Skip to main content
Top
Published in: Journal of Translational Medicine 1/2019

Open Access 01-12-2019 | Dyslipidemia | Research

Key metabolic parameters change significantly in early breast cancer survivors: an explorative PILOT study

Authors: Stine Overvad Fredslund, Claus Højbjerg Gravholt, Britt Elmedal Laursen, Anders Bonde Jensen

Published in: Journal of Translational Medicine | Issue 1/2019

Login to get access

Abstract

Background

With increasing number of breast cancer survivors, more attention is drawn to long-term consequences of curative cancer treatment. Adjuvant treatment of breast cancer patients is associated with several unfavorable medical conditions, including dyslipidemia, insulin resistance, and obesity, potentially leading to cardiovascular disease and/or the metabolic syndrome. The aim of this explorative study is to investigate metabolic side effects of adjuvant treatment in breast cancer patients.

Methods

A cohort of 13 premenopausal and 20 postmenopausal women with early stage breast cancer were extensively examined prior to, immediately after and 1 year after ended adjuvant chemotherapy and compared with healthy controls (N = 36) matched by age and menopausal status. Repeated examinations included: anthropometric measures, DEXA scans, 24-h blood pressure measurements, and blood samples [high sensitivity CRP, lipid profile and glucose metabolism, including homeostatic model assessment (HOMA)].

Results

At baseline, breast cancer patients were similar to healthy controls regarding all measures. From baseline to 1-year post-treatment specific components of the metabolic syndrome increased significantly in premenopausal breast cancer patients; body fat (P = 0.01), triglycerides (P = 0.03), waist circumference (P = 0.008) and diastolic blood pressure (P = 0.04). In postmenopausal patients, waist circumference also increased significantly (P = 0.03), and High density lipoprotein (HDL) cholesterol decreased significantly (P = 0.05).

Conclusions

Specific components of the metabolic syndrome changed significantly during chemotherapy in early stage breast cancer patients. After 1 year, several key parameters remained pathologically changed. Premenopausal breast cancer patients seemed to be especially prone to develop these unfavorable changes.
Trial registration ClinicalTrial.gov, registration number NCT02652975. Registered 15 December 2015—Retrospectively registered, https://​clinicaltrials.​gov/​.
Literature
1.
go back to reference Society AC. Cancer facts & figures 2018. Cancer Facts Fig 2018. 2018. Society AC. Cancer facts & figures 2018. Cancer Facts Fig 2018. 2018.
2.
go back to reference Boerman LM, Maass SWMC, van der Meer P, Gietema JA, Maduro JH, Hummel YM, et al. Long-term outcome of cardiac function in a population-based cohort of breast cancer survivors: a cross-sectional study. Eur J Cancer. 2017;81:56–65.CrossRef Boerman LM, Maass SWMC, van der Meer P, Gietema JA, Maduro JH, Hummel YM, et al. Long-term outcome of cardiac function in a population-based cohort of breast cancer survivors: a cross-sectional study. Eur J Cancer. 2017;81:56–65.CrossRef
3.
go back to reference Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6–13.CrossRef Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6–13.CrossRef
4.
go back to reference Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):R64.CrossRef Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):R64.CrossRef
5.
go back to reference Gernaat SAM, et al. The risk of cardiovascular disease following breast cancer by Framingham risk score. Breast Cancer Res Treat. 2018;170(1):119–27.CrossRef Gernaat SAM, et al. The risk of cardiovascular disease following breast cancer by Framingham risk score. Breast Cancer Res Treat. 2018;170(1):119–27.CrossRef
6.
go back to reference Lipscombe LL, Chan WW, Yun L, Austin PC, Anderson GM, Rochon PA. Incidence of diabetes among postmenopausal breast cancer survivors. Diabetologia. 2013;56(3):476–83.CrossRef Lipscombe LL, Chan WW, Yun L, Austin PC, Anderson GM, Rochon PA. Incidence of diabetes among postmenopausal breast cancer survivors. Diabetologia. 2013;56(3):476–83.CrossRef
7.
go back to reference de Haas EC, Oosting SF, Lefrandt JD, Wolffenbuttel BH, Sleijfer DT, Gietema JA. The metabolic syndrome in cancer survivors. Lancet Oncol. 2010;11(2):193–203.CrossRef de Haas EC, Oosting SF, Lefrandt JD, Wolffenbuttel BH, Sleijfer DT, Gietema JA. The metabolic syndrome in cancer survivors. Lancet Oncol. 2010;11(2):193–203.CrossRef
9.
go back to reference Westerink NL, Nuver J, Lefrandt JD, Vrieling AH, Gietema JA, Walenkamp AME. Cancer treatment induced metabolic syndrome: improving outcome with lifestyle. Crit Rev Oncol Hematol. 2016;108:128–36.CrossRef Westerink NL, Nuver J, Lefrandt JD, Vrieling AH, Gietema JA, Walenkamp AME. Cancer treatment induced metabolic syndrome: improving outcome with lifestyle. Crit Rev Oncol Hematol. 2016;108:128–36.CrossRef
10.
go back to reference Pribylova O, Springer D, Svobodnik A, Kyr M, Zima T, Petruzelka L. Influence of chemotherapy to hormonal levels in postmenopausal breast cancer patients. Neoplasma. 2008;55(4):294–8.PubMed Pribylova O, Springer D, Svobodnik A, Kyr M, Zima T, Petruzelka L. Influence of chemotherapy to hormonal levels in postmenopausal breast cancer patients. Neoplasma. 2008;55(4):294–8.PubMed
11.
go back to reference Lobo RA, Davis SR, De Villiers TJ, Gompel A, Henderson VW, Hodis HN, et al. Prevention of diseases after menopause. Climacteric. 2014;17(5):540–56.CrossRef Lobo RA, Davis SR, De Villiers TJ, Gompel A, Henderson VW, Hodis HN, et al. Prevention of diseases after menopause. Climacteric. 2014;17(5):540–56.CrossRef
12.
go back to reference Dieli-Conwright CM, Wong L, Waliany S, Bernstein L, Salehian B, Mortimer JE. An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy. Cancer. 2016;122(17):2646–53.CrossRef Dieli-Conwright CM, Wong L, Waliany S, Bernstein L, Salehian B, Mortimer JE. An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy. Cancer. 2016;122(17):2646–53.CrossRef
13.
go back to reference Muka T, Asllanaj E, Avazverdi N, Jaspers L, Stringa N, Milic J, et al. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia. 2017;60(10):1951–60.CrossRef Muka T, Asllanaj E, Avazverdi N, Jaspers L, Stringa N, Milic J, et al. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia. 2017;60(10):1951–60.CrossRef
14.
go back to reference Moon Z, Hunter MS, Moss-Morris R, Hughes LD. Factors related to the experience of menopausal symptoms in women prescribed tamoxifen. J Psychosom Obstet Gynecol. 2017;38(3):226–35.CrossRef Moon Z, Hunter MS, Moss-Morris R, Hughes LD. Factors related to the experience of menopausal symptoms in women prescribed tamoxifen. J Psychosom Obstet Gynecol. 2017;38(3):226–35.CrossRef
15.
go back to reference Kyvernitakis I, Ziller V, Hars O, Bauer M, Kalder M, Hadji P. Prevalence of menopausal symptoms and their influence on adherence in women with breast cancer. Climacteric. 2014;17(3):252–9.CrossRef Kyvernitakis I, Ziller V, Hars O, Bauer M, Kalder M, Hadji P. Prevalence of menopausal symptoms and their influence on adherence in women with breast cancer. Climacteric. 2014;17(3):252–9.CrossRef
16.
go back to reference Khosrow-Khavar F, Filion KB, Al-Qurashi S, Torabi N, Bouganim N, Suissa S, et al. Cardiotoxicity of aromatase inhibitors and tamoxifen in postmenopausal women with breast cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Oncol. 2017;28(3):487–96.PubMed Khosrow-Khavar F, Filion KB, Al-Qurashi S, Torabi N, Bouganim N, Suissa S, et al. Cardiotoxicity of aromatase inhibitors and tamoxifen in postmenopausal women with breast cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Oncol. 2017;28(3):487–96.PubMed
17.
go back to reference Kim YA, Lee S, Jung JW, Kwon YJ, Lee GB, Shin DG, et al. Severe acute pancreatitis due to tamoxifen-induced hypertriglyceridemia with diabetes mellitus. Chin J Cancer Res. 2014;26(3):341.PubMedPubMedCentral Kim YA, Lee S, Jung JW, Kwon YJ, Lee GB, Shin DG, et al. Severe acute pancreatitis due to tamoxifen-induced hypertriglyceridemia with diabetes mellitus. Chin J Cancer Res. 2014;26(3):341.PubMedPubMedCentral
18.
go back to reference Lipscombe LL, Fischer HD, Yun L, Gruneir A, Austin P, Paszat L, et al. Association between tamoxifen treatment and diabetes: a population-based study. Cancer. 2012;118(10):2615–22.CrossRef Lipscombe LL, Fischer HD, Yun L, Gruneir A, Austin P, Paszat L, et al. Association between tamoxifen treatment and diabetes: a population-based study. Cancer. 2012;118(10):2615–22.CrossRef
19.
go back to reference Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.CrossRef Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.CrossRef
21.
go back to reference Bicakli DH, Varol U, Degirmenci M, Tunali D, Cakar B, Durusoy R, et al. Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with breast cancer. J Oncol Pharm Pract. 2016;22(1):46–53.CrossRef Bicakli DH, Varol U, Degirmenci M, Tunali D, Cakar B, Durusoy R, et al. Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with breast cancer. J Oncol Pharm Pract. 2016;22(1):46–53.CrossRef
22.
go back to reference Park SH, Park JH, Park HY, Jang HJ, Kim HK, Park J, et al. Additional role of sarcopenia to waist circumference in predicting the odds of metabolic syndrome. Clin Nutr. 2014;33(4):668–72.CrossRef Park SH, Park JH, Park HY, Jang HJ, Kim HK, Park J, et al. Additional role of sarcopenia to waist circumference in predicting the odds of metabolic syndrome. Clin Nutr. 2014;33(4):668–72.CrossRef
23.
go back to reference Cullen P. Evidence that triglycerides are an independent coronary heart disease risk factor. Am J Cardiol. 2000;86(9):943–9.CrossRef Cullen P. Evidence that triglycerides are an independent coronary heart disease risk factor. Am J Cardiol. 2000;86(9):943–9.CrossRef
24.
go back to reference Gozzetti A, Gennari L, Merlotti D, Salvadori S, De Paola V, Avanzati A, et al. The effects of zoledronic acid on serum lipids in multiple myeloma patients. Calcif Tissue Int. 2008;82(4):258–62.CrossRef Gozzetti A, Gennari L, Merlotti D, Salvadori S, De Paola V, Avanzati A, et al. The effects of zoledronic acid on serum lipids in multiple myeloma patients. Calcif Tissue Int. 2008;82(4):258–62.CrossRef
25.
go back to reference Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc. 2002;61(3):329–36.CrossRef Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative insulin resistance by pre-operative carbohydrate loading. Proc Nutr Soc. 2002;61(3):329–36.CrossRef
26.
go back to reference Okita K, Iwahashi H, Kozawa J, Okauchi Y, Funahashi T, Imagawa A, et al. Homeostasis model assessment of insulin resistance for evaluating insulin sensitivity in patients with type 2 diabetes on insulin therapy. Endocr J. 2013;60(3):283–90.CrossRef Okita K, Iwahashi H, Kozawa J, Okauchi Y, Funahashi T, Imagawa A, et al. Homeostasis model assessment of insulin resistance for evaluating insulin sensitivity in patients with type 2 diabetes on insulin therapy. Endocr J. 2013;60(3):283–90.CrossRef
27.
go back to reference Barnes PJ. Anti-inflammatory actions of glucocorticoids: molecular mechanisms. Clin Sci. 1998;94(6):557–72.CrossRef Barnes PJ. Anti-inflammatory actions of glucocorticoids: molecular mechanisms. Clin Sci. 1998;94(6):557–72.CrossRef
28.
go back to reference Kato M, Suzuki H, Murakami M, Akama M, Matsukawa S, Hashimoto Y. Elevated plasma levels of interleukin-6, interleukin-8, and granulocyte colony-stimulating factor during and after major abdominal surgery. J Clin Anesth. 1997;9(4):293–8.CrossRef Kato M, Suzuki H, Murakami M, Akama M, Matsukawa S, Hashimoto Y. Elevated plasma levels of interleukin-6, interleukin-8, and granulocyte colony-stimulating factor during and after major abdominal surgery. J Clin Anesth. 1997;9(4):293–8.CrossRef
29.
go back to reference Breen KM, Mellon PL. Influence of stress-induced intermediates on gonadotropin gene expression in gonadotrope cells. Mol Cell Endocrinol. 2014;385(1–2):71–7.CrossRef Breen KM, Mellon PL. Influence of stress-induced intermediates on gonadotropin gene expression in gonadotrope cells. Mol Cell Endocrinol. 2014;385(1–2):71–7.CrossRef
30.
go back to reference Pasieka AM, Rafacho A. Impact of glucocorticoid excess on glucose tolerance: clinical and preclinical evidence. Metabolites. 2016;6(3):24.CrossRef Pasieka AM, Rafacho A. Impact of glucocorticoid excess on glucose tolerance: clinical and preclinical evidence. Metabolites. 2016;6(3):24.CrossRef
Metadata
Title
Key metabolic parameters change significantly in early breast cancer survivors: an explorative PILOT study
Authors
Stine Overvad Fredslund
Claus Højbjerg Gravholt
Britt Elmedal Laursen
Anders Bonde Jensen
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2019
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-019-1850-2

Other articles of this Issue 1/2019

Journal of Translational Medicine 1/2019 Go to the issue