Síndrome metabólica em mulheres na pós-menopausa tratadas de câncer de mama

Abstract

ResumoOBJETIVO: Avaliar a ocorrência de síndrome metabólica (SM) em mulheres na pós-menopausa tratadas de câncer de mama. MÉTODOS: Estudo clínico, transversal, com 158 mulheres na pós-menopausa (amenorreia >12 meses e idade ≥45 anos) tratadas de câncer de mama e livres de doença há pelo menos cinco anos. Por meio de entrevista foram coletados dados clínicos e avaliados o índice de massa corpórea (IMC) e a circunferência da cintura (CC). Na análise bioquímica foram solicitadas dosagens de colesterol total (CT), HDL, LDL, triglicerídeos (TG), glicemia, insulina e proteína C-reativa (PCR). Foram consideradas com SM as mulheres que apresentaram três ou mais critérios diagnósticos: CC>88 cm; TG≥150 mg/dL; HDL colesterol <50 mg/dL; pressão arterial≥130/85 mmHg; glicemia de jejum≥100 mg/dL. Para análise estatística foram empregados o teste t de Student e o teste do χ 2 . RESULTADOS: A média de idade das pacientes foi de 63,1±8,6 anos, com tempo médio de seguimento de 9,1±4,0 anos. A SM foi diagnosticada em 48,1% (76/158) e entre os critérios diagnósticos, o mais prevalente foi obesidade abdominal (CC>88 cm) afetando 54,4% (86/158) das mulheres. As pacientes sem SM tiveram maior tempo de seguimento quando comparadas àquelas com SM (p<0,05). Em relação ao IMC atual, aquelas sem SM eram em média sobrepeso e aquelas com SM eram obesas (p<0,05). Entre estas, na comparação entre o IMC no momento do diagnóstico do câncer e o atual foi observado ganho significativo de peso (27,8±5,4 versus 33,4±5,4 kg/m 2 ) (p<0,05). O valor médio de PCR foi superior nas mulheres com SM (p<0.05). Na comparação das características tumorais e tratamentos oncológicos não houve diferença significativa entre as mulheres com e sem SM. CONCLUSÃO: Mulheres na pós-menopausa tratadas de câncer de mama têm elevado risco de desenvolver síndrome metabólica e obesidade central. Abstract PURPOSE:To assess the occurrence of metabolic syndrome (MetS) in postmenopausal breast cancer survivors. METHODS: A total of 158 breast cancer survivors were included in this cross-sectional study. Eligibility criteria were: women with amenorrhea >12 months and age ≥45 years, treated for breast cancer and no metastasis for at least five years. Clinical history and anthropometric indicator data (body mass index (BMI), and waist circumference, (WC) were collected. Biochemical parameters, including total cholesterol, HDL, LDL, triglycerides (TG), glucose and C-reactive protein (CRP), were measured. MetS was diagnosed as the presence of at least three of the following diagnostic criteria: WC>88 cm, blood pressure≥130/85 mmHg, triglycerides≥150 mg/dl, HDL <50 mg/dL,and glucose≥100 mg/dL. The Student's t-test and χ 2 test were used for statistical analysis. RESULTS: The mean age of breast cancer survivors was 63.1±8.6 years, with a mean follow-up of 9.1±4.0 years. MetS was diagnosed in 48.1% (76/158) and the most prevalent diagnostic criterion was abdominal obesity (WC>88 cm), affecting 54.4% (86/158) of the women. The patients without MetS had a longer follow-up compared those wi...

Prevalência da obesidade em mulheres tratadas de câncer de mama numa UNACOM em Juiz de Fora

“…Após responderem ao questionário, as pacientes foram convidadas individualmente para o aferimento das seguintes medidas antropométricas, segundo os critérios da World Health Organization (WHO) 18 :…”

“…Durante o tratamento para o câncer de mama, vários fatores, como a quimioterapia e a radioterapia -somados ao comportamento sedentário, à fadiga e à indisposição -, predispõem as pacientes a um ganho de peso adicional 15 . A obesidade nessas mulheres, quando associada a outras comorbidades -como hipertensão arterial sistêmica (HAS) e síndrome metabólica (SM) -, aumenta as taxas de morte específicas para o câncer e relativas a outras doenças associadas 16,17,18 .…”

Prevalence of Metabolic Syndrome among Breast Cancer Survivors in East Coast of Peninsular Malaysia

“…This difference can be attributed to the variation in breast cancer survival duration and ethnic composition percentage among the breast cancer survivors between these two studies. Furthermore, MetS prevalence among breast cancer survivors as reported in the current study was also similar, or higher than the data reported in other countries such as India -NCEP ATP III de nition: 40.0% vs 40.0% [8], China -Harmonized de nition: 50.5% vs 32.6% [9], Korea -Harmonized de nition: 50.5% vs 43.9% [10], USA -Harmonized de nition: 50.5% vs 26.1% [11], Denmark -NCEP ATP III de nition: 40.0% vs 15.1% [12] and Brazil -Harmonized de nition: 50.5% vs 48.1% [13] respectively. The higher proportion of breast cancer survivors with MetS in Asian countries as compared to Western countries re ected that MetS has become more prevalent in developing countries when compared to its Western counterparts due to increasing economic development in lower to middle-income countries [33,34].…”

“…In Malaysia, the prevalence of MetS among breast cancer patients was reported at 37.8% [6]. In other Asian and Western countries, MetS prevalence among breast cancer survivors were reported at comparable magnitude in countries such as India (31.1% to 40.0%) [7,8], China (32.9%) [9], Korea (43.9%) [10], USA (26.1%) [11], and Brazil 48.1% [13]. Prevalence of MetS among breast cancer patients in Denmark was rather lower (15.1%) than other reported studies [12].…”

Prevalence of Metabolic Syndrome among Breast Cancer Survivors in East Coast of Peninsular Malaysia

“…In Malaysia, the prevalence of MetS among breast cancer patients was reported at 37.8% [6]. In other Asian and Western countries, MetS prevalence among breast cancer survivors were reported at comparable magnitude in countries such as India (31.1% to 40.0%) [7,8], China (32.9%) [9] and Korea (43.9%) [10], USA (26.1%) [11], and Brazil 48.1% [13]. Prevalence of MetS among breast cancer patients in Denmark was rather lower (15.1%) than other reported studies [12].…”