Weight and waist-to-hip ratio change pattern during the first five years of survival: data from a longitudinal observational Chinese breast cancer cohort

Abstract

Background Body weight management was an important component in breast cancer survivorship care. The present study described the change patterns of body weight and waist-to-hip ratio (WHR) during the first 5 years of survival, and investigated potential factors associated with very substantial changes. Patients and methods Based on a longitudinal cohort with 1462 Chinese women with breast cancer, anthropometric measurements including body weight, height, waist and hip circumferences were measured by trained interviewers following standard protocol at four time-points: baseline at study entry, 18-, 36- and 60-months follow up assessments (termed as T0, T1, T2 and T3, respectively). Body height was measured at baseline and body weight at cancer diagnosis were retrieved from medical record. Results Compared to weight at breast cancer diagnosis, the median weight change was − 0.5 kg, 0 kg, + 0.5 kg, and + 1 kg at T0, T1, T2 and T3, respectively. During the first 5 years of survival, the proportion of women who were obese have slightly increased. At 60-months after diagnosis, only 14.3% of women had weight gain by > 5 kg; and the percentage of women who had weight gain by > 10% was 10.7%. Nearly half of patients had abdominal obesity at study entry, and this proportion were gradually increased to nearly 70% at 60-months follow-up. Multivariate analysis indicated that older age, and frequent sports participation during the first 5 years of survival were related to lower risk of very substantial weight gain (> 10%) at 60-month follow-up; patients aged 40–49 years, having ≥2 comorbidities and ER negative were associated with less likelihood of very substantial WHR substantial increase (> 10%) at 60-month follow-up. Conclusion Weight gain was modest in Chinese breast cancer survivors during the first 5 years of survival, while central adiposity has become a contemporary public health issue. The incorporation of healthy weight and abdominal circumference patient education and management has a potential to improve cancer survivorship.

Higher Level of Sports Activities Participation during Five-Year Survival Is Associated with Better Quality of Life among Chinese Breast Cancer Survivors

“…It is well recognized that Asian women have a lower body mass index (BMI) than Western women [ 31 ]. In addition, our previous study showed that less than 10% of Chinese women with breast cancer were obese, according to the BMI classification of the World Health Organization (WHO) [ 32 ]. Taken together, these data suggest that the beneficial impact of exercise on QoL may differ between Western and Chinese women.…”

Sobrepeso, obesidad y cáncer de mama

“…La hiperinsulinemia en mujeres obesas puede promover la carcinogénesis mamaria al aumentar la concentración del IGF y leptina. Estas interactúan en forma sinérgica con los estrógenos en las células epiteliales mamarias, promoviendo la angiogénesis (11).…”

Changes in body composition and subsequent cardiovascular disease risk among 5-year breast cancer survivors

“…Chemotherapy also causes alternations in skeletal muscle and creates a predisposition to muscle atrophy and weakness ( 7 ). As a result, CVD burden associated with post-diagnosis weight gain has been observed to as long as 5 years in Asian patients ( 8 ). Of equal importance, excessive body fat in cancer survivors has been shown to affect quality of life and disease-free survival ( 9 ).…”