Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with breast cancer

Bıçaklı, Derya Hopancı; Varol, Umut; Degirmenci, Mustafa; Tunali, Didem; Çakar, Burcu; Durusoy, Raika; Karaca, Burçak; Şanlı, Ulus Ali; Uslu, Rüçhan

doi:10.1177/1078155214551315

Cited by 24 publications

(26 citation statements)

References 28 publications

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“…To the best of our knowledge, the current study is the largest study to date to systematically address the effect of (neo)adjuvant chemotherapy alone on MetS and its components in both premenopausal and postmenopausal women. Smaller studies have reported MetS or its components after the completion of all treatments for breast cancer …”

Section: Discussionmentioning

confidence: 99%

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

Dieli‐Conwright

Wong

Waliany

et al. 2016

Cancer

107

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BACKGROUND We sought to determine the effect of chemotherapy on the development of metabolic syndrome (MetS) in premenopausal and postmenopausal women undergoing (neo) adjuvant therapy for early stage breast cancer. METHODS Eighty-six women with early stage (I-III) breast cancer who were free from clinically diagnosed MetS (defined as three out of five components of MetS) were prospectively tested for presence of the five components of MetS within one week before initiating and after completing (neo) adjuvant chemotherapy. The five components of MetS measured were waist circumference, blood pressure, and fasting levels of blood glucose, triglycerides, and high-density lipoprotein cholesterol. Anthropometrics (body weight, percent body fat, fat mass), lipid profile (total cholesterol, low-density lipoprotein cholesterol), glucose metabolism (insulin, homeostatic model assessment-insulin resistance, glycated hemoglobin), and inflammation (C-reactive protein) were also examined before initiating and after completing treatment. RESULTS The study included 46 premenopausal and 40 postmenopausal women. All individual MetS components and overall MetS score were statistically significantly increased (p<0.01) after chemotherapy. Body weight, percent body fat, fat mass, lipids, glucose metabolism, and inflammation were also statistically significantly increased (p<0.01). CONCLUSION A 12–18 week course of chemotherapy statistically significantly increases MetS and related anthropometrics, biomarkers of glucose metabolism, and inflammation in early stage breast cancer patients with no pre-existing MetS. Lifestyle interventions such as diet and exercise may be preventive approaches to employ during chemotherapy to reduce the onset of MetS in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

Dieli‐Conwright

Wong

Waliany

et al. 2016

Cancer

107

View full text Add to dashboard Cite

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“…Obese, diabetic breast cancer patients undergoing chemotherapy have increased likelihood of side effects including infection and chemotherapy-related toxicity (Srokowski, et al 2009). In addition, cytotoxic therapy has been associated with treatment-related weight gain and metabolic syndrome in breast cancer patients (Bicakli, et al 2014; Makari-Judson, et al 2014), potentially exacerbating these aforementioned side effects. In prostate cancer, obesity is associated with weight gain and increased risk of diabetes following androgen deprivation therapy (Keto, et al 2011; Tsai, et al 2014), particularly among older men (Morgans, et al 2014).…”

Section: Non-biologic Mechanisms Contributing To the Obesity - Canmentioning

confidence: 99%

Obesity and cancer: mechanistic insights from transdisciplinary studies

Allott¹,

Hursting²

2015

Endocrine-Related Cancer

140

101

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Obesity is associated with a range of health outcomes that are of clinical and public health significance, including cancer. Herein, we summarize epidemiologic and preclinical evidence for an association between obesity and increased risk of breast and prostate cancer incidence and mortality. Moreover, we describe data from observational studies of weight change in humans and from calorie restriction studies in mouse models which support a potential role for weight loss in counteracting tumor-promoting properties of obesity in breast and prostate cancers. Given that weight loss is challenging to achieve and maintain, we also consider evidence linking treatments for obesity-associated co-morbidities, including metformin, statins and non-steroidal anti-inflammatory drugs, with reduced breast and prostate cancer incidence and mortality. Finally, we highlight several challenges that should be considered when conducting epidemiologic and preclinical research in the area of obesity and cancer, including the measurement of obesity in population-based studies, the timing of obesity and weight change in relation to tumor latency and cancer diagnosis, and the heterogeneous nature of obesity and its associated co-morbidities. Given that obesity is a complex trait, comprised of behavioral, epidemiologic and molecular/metabolic factors, we argue that a transdisciplinary approach is the key to understanding the mechanisms linking obesity and cancer. As such, this review highlights the critical need to integrate evidence from both epidemiologic and preclinical studies to gain insight into both biologic and non-biologic mechanisms contributing to the obesity-cancer link.

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“…Therefore, anthracycline may cause long-term atherosclerosis and cardiotoxicity through thrombocyte reactivation when evaluated with present preclinic studies. Also, metabolic syndrome parameters related to atherosclerosis were previously shown to get worse in the breast cancer patients receiving adjuvant anthracycline [32]. When our study is evaluated with previous studies, we have suggested that anthracyclines may cause long-term cardiotoxicity by provoking atherosclerosis.…”

Section: Discussionmentioning

confidence: 58%

Assessment of platelet reactivity after the anthracyclinebased chemotherapy via mean platelet volume: Does it act on anthracycline-induced cardiotoxicity?

Aktaş¹

2018

Ann Clin Anal Med

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Aim: Anthracycline-induced cardiotoxicity is the most frequent dose-limited toxicity. There has been numerous hypothesis about this matter. As an indicator of platelet size, mean platelet volume (MPV) is correlated with platelet reactivity, aggregation, and long-term atherosclerosis. We aimed to study whether the anthracycline triggers the elevation of MPV. Material and Method: Patients who had breast carcinoma and received anthracycline-based chemotherapy for only adjuvant setting were included. Age, disease stage, history of diabetes mellitus (DM), hypertension (HT) and body mass index (BMI) were recorded. Patients with systemic inflammatory rheumatic disorders, the symptoms of infectious diseases, cytopenia after the chemotherapyand, BMI over 40 and metastatic disease were excluded. Blood samples were collected for initial MPV value and after four cycles of adjuvant anthracycline treatment. Statistical significance of the associations was analyzed using Pearson correlation, Student's t, ANOVA tests and Wilcoxon signed-rank test. Results: Three hundred operated breast cancer patients were recruited in this study. Mean age was 49.1 (20-77). There was no significant correlation between age and initial MPV (r=-1.111, p= 0.056) or between BMI and initial MPV (r=0.023, p=0.697). Stage, DM, and HT did not affect initial MPV levels. Initial median MPV was 9.1 (6.2-12.8), and the last median MPV was 9.2 (6.1-12.9). According to Wilcoxon signed ranks test, positive ranks were found in 151 patients (p=0.003, Z=-3,002, based on positive ranks) after anthracycline therapy. Discussion: Anthracycline causes elevation in MPV value which is a marker of thrombocyte reactivation and atherosclerosis. This might be responsible for the possible long-term cardiotoxicity of anthracyclines.

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Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with breast cancer

Abstract: Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with BC and these changes are more profound in pre-menopausal patients.

Cited by 24 publications

References 28 publications

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy

Obesity and cancer: mechanistic insights from transdisciplinary studies

Assessment of platelet reactivity after the anthracyclinebased chemotherapy via mean platelet volume: Does it act on anthracycline-induced cardiotoxicity?

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