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Rodríguez de Vera Gómez P, Mayoral Sánchez E, Vilches Arenas Á, Ravé-García R, De la Cal Ramírez M, Umpierrez G, Martínez-Brocca MA. Population-based study on the implementation of flash glucose monitoring and severe hypoglycemia in adults with type 1 diabetes. Diabetes Technol Ther 2024. [PMID: 38885322 DOI: 10.1089/dia.2024.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Objective We analyzed the effect of implementing a flash glucose monitoring (FGM) technology in a public healthcare system with universal coverage on the rate of severe hypoglycemia requiring urgent care in adults with type 1 diabetes mellitus (T1DM). Methods Using a comprehensive regional dataset, we extracted emergency care codes with hypoglycemia in individuals with T1DM who initiated the use of FGM in Andalucia, Spain from 01/01/2020 to 12/31/2021. Severe hypoglycemia was defined as a confirmed blood glucose <70 mg/dl, which required the urgent dispatch of an emergency medical service (EMS) for on-site management. We compared hypoglycemic events reported in the 12 months before and after the initiation of FGM to determine the population incidence rates. Results A total of 13,616 participants with a mean age of 43.7±13.5 years were included. The follow-up periods were 23.4 and 24.8 months before and after FGM. There were 969 and 737 cases of hypoglycemia before and after the initiation of FGM. The baseline incidence rate was 358.58 episodes per 10,000 person-years, which decreased to 260.9 at the end of the follow-up (rate-ratio 0.72 [0.66; 0.80]). The reduction in hypoglycemia was significant in individuals aged ≥60 years (rate-ratio 0.40 [0.28; 0.55]) and males (0.64 [0.56; 0.72]). In addition, there was a reduction in the overall median HbA1c of -0.35% (95% CI [-0.38; -0.33], p<0.001) Conclusion The implementation of FGM systems in a public healthcare system as a provision for adults with T1DM was associated with significant reductions in the rate of severe hypoglycemic events that required urgent EMS care.
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Affiliation(s)
| | - Eduardo Mayoral Sánchez
- Andalusian Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health, Andalusian Public Health System, Spain, Sevilla, Spain;
| | - Ángel Vilches Arenas
- Universidad de Sevilla, Preventive Medicine and Public Health Department, Sevilla, Andalucía, Spain;
| | - Reyes Ravé-García
- Virgen Macarena University Hospital, Endocrinology and Nutrition Department, Sevilla, Andalucía, Spain;
| | | | - Guillermo Umpierrez
- Emory University, Medicine, 49 Jesse Hill Jr Dr, Atlanta, Georgia, United States, 30303;
| | - Mª Asunción Martínez-Brocca
- Hospital Universitario Virgen Macarena, Sevilla, Andalucía, Spain
- Instituto de Biomedicina de Sevilla, Sevilla, Andalucía, Spain;
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Galvão NMS, Matos SMAD, Almeida MDCCD, Gabrielli L, Barreto SM, Aquino EML, Schmidt MI, Amorim LDAF. Patterns of metabolic syndrome and associated factors in women from the ELSA-Brasil: a latent class analysis approach. CAD SAUDE PUBLICA 2023; 39:e00039923. [PMID: 38088734 PMCID: PMC10715568 DOI: 10.1590/0102-311xen039923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/26/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.
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Affiliation(s)
| | | | | | - Ligia Gabrielli
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Sandhi Maria Barreto
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Maria Inês Schmidt
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Mohammadbeigy I, Khalilian MS, Najafizadeh N, Moazam E, Hemati S, Zeinalian M. The role of serum lipid profile, fasting blood sugar, and body mass index on recurrence and metastasis in patients with estrogen receptor-positive breast cancer: A case-control study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:83. [PMID: 38292335 PMCID: PMC10826846 DOI: 10.4103/jrms.jrms_163_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/11/2023] [Accepted: 04/27/2023] [Indexed: 02/01/2024]
Abstract
Background Breast cancer (BC) is the leading cause of cancer death in women. The current study is designed to evaluate the association of lipid profiles, FBS, and body mass index (BMI) with BC recurrence and metastasis. Materials and Methods This is a case-control study on estrogen receptor-positive BC patients in Isfahan Province, Central Iran, between 2008 and 2020. The control group was patients who had no evidence of recurrence or metastasis at least 1 year after the end of chemotherapy and hormone therapy. The case group was patients with evidence of metastasis or recurrence within 1 year after the end of chemotherapy and hormone therapy. Fasting blood sugar (FBS), total cholesterol (Chol), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured before treatment, after chemotherapy, and after hormone therapy as well as BMI in the case and control groups. Results There were 108 patients in the case and 119 patients in the control group with a mean age of 50.72 ± 13.26 and 51.91 ± 11.79, respectively. There were no meaningful differences between the case and control groups regarding serum FBS, Chol, TG, HDL, LDL, and BMI. Conclusion We found no association between serum FBS, lipid profile, and BMI at initial diagnosis and BC recurrence or metastasis.
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Affiliation(s)
- Iman Mohammadbeigy
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Sadegh Khalilian
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nadia Najafizadeh
- Department of Radiation Oncology, Seyed Al-Shohada (Omid) Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Moazam
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Simin Hemati
- Department of Radiation Oncology, Seyed Al-Shohada (Omid) Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Zeinalian
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Iranian Cancer Control Center (MACSA), Isfahan, Iran
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Van Hoang D, Inoue Y, Fukunaga A, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Yamamoto M, Miyamoto T, Gommori N, Kochi T, Shirasaka T, Eguchi M, Ogasawara T, Yamamoto K, Konishi M, Katayama N, Kabe I, Dohi S, Mizoue T. Metabolic syndrome and the risk of severe cancer events: a longitudinal study in Japanese workers. BMC Cancer 2023; 23:555. [PMID: 37328825 DOI: 10.1186/s12885-023-11026-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with cancer risk; however, little is known regarding its relationship with the risk of cancer-related premature death and long-term sick leave (LTSL), which can lead to a substantial loss in working years. The present study aimed to quantify the all-site and site-specific associations between MetS and the risk of severe cancer events (a composite outcome of LTSL and mortality due to cancer) in a large working population in Japan. METHODS We recruited 70,875 workers (59,950 men and 10,925 women), aged 20-59 years, who attended health check-ups in 2011 (10 companies) and 2014 (2 companies). All workers underwent follow up for severe cancer events until March 31, 2020. MetS was defined in accordance with the Joint Interim Statement. Cox regression models were used to quantify the association between baseline MetS and severe cancer events. RESULTS During 427,379 person-years of follow-up, 523 participants experienced the outcome consisting of 493 LTSLs of which 124 eventually resulted in death, and 30 deaths without taking LTSL. The adjusted hazard ratios (HR) (95% confidence intervals [CI]) for composite severe events due to all-site, obesity-related, and non-obesity-related cancer among those with vs. without MetS were 1.26 (1.03, 1.55), 1.37 (1.04, 1.82), and 1.15 (0.84, 1.56), respectively. In cancer site-specific analyses, MetS was associated with an increased risk of severe events due to pancreatic cancer (HR, 2.06; 95% CI, 0.99-4.26). When mortality was treated solely as the endpoint, the association was significant for all-site (HR, 1.58; 95% CI, 1.10-2.26), and obesity-related (HR, 1.59; 95% CI, 1.00-2.54) cancer. Additionally, a greater number of MetS components was associated with a greater risk of both severe cancer events and cancer-related mortality (P trend < 0.05). CONCLUSION Among Japanese workers, MetS was associated with an increased risk of severe cancer events, especially those due to obesity-linked cancer.
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Affiliation(s)
- Dong Van Hoang
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan.
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | | | | | | | | | - Naoki Gommori
- East Japan Works (Keihin), JFE Steel Corporation, Keihin, Kanagawa, Japan
| | | | | | | | | | - Kenya Yamamoto
- Division of Chemical Information, National Institute of Occupational Safety and Health, Kiyose, Kanagawa, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan
| | - Nobumi Katayama
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan
| | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 1628655, Japan
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Fiorica PN, Sheng H, Zhu Q, Roh JM, Laurent CA, Ergas IJ, Delmerico J, Kwan ML, Kushi LH, Ambrosone CB, Yao S. A Mendelian Randomization Analysis of 55 Genetically Predicted Metabolic Traits with Breast Cancer Survival Outcomes in the Pathways Study. CANCER RESEARCH COMMUNICATIONS 2023; 3:1104-1112. [PMID: 37377609 PMCID: PMC10286812 DOI: 10.1158/2767-9764.crc-23-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/05/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Previous studies suggest associations of metabolic syndromes with breast cancer prognosis, yet the evidence is mixed. In recent years, the maturation of genome-wide association study findings has led to the development of polygenic scores (PGS) for many common traits, making it feasible to use Mendelian randomization to examine associations between metabolic traits and breast cancer outcomes. In the Pathways Study of 3,902 patients and a median follow-up time of 10.5 years, we adapted a Mendelian randomization approach to calculate PGS for 55 metabolic traits and tested their associations with seven survival outcomes. Multivariable Cox proportional hazards models were used to derive HRs and 95% confidence intervals (CI) with adjustment for covariates. The highest tertile (T3) of PGS for cardiovascular disease was associated with shorter overall survival (HR = 1.34, 95% CI = 1.11-1.61) and second primary cancer-free survival (HR = 1.31, 95% CI = 1.12-1.53). PGS for hypertension (T3) was associated with shorter overall survival (HR = 1.20, 95% CI = 1.00-1.43), second primary cancer-free survival (HR = 1.24, 95% CI = 1.06-1.45), invasive disease-free survival (HR = 1.18, 95% CI = 1.01-1.38), and disease-free survival (HR = 1.21, 95% CI = 1.04-1.39). PGS for serum cystatin C levels (T3) was associated with longer disease-free survival (HR = 0.82, 95% CI = 0.71-0.95), breast event-free survival (HR = 0.74, 95% CI = 0.61-0.91), and breast cancer-specific survival (HR = 0.72, 95% CI = 0.54-0.95). The above associations were significant at a nominal P < 0.05 level but not after correcting for multiple testing (Bonferroni P < 0.0009). Our analyses revealed notable associations of PGS for cardiovascular disease, hypertension, and cystatin C levels with breast cancer survival outcomes. These findings implicate metabolic traits in breast cancer prognosis. Significance To our knowledge, this is the largest study of PGS for metabolic traits with breast cancer prognosis. The findings revealed significant associations of PGS for cardiovascular disease, hypertension, and cystatin C levels with several breast cancer survival outcomes. These findings implicate an underappreciated role of metabolic traits in breast cancer prognosis that would warrant further exploration.
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Affiliation(s)
- Peter N. Fiorica
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Haiyang Sheng
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Qianqian Zhu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Janise M. Roh
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Cecile A. Laurent
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Isaac J. Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Jennifer Delmerico
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Marilyn L. Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Christine B. Ambrosone
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Song Yao
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Greco G, Bickell NA, Lin S, Yagnik R, LeRoith D, Gallagher EJ. Subjective social status, race, and metabolic syndrome in women with breast cancer. Breast Cancer Res Treat 2023; 199:479-487. [PMID: 37087701 DOI: 10.1007/s10549-023-06949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/06/2023] [Indexed: 04/24/2023]
Abstract
PURPOSE To evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer. METHODS Multicenter cross-sectional study (10 US hospitals) in women (n = 1206) with primary diagnosis of invasive breast cancer received during Mar/2013-Feb/2020. Participants, self-identified as non-Hispanic White or Black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history, and behavioral risks. SSS was measured with the 10-rung MacArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation. RESULTS Average age was 58 years. On average, the SSS of Black women, given equivalent level of income and education, was lower than the SSS of White women: 6.6 (6.1-7.0) vs 7.7 (7.54-7.79) among college graduates and 6.8 (6.4-7.2) vs 7.6 (7.5-7.8) among women in the high-income category (> $75,000). In multivariable analysis, after controlling for age, income, education, diet, and physical activity, increasing SSS was associated with a decrease in MetS-Z score, - 0.10 (- 0.16 to - 0.04) per every 2 rung increase in the MacArthur scale. CONCLUSION Black women with breast cancer rank their SSS lower than White women with breast cancer do at each level of income and education. As SSS is strongly associated with MetS severity these results identify potentially modifiable factors that contribute to racial disparities.
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Affiliation(s)
- Giampaolo Greco
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nina A Bickell
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia Lin
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Radhi Yagnik
- Department of Population Health Science and Policy, Center for Health Equity and Community Engaged Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Derek LeRoith
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, Box 1055, New York, NY, 10029, USA
| | - Emily J Gallagher
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, Box 1055, New York, NY, 10029, USA.
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Gonzalo-Encabo P, Christopher CN, Lee K, Normann AJ, Yunker AG, Norris MK, Wang E, Dieli-Conwright CM. High-intensity interval training improves metabolic syndrome in women with breast cancer receiving Anthracyclines. Scand J Med Sci Sports 2023; 33:475-484. [PMID: 36427275 DOI: 10.1111/sms.14280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Anthracycline chemotherapy is a frequent treatment for breast cancer, whereas it can increase risk of physiologic side-effects, such as metabolic syndrome (MetS). Exercise has been used as a non-pharmacological strategy to decrease MetS. Specifically, high-intensity interval training (HIIT) has been shown to improve MetS in patients with diabetes or cardiac rehabilitation patients; however, the effects of HIIT on MetS and associated biomarkers in patients with breast cancer receiving anthracycline chemotherapy have not been previously explored. Therefore, we purposed to determine the effects of HIIT on MetS in breast cancer patients undergoing anthracycline chemotherapy. METHODS In total, 30 patients with breast cancer were recruited prior to initiating treatment and randomized into HIIT (n = 15) or control (n = 15). The HIIT group attended supervised cycling sessions 3 days/week for 8 weeks. MetS was assessed by waist circumference, blood pressure, fasting levels of high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose. Circulating levels of MetS-related biomarkers were also measured (total cholesterol, insulin, HbA1c, leptin, adiponectin, and c-reactive protein). RESULTS After 8 weeks, MetS z-score was significantly improved in the HIIT group compared with controls (-7.60, 95% CI: -9.08 to -6.13, p < 0.001). MetS variables (HDL-C, glucose, and triglycerides) and circulating levels of MetS-related biomarkers were significantly improved in the HIIT group compared with controls (p < 0.001). Non-significant differences were found in body composition outcomes at the end of the study. CONCLUSIONS HIIT may be an effective strategy to improve MetS in breast cancer patients undergoing anthracycline chemotherapy. Furthermore, changes in MetS were independent of changes in body composition.
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Affiliation(s)
- Paola Gonzalo-Encabo
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Massachusetts, Boston, USA
| | - Cami N Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Kyuwan Lee
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Amber J Normann
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Health Sciences, Boston University, Boston, Massachusetts, USA
| | - Alexandra G Yunker
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ellice Wang
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Massachusetts, Boston, USA
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Li LR, Song JL, Liu HQ, Chen C. Metabolic syndrome and thyroid Cancer: risk, prognosis, and mechanism. Discov Oncol 2023; 14:23. [PMID: 36811728 PMCID: PMC9947216 DOI: 10.1007/s12672-022-00599-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/01/2022] [Indexed: 02/24/2023] Open
Abstract
The increasing incidence of thyroid cancer (TC) cannot be fully explained by overdiagnosis. Metabolic syndrome (Met S) is highly prevalent due to the modern lifestyle, which can lead to the development of tumors. This review expounds on the relationship between Met S and TC risk, prognosis and its possible biological mechanism. Met S and its components were associated with an increased risk and aggressiveness of TC, and there were gender differences in most studies. Abnormal metabolism places the body in a state of chronic inflammation for a long time, and thyroid-stimulating hormones may initiate tumorigenesis. Insulin resistance has a central role assisted by adipokines, angiotensin II, and estrogen. Together, these factors contribute to the progression of TC. Therefore, direct predictors of metabolic disorders (e.g., central obesity, insulin resistance and apolipoprotein levels) are expected to become new markers for diagnosis and prognosis. cAMP, insulin-like growth factor axis, angiotensin II, and AMPK-related signaling pathways could provide new targets for TC treatment.
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Affiliation(s)
- Ling-Rui Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Jun-Long Song
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Han-Qing Liu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China.
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9
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Lu B, Qian JM, Li JN. The metabolic syndrome and its components as prognostic factors in colorectal cancer: A meta-analysis and systematic review. J Gastroenterol Hepatol 2023; 38:187-196. [PMID: 36287138 PMCID: PMC10100176 DOI: 10.1111/jgh.16042] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/21/2022] [Accepted: 10/23/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Metabolic syndrome (MetS) increases the risk of colorectal cancer (CRC), and the impact of MetS on CRC prognosis remains controversial after the diagnosis of CRC has been established. This study aimed to explore the impact of the individual components and synergies of MetS on the prognosis of patients with CRC. METHODS We searched articles published before August 3, 2022, in four databases, including PubMed, Embase, Cochrane Library, and ScienceDirect. The random-effects model inverse variance method was used to estimate the summarized effect size. RESULTS Patients with CRC with MetS were 1.342 times more likely to experience all-cause mortality than those without MetS, and the 95% confidence interval (CI) of hazard ratio (HR) was 1.107-1.627 (P = 0.003). CRC-specific mortality in patients with CRC with MetS was 2.122 times higher than in those without MetS, and the 95% CI of HR was 1.080-4.173 (P = 0.029). CRC-specific mortality exhibited an increasing trend of risk with increased metabolic risk factors. The HR of CRC-specific mortality for one, two, and three metabolic risk factors was 1.206 (95% CI, 1.034-1.407; P = 0.017), 1.881 (95% CI, 1.253-2.824; P = 0.002), and 2.327 (95% CI, 1.262-4.291; P = 0.007), respectively. CONCLUSIONS Metabolic syndrome increased all-cause and CRC-specific mortality in patients with CRC. As a single component of MetS, diabetes mellitus increased overall mortality in patients with CRC, while obesity increased CRC-specific mortality in patients with CRC, with a significant difference from non-MetS. Moreover, the risk of CRC-specific mortality increased with increasing number of metabolic risk factors.
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Affiliation(s)
- Bo Lu
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia-Ming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing-Nan Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Fu J, Jiang J, Liu K. Metabolic syndrome and survival of patients with hepatocellular carcinoma: A meta-analysis. Front Oncol 2023; 13:1117846. [PMID: 36910647 PMCID: PMC9995822 DOI: 10.3389/fonc.2023.1117846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/04/2023] [Indexed: 02/25/2023] Open
Abstract
Background Metabolic syndrome (MetS) has been related to a high incidence of hepatocellular carcinoma (HCC). However, the influence of MetS on survival of patients with HCC is still unclear. We performed a systematic review and meta-analysis to evaluate the association between MetS and survival of HCC patients. Methods A search of PubMed, Embase, and Web of Science retrieved relevant cohort studies from the inception of the databases to October 16, 2022. Data collection, literature search, and statistical analysis were carried out independently by two authors. We pooled the results using a random-effects model that incorporates heterogeneity. Results In the meta-analysis, 8080 patients with HCC were included from ten cohort studies, and 1166 patients (14.4%) had MetS. Eight studies included patients treated primarily with radical hepatectomy, one study with patients receiving sorafenib, and another study included patients who were treated with radical hepatectomy or non-surgical treatments. Pooled results showed that MetS was associated with poor overall survival (OS, risk ratio [RR]: 1.21, 95% confidence interval [CI]:1.08 to 1.37, p = 0.001; I2 = 32%) and progression-free survival (PFS, RR: 1.33, 95% CI: 1.18 to 1.49, p < 0.001, I2 = 14%). Influencing analysis by excluding one study at a time showed consistent results (p all < 0.05). Subgroup analyses showed similar results in studies with MetS diagnosed with the National Cholesterol Education Program Adult Treatment Panel III or International Diabetes Federal criteria, and in studies with mean follow-up durations < or ≥ 3.5 years (p for subgroup difference all > 0.05). Conclusion In patients with HCC, MetS may be a risk factor of poor OS and PFS, particularly for those after radical hepatectomy.
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Affiliation(s)
- Jia Fu
- Department of Oncology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Hunan Normal University, Changsha, China
| | - Jinqiong Jiang
- Department of Oncology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Hunan Normal University, Changsha, China
| | - Kanghan Liu
- Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Hunan Normal University, Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, China
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11
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Clèries R, Ameijide A, Buxó M, Vilardell M, Martínez JM, Font R, Marcos-Gragera R, Puigdemont M, Viñas G, Carulla M, Espinàs JA, Galceran J, Izquierdo Á, Borràs JM. Ten-Year Probabilities of Death Due to Cancer and Cardiovascular Disease among Breast Cancer Patients Diagnosed in North-Eastern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:405. [PMID: 36612726 PMCID: PMC9819018 DOI: 10.3390/ijerph20010405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Mortality from cardiovascular disease (CVD), second tumours, and other causes is of clinical interest in the long-term follow-up of breast cancer (BC) patients. Using a cohort of BC patients (N = 6758) from the cancer registries of Girona and Tarragona (north-eastern Spain), we studied the 10-year probabilities of death due to BC, other cancers, and CVD according to stage at diagnosis and hormone receptor (HR) status. Among the non-BC causes of death (N = 720), CVD (N = 218) surpassed other cancers (N = 196). The BC cohort presented a significantly higher risk of death due to endometrial and ovarian cancers than the general population. In Stage I, HR- patients showed a 1.72-fold higher probability of all-cause death and a 6.11-fold higher probability of breast cancer death than HR+ patients. In Stages II-III, the probability of CVD death (range 3.11% to 3.86%) surpassed that of other cancers (range 0.54% to 3.11%). In Stage IV patients, the probability of death from any cancer drove the mortality risk. Promoting screening and preventive measures in BC patients are warranted, since long-term control should encompass early detection of second neoplasms, ruling out the possibility of late recurrence. In patients diagnosed in Stages II-III at an older age, surveillance for preventing late cardiotoxicity is crucial.
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Affiliation(s)
- Ramon Clèries
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Sciences Department, Universitat de Barcelona, 08907 Barcelona, Spain
| | - Alberto Ameijide
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Maria Buxó
- Girona Biomedical Research Institute, IDIBGI, C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Salt, Spain
| | | | - José Miguel Martínez
- Statistics and Operational Research Department, Universitat Politècnica de Catalunya, EDIFICI H, Diagonal 647, 08028 Barcelona, Spain
- Public Health Research Group, University of Alicante, 03690 Alicante, Spain
| | - Rebeca Font
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Marcos-Gragera
- Girona Biomedical Research Institute, IDIBGI, C/Dr. Castany s/n, Edifici M2, Parc Hospitalari Martí i Julià, 17190 Salt, Spain
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
- Medical School, Universitat de Girona (UdG), 17071 Girona, Spain
- Epidemiology and Public Health Research Network Centre (CIBERESP), 28029 Madrid, Spain
| | - Montse Puigdemont
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
| | - Gemma Viñas
- Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain
| | - Marià Carulla
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Josep Alfons Espinàs
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Jaume Galceran
- Tarragona Cancer Registry, Epidemiology and Cancer Prevention Service, Hospital Universitari Sant Joan de Reus, IISPV, 43204 Reus, Spain
| | - Ángel Izquierdo
- Girona Cancer Registry, Epidemiology Unit, Pla Director d’Oncologia, Institut Català d’Oncología, Group for Descriptive Epidemiology, Genetics and Cancer Prevention, Girona-IDIBGI, 17005 Girona, Spain
- Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari de Girona “Doctor Josep Trueta”, 17005 Girona, Spain
| | - Josep Maria Borràs
- Pla Director d’Oncología, Av Gran Vía 199-203, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute, IDIBELL, Av. Gran Via de l’Hospitalet, 199-203-1a planta, 08908 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Sciences Department, Universitat de Barcelona, 08907 Barcelona, Spain
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12
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Nguyen V, Chen J, Lord R, Preda V. The Impact of Multidisciplinary Weight Management on Body Weight and Body Mass Composition in Women with Breast Cancer Post-Adjuvant Chemotherapy: A Retrospective Chart Review. Oncology 2022; 100:344-353. [PMID: 35405672 PMCID: PMC9227675 DOI: 10.1159/000524519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Weight gain during chemotherapy for breast cancer is a well-documented adverse effect. The purpose of this study was to investigate how multidisciplinary weight management involving endocrinology, dietitian, and exercise physiology care, in a real-life healthy weight clinic (HWC) would impact body weight and mass composition in breast cancer women post-adjuvant chemotherapy compared to a cohort of non-cancer women who have been matched by age, ethnicity, smoking, and menopausal status. METHODS Body weight (kg), BMI (kg/m2), skeletal muscle mass (SMM %), fat mass (FM %), and waist circumference (cm) were collected at baseline of the first HWC appointment, 3 months after baseline, and 6 months after baseline. A total of 32 women were included, 11 in the breast cancer cohort and 21 in the control cohort, that matched inclusion and exclusion criteria based on a retrospective chart review from 28 July 2017 to 19 July 2021. RESULTS By 6 months, the breast cancer women had a mean weight change of -6.99 kg (SD = 3.87, p = 0.003, n = 11) and change in BMI by -2.72 kg/m2 (SD = 1.62, p = 0.004, n = 11). There was a change in SMM of 1.21% (SD = 0.73, p = 0.005, n = 11), a change in FM of -2.76% (SD = 1.33, p = 0.002, n = 11), and a change in waist circumference of -8.13 cm (SD = 4.21, p = 0.031, n = 3). By 6 months in the breast cancer cohort, there was a larger change in body weight in women who did not have MetS (-8.72 kg, SD = 2.41, n = 6) in comparison to women with MetS (-2.65 kg, SD = 3.75 kg, n = 3) (p = 0.045). CONCLUSION Findings indicate that multidisciplinary weight management has a positive role in early-stage breast cancer survival through improving body weight and mass composition. These results can add to the development of long-term treatment plans for survivors in order to shine a light on ways to reduce risk recurrence and chronic disease mortality.
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Affiliation(s)
- Vivien Nguyen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Juliana Chen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Healthy Weight Clinic, MQ Health, Sydney, New South Wales, Australia
- Susan Wakil School of Nursing and Midwifery, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Reginald Lord
- Healthy Weight Clinic, MQ Health, Sydney, New South Wales, Australia
- Department of Surgery, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Veronica Preda
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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13
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Ademi-Islami D, Manxhuka-Kerliu S, Tarifa-Koroveshi D, Koliqi R, Mujaj B. Metabolic Syndrome and Breast Cancer Molecular Subtypes: An Observational Patient Study. BREAST CANCER: BASIC AND CLINICAL RESEARCH 2022; 16:11782234221080555. [PMID: 35340887 PMCID: PMC8950023 DOI: 10.1177/11782234221080555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 01/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Breast cancer molecular subtypes share various prognostic profiles, and luminal A molecular subtypes have a better prognosis compared with other molecular subtypes. However, whether metabolic syndrome or individual risk factors of metabolic syndrome influence on the development of molecular subtype remains elusive. We aimed to assess the association between metabolic syndrome risk factors and breast cancer molecular subtypes among patients with metabolic syndrome in a clinical setting. Methods: In total, 101 breast cancer patients with mean age, 58.4 ± 8.5 years, and overt metabolic syndrome prospectively were recruited. Immunohistochemistry procedure was used to determine molecular subtypes. Assessment of clinical, biochemical, and anthropometric parameters was performed. Logistic regression analysis was used to assess the relationship between risk factors and breast cancer molecular subtypes categories. A similar approach was used to assess the relation between breast cancer molecular subtypes and menopause. Results: Comparison of metabolic syndrome individual risk factors according to breast cancer molecular subtypes no statistical difference was found for systolic (P = .33) and diastolic blood pressure (P = .17), fasting glucose (P = .77), triglycerides (P = .62), high-density lipoprotein (P = .33), body mass index (P = .87), and waist circumference (P = .81). A positive trend was found between high-density lipoprotein and HER2+. No association was found with other risk factors. Moreover, an association was found between HER2+ categories and menopause. Conclusion: In breast cancer patients with metabolic syndrome, we observed an increased trend between high-density lipoprotein and HER2+ molecular subtype, suggesting that underlying dyslipidemia may favor poor prognosis. HER2+ was associated with menopause which may influence further expression of HER2+ .
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Affiliation(s)
- Dafina Ademi-Islami
- Oncology Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo.,Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Suzana Manxhuka-Kerliu
- Faculty of Medicine, University of Prishtina, Prishtina, Kosovo.,Institute of Pathology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Dhurata Tarifa-Koroveshi
- Department of Oncology, University Hospital of Tirana, Tirana, Albania.,Faculty of Medicine, University of Tirana, Tirana, Albania
| | - Rozafa Koliqi
- Department of Clinical Pharmacy and Biopharmacy, Pharmacy Division, Faculty of Medicine, Universiteti i Prishtines, Pristina, Kosovo
| | - Blerim Mujaj
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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14
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Yang P, He Y, Yu X, Liu B, Wang X, Li X, Wang P. Impact of body mass index, weight gain, and metabolic disorders on survival and prognosis in patients with breast cancer who underwent chemotherapy. Chin Med J (Engl) 2022; 135:00029330-900000000-98103. [PMID: 35276702 PMCID: PMC9532034 DOI: 10.1097/cm9.0000000000001988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Weight gain during chemotherapy in patients with breast cancer contributes to their poor prognosis. However, a growing number of studies have found that metabolic disorders seem to play a more important role in breast cancer prognosis than weight gain. This study aimed to explore the prognostic effects of body mass index (BMI), weight gain, and metabolic disorders on the overall survival (OS) and prognosis of patients with breast cancer who underwent chemotherapy. METHODS Data from the inpatient medical records of patients with breast cancer who underwent chemotherapy at the Beijing Cancer Hospital Breast Cancer Center from January to December 2010 were retrospectively collected, and the patients were followed up until August 2020. RESULTS A total of 438 patients with stages I to III breast cancer met the inclusion and exclusion criteria. Forty-nine (11.19%) patients died, while 82 (18.72%) patients had tumor recurrence and metastasis at the last follow-up (August 2020). From the time of diagnosis until after chemotherapy, no significant differences were observed in the body weight (t = 4.694, P < 0.001), BMI categories (χ2 = 19.215, P = 0.001), and incidence of metabolic disorders (χ2 = 24.841, P < 0.001); the BMI categories and weight change had no effect on the OS. Both univariate (χ2 = 6.771, P = 0.009) and multivariate survival analyses (hazard ratio = 2.775, 95% confidence interval [CI]: 1.326-5.807, P = 0.007) showed that low high-density lipoprotein cholesterol (HDL-C) levels at diagnosis had a negative impact on the OS. The multivariate logistic regression analysis showed that the HDL-C level at diagnosis (odds ratio [OR] = 2.200, 95% CI: 0.996-4.859, P = 0.051) and metabolic disorders after chemotherapy (OR = 1.514, 95% CI: 1.047-2.189, P = 0.028) are risk factors for poor prognosis in patients with breast cancer. CONCLUSIONS Chemotherapy led to weight gain and aggravated the metabolic disorders in patients with breast cancer. Low HDL-C levels at diagnosis and metabolic disorders after chemotherapy may have negative effects on the OS and prognosis of patients with breast cancer.
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Affiliation(s)
- Ping Yang
- School of Public Health, Peking University, Beijing 100191, China
- School of Nursing, Peking University, Beijing 100191, China
| | - Yingjian He
- Breast Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Xinying Yu
- Breast Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Baohua Liu
- School of Public Health, Peking University, Beijing 100191, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, China
| | - Xiangping Li
- School of Nursing, Peking University, Beijing 100191, China
| | - Peiyu Wang
- School of Public Health, Peking University, Beijing 100191, China
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15
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Huang S, Tan X, Feng P, Gong S, He Q, Zhu X, Liu N, Li Y. Prognostic Implication of Metabolic Syndrome in Patients with Nasopharyngeal Carcinoma: A Large Institution-Based Cohort Study from an Endemic Area. Cancer Manag Res 2022; 13:9355-9366. [PMID: 34992461 PMCID: PMC8713719 DOI: 10.2147/cmar.s336578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 12/16/2021] [Indexed: 12/24/2022] Open
Abstract
Objective Metabolic syndrome has been identified as a prognostic predictor in multiple cancers. This study aimed to evaluate the impact of metabolic syndrome on the clinical outcome of patients with nasopharyngeal carcinoma (NPC) and its mechanism. Methods A cohort of 2003 NPC patients with a median follow-up time of 96.3 months (range: 4.1–120.0 months) were enrolled in this analysis. Kaplan–Meier curves and the Log rank test were used to determine the differences in progression-free survival (PFS), cancer specific survival (CSS) and overall survival (OS). Univariate and multivariable analyses were used to identify independent prognostic predictors. Untargeted metabolomics (LC-HRMS) was used to detect the serum metabolic profiles of 10 well-matched patients with or without metabolic syndrome. Differential metabolite-based enrichment analysis and pathway analysis were performed to identify the potential mechanism of metabolic syndrome in NPC. Results A total of 171/2003 (8.5%) patients were diagnosed with metabolic syndrome, and these patients tended to be male (P < 0.001) and older (P = 0.003). Patients with metabolic syndrome had poorer PFS (P = 0.011), CSS (P = 0.003) and OS (P = 0.001) than those without metabolic syndrome. Univariate and multivariable analyses showed that metabolic syndrome was a statistically significant and independent predictor for PFS (HR: 1.34, 95% CI: 1.03–1.75, P = 0.032), CSS (HR: 1.53, 95% CI: 1.12–2.08, P = 0.008), and OS (HR: 1.50, 95% CI: 1.13–2.00, P = 0.006). The serum metabolic profile of patients with metabolic syndrome was distinct from that of patients without metabolic syndrome. A total of 319 differential metabolites [log2(FC)>1 or log2 (FC)<-1] were identified and were significantly involved in D-glutamine and D-glutamate metabolism, and valine, leucine and isoleucine biosynthesis. Conclusion Metabolic syndrome can serve as a prognostic predictor and guide a more personalized therapy for NPC patients.
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Affiliation(s)
- Shengyan Huang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Xirong Tan
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Ping Feng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.,The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, People's Republic of China
| | - Sha Gong
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Qingmei He
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Xunhua Zhu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Na Liu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Yingqing Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy; Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
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16
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Rezaiian F, Davoodi SH, Nikooyeh B, Ehsani AH, Kalayi A, Shariatzadeh N, Zahedirad M, Neyestani TR. Metabolic Syndrome and Its Components are Linked with Increased Risk of Non-Melanoma Skin Cancers in Iranian Subjects: A Case-Control Study. Nutr Cancer 2021; 74:2451-2459. [PMID: 34875944 DOI: 10.1080/01635581.2021.2012581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The associations between components of metabolic syndrome (MetS), insulin resistance (IR), and several malignancies have been reported. However, the possible link between IR and dermal malignancies, including non-melanoma skin cancers (NMSCs), has not been investigated to date. In this study, we aimed to examine the possible association between components of MetS, IR, adhesion molecules, and NMSC for the first time. This was a case-control study comprising 73 confirmed cases of NMSC and 72 unrelated healthy controls. Anthropometric and biochemical assessments including fasting blood lipid profile, glucose and insulin assays were performed. To evaluate IR, HOMA-IR formula was used. Though fasting serum glucose showed no significant between-group difference, serum concentrations of insulin (p = 0.048) as well as HOMA-IR (p = 0.037) were both significantly higher in NMSC group than in controls. Logistic regression analysis revealed significant associations between waist circumference (OR: 1.04, 95% CI: 1.007-1.080, p = 0.018), percent of visceral fat (OR: 1.10, 95% CI: 1.024-1.190, p = 0.01), HOMA-IR (OR: 1.169, 95% CI: 1.004-1.360, p = 0.044), circulating VCAM-1 concentrations (OR: 1.005, 95% CI: 1.003-1.007, p < 0.001) and NMSC risk. Interestingly, the occurrence of MetS was significantly higher in subjects with NMSC than in healthy controls (p = 0.038). MetS and its components were associated with increased NMSC risk.
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Affiliation(s)
- Fatemeh Rezaiian
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Hossein Davoodi
- Department of Cellular Molecular Nutrition, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Nikooyeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Houshang Ehsani
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Shariatzadeh
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R Neyestani
- Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition and Food Technology Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Abbasi F, Pourjalali H, do Nascimento IJB, Zargarzadeh N, Mousavi SM, Eslami R, Milajerdi A. The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis. Cytokine 2021; 149:155712. [PMID: 34644675 DOI: 10.1016/j.cyto.2021.155712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/17/2021] [Accepted: 09/13/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite several studies on the effects of exercise training on inflammatory biomarkers in patients with breast cancer, no earlier study has systematically summarized their findings. Current systematic review and meta-analysis has been done on earlier clinical trials in this topic. METHOD Relevant studies published up to August 2021 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar using predefined keywords. Studies that examined the effect of exercise training on inflammatory biomarkers in adult women with breast cancer were included. RESULT A total of 18 studies were included. Combining 11 effect sizes, exercise training significantly reduced CRP level (WMD: -0.55; 95% CI: -1.10, -0.01). However, it had no significant influence on serum TNF-α (WMD: -0.40; 95% CI: -1.30, 0.50) and IL-6 concentrations (WMD: -0.05, 95% CI: -0.53, 0.43) in 8 and 15 studies, respectively. Pooling 7 effect sizes, we failed to find significant changes in IL-8 following exercise training (WMD: -0.65, 95% CI: -1.57, 0.28). Moreover, we reached no significant findings for serum levels of INF-ɣ (WMD: -2.66, 95% CI: -7.67, 2.36), IL-1β (WMD: 0.03, 95% CI: -0.26, 0.21), and IL-10 (WMD: -0.70, 95% CI: -2.92, 1.52). Based on subgroup analyses, best findings were reached in long-term intervention and after concurrent training. DISCUSSION Chronic inflammation is hypothesized to be associated with breast cancer development. We found significant reduction in CRP level following exercise training, which was more considerable after concurrent aerobic and resistance training and in long-term intervention. No significant changes were seen in serum levels of TNF-α, IL-6, IL-8, IL-10, INF-ɣ, IL-1β following exercise training. Further studies are needed to find more details.
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Affiliation(s)
- Fatemeh Abbasi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Hanieh Pourjalali
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Israel Júnior Borges do Nascimento
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States; University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Eslami
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran.
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
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Pan K, Aragaki AK, Neuhouser ML, Simon MS, Luo J, Caan B, Snetselaar L, Mortimer JE, Manson JE, Kroenke C, Lane D, Reding K, Rohan TE, Chlebowski RT. Low-fat dietary pattern and breast cancer mortality by metabolic syndrome components: a secondary analysis of the Women's Health Initiative (WHI) randomised trial. Br J Cancer 2021; 125:372-379. [PMID: 34006923 PMCID: PMC8329224 DOI: 10.1038/s41416-021-01379-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/05/2021] [Accepted: 03/24/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In the Women's Health Initiative (WHI) dietary modification (DM) randomised trial, the low-fat dietary intervention reduced deaths from breast cancer (P = 0.02). Extending these findings, secondary analysis examined dietary intervention influence on breast cancer mortality by metabolic syndrome (MS) components. METHODS In total, 48,835 postmenopausal women with no prior breast cancer were randomised to a low-fat dietary intervention or comparison groups. Four MS components were determined at entry in 45,833 participants: (1) high waist circumference, (2) high blood pressure, (3) high cholesterol and (4) diabetes history. Forest plots of hazard ratios (HRs) were generated with P-values for interaction between randomisation groups and MS component score. Primary outcome was death from breast cancer by metabolic syndrome score. RESULTS HRs and 95% confidence intervals (CI) for dietary intervention influence on death from breast cancer were with no MS components (n = 10,639), HR 1.09, 95% CI 0.63-1.87; with 1-2 MS components (n = 30,948), HR 0.80, 95% CI 0.62-1.02; with 3-4 MS components (n = 4,246), HR 0.31, 95% CI 0.14-0.69 (interaction P = 0.01). CONCLUSIONS While postmenopausal women with 3-4 MS components were at higher risk of death from breast cancer, those randomised to a low-fat dietary intervention more likely had reduction in this risk. REGISTRY ClinicalTrials.gov (NCT00000611).
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Affiliation(s)
- Kathy Pan
- grid.239844.00000 0001 0157 6501Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Aaron K. Aragaki
- grid.270240.30000 0001 2180 1622Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Marian L. Neuhouser
- grid.270240.30000 0001 2180 1622Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Michael S. Simon
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Research Center, Seattle, WA USA ,grid.254444.70000 0001 1456 7807Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI USA
| | - Juhua Luo
- grid.257410.50000 0004 0413 3089University of Indiana, Bloomington, IN USA
| | - Bette Caan
- grid.280062.e0000 0000 9957 7758Kaiser Permanente Northern California Division of Research, Oakland, CA USA
| | - Linda Snetselaar
- grid.214572.70000 0004 1936 8294University of Iowa, Bloomington, IN USA
| | - Joanne E. Mortimer
- grid.410425.60000 0004 0421 8357City of Hope National Medical Center, Duarte, CA USA
| | - JoAnn E. Manson
- grid.38142.3c000000041936754XBrigham and Women’s Hospital/Harvard Medical School, Boston, MA USA
| | - Candyce Kroenke
- grid.280062.e0000 0000 9957 7758Kaiser Permanente Northern California Division of Research, Oakland, CA USA
| | - Dorothy Lane
- grid.36425.360000 0001 2216 9681State University of New York at Stony Brook, Stony Brook, NY USA
| | - Kerryn Reding
- grid.34477.330000000122986657Fred Hutchinson Cancer Research Center & University of Washington, School of Nursing, Seattle, WA USA
| | - Thomas E. Rohan
- grid.251993.50000000121791997Albert Einstein College of Medicine, Bronx, NY USA
| | - Rowan T. Chlebowski
- grid.239844.00000 0001 0157 6501Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
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The Effect of Exercise Training on Serum Glucose and Lipid Profiles in Patients With Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Phys Act Health 2021; 18:863-877. [PMID: 34034225 DOI: 10.1123/jpah.2020-0637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Despite several studies on the effects of exercise training on glucose and lipid profiles in patients with breast cancer, no earlier study has systematically summarized their findings. Current systematic review and meta-analysis have been done on earlier clinical trials in this topic. METHODS Relevant studies published up to May 2020 were searched through PubMed, SCOPUS, and Google Scholar using predefined keywords. Studies that examined the effect of exercise training on serum glucose and lipid profiles in adult women with breast cancer were included. RESULTS A total of 16 studies were included. Combining 10 effect sizes, exercise training had no significant influence on serum fasting plasma glucose concentrations (weighted mean difference [WMD] = 4.87; 95% confidence interval [CI], -4.65 to 14.29). However, it resulted in significant reduction of serum insulin (WMD = -2.37; 95% CI, -3.57 to -1.16) and homeostatic model assessment for insulin resistance (WMD = -0.71; 95% CI, -1.27 to -0.15) in 14 and 8 studies, respectively. Pooling 6 effect sizes, exercise training did not change serum total cholesterol (WMD = -11.99; 95% CI, -32.42 to 8.45), low-density lipoprotein (WMD = -3.21; 95% CI, -10.45 to 4.04), high-density lipoprotein (WMD = 4.13; 95% CI, -6.20 to 14.46), and triglyceride (WMD = -23.34; 95% CI, -66.96 to 20.29) concentrations. Subgroup analyses showed beneficial effects of exercise training on outcomes of interest among studies with higher methodological quality. CONCLUSION Current meta-analysis demonstrated significant reductions in serum levels of insulin and insulin resistance following exercise training. However, exercise training had no significant effect on serum levels of fasting plasma glucose, total cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein. Further high-quality studies are needed to shed light on this issue.
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Hosio M, Urpilainen E, Hautakoski A, Marttila M, Arffman M, Sund R, Ahtikoski A, Puistola U, Läärä E, Karihtala P, Jukkola A. Association of antidiabetic medication and statins with survival from ductal and lobular breast carcinoma in women with type 2 diabetes. Sci Rep 2021; 11:10445. [PMID: 34001921 PMCID: PMC8129135 DOI: 10.1038/s41598-021-88488-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
We investigated the survival of female patients with pre-existing type 2 diabetes (T2D) diagnosed with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) of breast, in relation to the use of metformin, other antidiabetic medication (ADM) and statins. The study cohort consisted of 3,165 women (2,604 with IDC and 561 with ILC). The cumulative mortality from breast cancer (BC) and from other causes was calculated using the Aalen-Johansen estimator. The cause-specific mortality rates were analysed by Cox models, and adjusted hazard ratios (HRs) were estimated for the use of different medications. No evidence of an association of metformin use with BC mortality was observed in either IDC (HR 0.92, 95% confidence interval [CI] 0.64–1.31) or ILC (HR 0.68, 95% CI 0.32–1.46) patients, when compared to other oral ADMs. The mortality from other causes was found to be lower amongst the IDC patients using metformin (HR 0.64, 95% CI 0.45–0.89), but amongst ILC patients the evidence was inconclusive (HR 1.22, 95% CI 0.64–2.32). Statin use was consistently associated with reduced mortality from BC in IDC patients (HR 0.77, 95% CI 0.62–0.96) and ILC patients (HR 0.59, 95% CI 0.37–0.96), and also mortality from other causes in IDC patients (HR 0.81, 95% CI 0.67–0.96) and in ILC patients (HR 0.66, 95% CI 0.43–1.01). We found no sufficient evidence for the possible effects of metformin and statins on the prognosis of BC being different in the two histological subtypes.
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Affiliation(s)
- Mayu Hosio
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 22, 90029, Oulu, Finland.
| | - Elina Urpilainen
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 23, 90029, Oulu, Finland
| | - Ari Hautakoski
- Research Unit of Mathematical Sciences, University of Oulu, PO Box 3000, 90014, Oulu, Finland
| | - Mikko Marttila
- Orion Corporation, Orionintie 1, PO Box 65, 02101, Espoo, Finland
| | - Martti Arffman
- Service System Research Unit, Finnish Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland
| | - Reijo Sund
- Institute of Clinical Medicine, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland
| | - Anne Ahtikoski
- Cancer and Translational Medicine Research Unit, Department of Pathology, Oulu University Hospital and University of Oulu, PO Box 50, 90029, Oulu, Finland
| | - Ulla Puistola
- Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 23, 90029, Oulu, Finland
| | - Esa Läärä
- Research Unit of Mathematical Sciences, University of Oulu, PO Box 3000, 90014, Oulu, Finland
| | - Peeter Karihtala
- Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PO Box 22, 90029, Oulu, Finland.,Department of Oncology, Helsinki University Comprehensive Cancer Center, P.O.Box 180, 00029, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Arja Jukkola
- Department of Oncology and Radiotherapy, Cancer Center Tampere, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Box 2000, 33521, Tampere, Finland
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Low Carb and Ketogenic Diets Increase Quality of Life, Physical Performance, Body Composition, and Metabolic Health of Women with Breast Cancer. Nutrients 2021; 13:nu13031029. [PMID: 33806775 PMCID: PMC8004887 DOI: 10.3390/nu13031029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022] Open
Abstract
Breast cancer (BC) patients often ask for a healthy diet. Here, we investigated a healthy standard diet (SD), a low carb diet (LCD), and a ketogenic diet (KD) for BC patients during the rehabilitation phase. KOLIBRI was an open-label non-randomized one-site nutritional intervention trial, combining inpatient and outpatient phases for 20 weeks. Female BC patients (n = 152; mean age 51.7 years) could select their diet. Data collected were: Quality of life (QoL), spiroergometry, body composition, and blood parameters. In total 30, 92, and 30 patients started the KD, LCD, and SD, respectively. Of those, 20, 76, and 25 completed the final examination. Patients rated all diets as feasible in daily life. All groups enhanced QoL, body composition, and physical performance. LCD participants showed the most impressive improvement in QoL aspects. KD participants finished with a very good physical performance and muscle/fat ratio. Despite increased cholesterol levels, KD patients had the best triglyceride/high-density lipoprotein (HDL) ratio and homeostatic model assessment of insulin resistance index (HOMA-IR). Most metabolic parameters significantly improved in the LCD group. SD participants ended with remarkably low cholesterol levels but did not improve triglyceride/HDL or HOMA-IR. In conclusion, both well-defined KDs and LCDs are safe and beneficial for BC patients and can be recommended during the rehabilitation phase.
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Zhao H, Song R, Ye Y, Chow WH, Shen J. Allostatic score and its associations with demographics, healthy behaviors, tumor characteristics, and mitochondrial DNA among breast cancer patients. Breast Cancer Res Treat 2021; 187:587-596. [PMID: 33507481 DOI: 10.1007/s10549-021-06102-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/09/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Allostatic load (AL), a composite index, has been used to capture variation in life-course stresses. However, few studies have been carried out among breast cancer patients. METHODS In this study, we examined the cross-sectional association of AL with demographics, healthy behaviors, tumor characteristics, and mitochondrial DNA copy number in breast cancer patients. The study used a sub-sample of 934 women with newly diagnosed breast cancer at M.D. Anderson from 2013 to 2018. To construct the AL score, the study used a battery of seventeen factors that represents the activity of five physiological systems: metabolic, cardiovascular, immunological, renal, and liver. RESULTS AL was positively associated with the age of disease diagnosis (P = 0.002), and was higher in Black and Hispanic populations than White (P = 0.001 and 0.032, respectively). AL was also found more abundant in those who experienced marital dissolution (P = 0.006), lacked a college education (P = 0.045), currently smoked (P = 0.011), and had low levels of physical activity (P = 0.037) than their counterparts. The study then found that higher AL was associated with increased odds of having poorly differentiated tumors (Odds ratio (OR): 1.40, 95% confidence interval (CI): 1.28, 1.62). An additional significant association was observed between AL with estrogen receptor negative (ER-) (OR = 1.56, 95%CI: 1.02, 2.36) among Black patients. Finally, we observed a significant positive correlation between AL with leukocyte mitochondrial DNA copy number variation (P < 0.001). CONCLUSIONS We conclude AL is influenced by selected demographics and healthy behaviors, and further is correlated with tumor characteristics and mitochondrial DNA copy number in breast cancer patients.
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Affiliation(s)
- Hua Zhao
- Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. .,Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA.
| | - Renduo Song
- Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yuanqing Ye
- Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.,Department of Precision Health and Data Science, School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wong-Ho Chow
- Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Jie Shen
- Departments of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.,Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA
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