., Buffalo, NY, 14263, USA.
| |
Collapse
|
96
|
Bruno E, Gargano G, Villarini A, Traina A, Johansson H, Mano MP, Santucci De Magistris M, Simeoni M, Consolaro E, Mercandino A, Barbero M, Galasso R, Bassi MC, Zarcone M, Zagallo E, Venturelli E, Bellegotti M, Berrino F, Pasanisi P. Adherence to WCRF/AICR cancer prevention recommendations and metabolic syndrome in breast cancer patients. Int J Cancer 2015; 138:237-44. [PMID: 26175188 DOI: 10.1002/ijc.29689] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/18/2015] [Accepted: 07/01/2015] [Indexed: 12/18/2022]
Abstract
Metabolic syndrome (MetS), conventionally defined by the presence of at least three out of five dismetabolic traits (abdominal obesity, hypertension, low plasma HDL-cholesterol and high plasma glucose and triglycerides), has been associated with both breast cancer (BC) incidence and prognosis. We investigated the association between the prevalence of MetS and a score of adherence to the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) recommendations for the prevention of cancer in a cross-sectional study of BC patients. The DIet and ANdrogen-5 study (DIANA-5) for the prevention of BC recurrences recruited 2092 early stage BC survivors aged 35-70. At recruitment, all women completed a 24-hour food frequency and physical activity diary on their consumption and activity of the previous day. Using these diaries we created a score of adherence to five relevant WCRF/AICR recommendations. The prevalence ratios (PRs) and 95% confidence intervals (CIs) of MetS associated with the number of recommendations met were estimated using a binomial regression model. The adjusted PRs of MetS decreased with increasing number of recommendations met (p < 0.001). Meeting all the five recommendations versus meeting none or only one was significantly associated with a 57% lower MetS prevalence (95% CI 0.35-0.73). Our results suggest that adherence to WCRF/AICR recommendations is a major determinant of MetS and may have a clinical impact.
Collapse
Affiliation(s)
- Eleonora Bruno
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Giuliana Gargano
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Anna Villarini
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Adele Traina
- Department of Oncology, A.R.N.A.S Ospedali Civico E Benfratelli G. Di Cristina E M. Ascoli, Palermo, Italy
| | - Harriet Johansson
- Division of Chemoprevention and Genetics, European Institute Of Oncology, Milan, Italy
| | - Maria Piera Mano
- Dipartimento Scienze Chirurgiche, Study University, Turin, Italy.,S.C. Epidemiologia Dei Tumori, AOU Città Della Salute E Della Scienza, CPO Piemonte, Turin, Italy
| | | | - Milena Simeoni
- Associazione LUMEN, San Pietro In Cerro (Piacenza), Italy
| | | | | | | | - Rocco Galasso
- Biostatistics and Cancer Registry, Unit Of Clinical Epidemiology, IRCCS Centro Di Riferimento Oncologico Di Basilicata, Rionero In Vulture (Potenza), Italy
| | | | - Maurizio Zarcone
- Department of Oncology, A.R.N.A.S Ospedali Civico E Benfratelli G. Di Cristina E M. Ascoli, Palermo, Italy
| | - Emanuela Zagallo
- Division of Chemoprevention and Genetics, European Institute Of Oncology, Milan, Italy
| | - Elisabetta Venturelli
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Manuela Bellegotti
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Franco Berrino
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Patrizia Pasanisi
- Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| |
Collapse
|
97
|
The metabolic syndrome and mammographic breast density in a racially diverse and predominantly immigrant sample of women. Cancer Causes Control 2015; 26:1393-403. [PMID: 26169301 DOI: 10.1007/s10552-015-0630-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/01/2015] [Indexed: 12/11/2022]
Abstract
PURPOSE The metabolic syndrome [MetS, clustering of elevated blood pressure, triglycerides and glucose, reduced high-density lipoprotein cholesterol (HDL-C), abdominal obesity] has been associated with increased breast cancer risk, but less is known about its association with mammographic breast density, a strong risk factor for breast cancer. METHODS We collected data on risk factors, body size, and blood pressure via in-person interviews and examinations and measured glucose, triglycerides, and HDL-C from dried blood spots from women recruited through a mammography screening clinic (n = 373; 68 % Hispanic, 17 % African-American, 63 % foreign born). We performed linear regression models to examine the associations of each MetS component and the MetS cluster (≥3 components) with percent density and dense breast area, measured using a computer-assisted technique and Cumulus software. RESULTS About 45 % of women had the MetS, with the prevalence of the individual components ranging from 68 % for abdominal obesity to 33 % for elevated triglycerides. The prevalence of the MetS increased with higher body mass index (BMI) and postmenopausal status, but did not vary substantially by ethnicity, immigrant generational status, parity, age at menarche, or alcohol consumption. Low HDL-C (<50 mg/dL), but not the MetS cluster or the other MetS components, was associated with larger dense breast area after adjusting for age, BMI, fasting time, and educational attainment (β = 8.77, 95 % CI 2.39, 15.14). The MetS and its individual components were not associated with BMI-adjusted percent density. CONCLUSIONS HDL-C alone may have an influence on dense breast tissue that is independent of BMI, and may be in the same direction as its association with breast cancer risk.
Collapse
|
98
|
Yang C, Tian G, Mi J, Wei X, Li X, Li X, Wang W, Wang B. Causal relevance of circulating high-density lipoprotein cholesterol with cancer: a Mendelian randomization meta-analysis. Sci Rep 2015; 5:9495. [PMID: 25820350 PMCID: PMC4377635 DOI: 10.1038/srep09495] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 03/09/2015] [Indexed: 12/26/2022] Open
Abstract
We summarized published data on the associations of apolipoprotein E (APOE) gene ε2/ε3/ε4 polymorphism with both cancer risk and circulating lipid profiles, aiming to examine the causal relevance between lipids and cancer risk. Article identification and data abstraction were conducted in duplicate and independently by two authors. Data were analyzed by STATA software. Twenty-five articles that examined the associations of APOE gene ε2/ε3/ε4 polymorphism with either cancer risk (n = 22) or circulating lipid changes (n = 4) were eligible. The presence of ε2 and ε4 alleles showed no overall associations with overall cancer risk when compared with ε3 allele. The ε4 allele was significantly associated with 1.40-fold (odds ratio or OR = 1.40; 95% confidence interval or CI: 1.00–1.94; P = 0.047) increased risk of developing cancer in Asian populations, and the presence of heterogeneity was low (I2 = 37.6%). Carriers of ε3/ε4 genotype had a significant reduction in circulating HDL-C (WMD = −2.62; 95% CI: −4.19 to −1.04; P = 0.001) without heterogeneity (I2 = 16.6%). The predicted odds of having cancer for 1 mg/dL reduction in circulating HDL-C was 1.14 (95% CI: 1.00 to 1.89). The findings of this Mendelian randomization meta-analysis demonstrate that reduced circulating HDL-C might be a potentially causal risk factor for the development of overall cancer in Asians.
Collapse
Affiliation(s)
- Chunhua Yang
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Geng Tian
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Jia Mi
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Xiaodan Wei
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Xuri Li
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Xianglin Li
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Wenming Wang
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| | - Bin Wang
- Medicine and Pharmacy Research Center, Binzhou Medical University, Laishan District, Yantai, Shandong, China
| |
Collapse
|
99
|
Comorbidities and Their Management: Potential Impact on Breast Cancer Outcomes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 862:155-75. [DOI: 10.1007/978-3-319-16366-6_11] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
100
|
McDonnell DP, Chang CY, Nelson ER. The estrogen receptor as a mediator of the pathological actions of cholesterol in breast cancer. Climacteric 2014; 17 Suppl 2:60-5. [PMID: 25320023 DOI: 10.3109/13697137.2014.966949] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite increased survivorship among patients, breast cancer remains the most common cancer among women and is the second leading cause of cancer death in women. The magnitude of this problem provides a strong impetus for new chemopreventative strategies and/or lifestyle changes that reduce cancer incidence. It is of significance, therefore, that several studies positively correlate obesity to the development of breast cancer. Importantly, obesity is also highly associated with elevated cholesterol, and cholesterol itself is a risk factor for breast cancer. Furthermore, patients taking statins demonstrate a lower breast cancer incidence and decreased recurrence. The recent observation that 27-hydroxycholesterol (27HC) is produced in a stoichiometric manner from cholesterol, together with our recent demonstration that it exerts partial agonist activity on both the estrogen and liver X receptors, suggested a potential mechanistic link between hyper-cholesterolemia and breast cancer incidence. Using genetic and pharmacological approaches, we have recently shown that elevation of circulating 27HC significantly increases tumor growth and metastasis in murine models of breast cancer. Further, we have demonstrated in appropriate animal models that the impact of high-fat diet on tumor pathogenesis can be mitigated by statins or by small molecule inhibitors of CYP27A1. These findings suggest that pharmacological or dietary modifications that lower total cholesterol, and by inference 27HC, are likely to reduce the impact of obesity/metabolic syndrome on breast cancer incidence.
Collapse
Affiliation(s)
- D P McDonnell
- Department of Pharmacology and Cancer Biology, Duke University School of Medicine , Durham, NC , USA
| | | | | |
Collapse
|