Impact of Weight Loss on Plasma Leptin and Adiponectin in Overweight-to-Obese Post Menopausal Breast Cancer Survivors

Abstract

Women who are obese at the time of breast cancer diagnosis have higher overall mortality than normal weight women and some evidence implicates adiponectin and leptin as contributing to prognostic disadvantage. While intentional weight loss is thought to improve prognosis, its impact on these adipokines is unclear. This study compared the pattern of change in plasma leptin and adiponectin in overweight-to-obese post-menopausal breast cancer survivors during weight loss. Given the controversies about what dietary pattern is most appropriate for breast cancer control and regulation of adipokine metabolism, the effect of a low fat versus a low carbohydrate pattern was evaluated using a non-randomized, controlled study design. Anthropometric data and fasted plasma were obtained monthly during the six-month weight loss intervention. While leptin was associated with fat mass, adiponectin was not, and the lack of correlation between leptin and adiponectin concentrations throughout weight loss implies independent mechanisms of regulation. The temporal pattern of change in leptin but not adiponectin was affected by magnitude of weight loss. Dietary pattern was without effect on either adipokine. Mechanisms not directly related to dietary pattern, weight loss, or fat mass appear to play dominant roles in the regulation of circulating levels of these adipokines.

Changes in metabolic risk, insulin resistance, leptin and adiponectin following a lifestyle intervention in overweight and obese breast cancer survivors

“…Several studies that offered lifestyle interventions to BC survivors have reported significant decreases in leptin (Befort et al, 2012;Rogers et al, 2013;Scott et al, 2013;Thompson et al, 2015). In our study, leptin concentrations decreased by 13% but this decrease did not reach statistical significance.…”

“…The authors indicated that part of the differences observed across studies might be due to hormonal treatment as Tamoxifen has been shown to reduce IGF1 and exercise may not be able to further reduce it. In our study, the analysis performed in participants who were not taking Tamoxifen (n = 15) showed a significant 11% decrease in (Befort et al, 2012;Rogers et al, 2013;Scott et al, 2013;Thompson et al, 2015). In our study, leptin concentrations decreased by 13% but this decrease did not reach statistical significance.…”

“…Indeed, in their review summarising the evidence on the effects of caloric restriction and weight loss on circulating adiponectin concentrations, Swarbrick and Havel (2008) explained that longer-term caloric restrictions producing significant weight loss are consistently associated with increases in adiponectin, while the results after short-term caloric restrictions are not that clear. Thompson et al (2015) who evaluated the effect of a 6month weight loss intervention offered to overweight/obese BC survivors also reported the importance of the length of the intervention as they first observed a decrease in adiponectin and then an increase. At baseline, the participants following the low-fat diet (n = 72) showed adiponectin plasma concentrations of 14.0 μg/ml, after 1 month concentrations had decreased to 12.5 μg/ml and even though they had increased again by 3 months, adiponectin concentrations were still lower than those measured at baseline, similar to our study.…”

Primary and secondary prevention of breast cancer

“…Protani et al carried out between 1963-2005, meta-analysis of 43 examinations among women diagnosed with cancer. The group of women who were already obese when the disease was recognized was characterized by a 33% higher mortality risk than women with normal body weight [22,23]. Hauner et al came to similar conclusions by assessing examinations and metaanalyses which were published between 1996-2010 [24].…”

Undernutrition and hyperandrogenism during pregnancy: Role in programming of cardiovascular disease and infertility

“…Unlike leptin, circulating concentrations of adiponectin, increase during weight/adipose tissue loss (Ma et al, 2016;Thompson et al, 2015). Adiponectin can reduce androgen secretion.…”