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代谢综合征与接受辅助激素治疗的乳腺癌幸存者中 C 反应蛋白升高。

Metabolic syndrome and elevated C-reactive protein in breast cancer survivors on adjuvant hormone therapy.

机构信息

Department of Nutritional Sciences, University of Arizona, Tucson, Arizona 85724, USA.

出版信息

J Womens Health (Larchmt). 2009 Dec;18(12):2041-7. doi: 10.1089/jwh.2009.1365.

Abstract

AIMS

As the efficacy of treatment for breast cancer has improved, particularly with the use of antiestrogenic therapies, there is an increasing population of long-term breast cancer survivors who seeks care with unique health issues. These patients may be at increased risk for cardiovascular disease (CVD) resulting from excess adiposity and treatment effects. Metabolic syndrome (MetS) and elevated C-reactive protein (CRP), two predictors of CVD, have not been fully evaluated in overweight breast cancer survivors on hormone-modulating agents.

METHODS

Anthropometric measures, including weight, height, waist and hip circumferences; clinical laboratory assessments, including lipids, glucose, glycoslyated hemoglobin (HbA1c), insulin, and high sensitivity CRP; and body composition and blood pressure (BP) were collected from overweight breast cancer survivors (n=42). Select measures were used to derive MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) diagnostic criteria.

RESULTS

Participants had a mean body weight of 83.8 kg and body mass index (BMI) of 31.4 kg/m2. Mean fasting glucose (98+/-12.9 mg/dL), HbA1c (6.0+/-0.5 mg/dL), cholesterol (199+/-33.7 mg/dL), and insulin (16+/-3.2 mg/dL) were all at the upper end of the normal range. MetS was diagnosed in 54.8% of overweight postmenopausal breast cancer survivors. CRP was moderately or severely elevated in 90.5% of the population (mean of 5.1+/-5.3 mg/dL).

CONCLUSIONS

In our sample, overweight breast cancer survivors commonly have MetS and elevated CRP that place them at increased risk for cardiovascular and other metabolic diseases. If replicated in a larger sample, this warrants close medical monitoring to prevent and reduce morbidity and mortality unrelated to breast cancer.

摘要

目的

随着乳腺癌治疗效果的提高,特别是使用抗雌激素治疗后,越来越多的长期乳腺癌幸存者出现了独特的健康问题,需要接受治疗。这些患者可能由于超重和治疗效果而面临更高的心血管疾病(CVD)风险。代谢综合征(MetS)和 C 反应蛋白(CRP)升高是 CVD 的两个预测指标,但在接受激素调节药物治疗的超重乳腺癌幸存者中尚未得到充分评估。

方法

从超重的乳腺癌幸存者(n=42)中收集了人体测量学指标,包括体重、身高、腰围和臀围;临床实验室评估指标,包括血脂、血糖、糖化血红蛋白(HbA1c)、胰岛素和高敏 CRP;以及身体成分和血压(BP)。使用国家胆固醇教育计划成人治疗专家组 III (NCEP-ATP III)诊断标准,选择部分指标来诊断 MetS。

结果

参与者的平均体重为 83.8 公斤,体重指数(BMI)为 31.4 公斤/平方米。空腹血糖(98+/-12.9 mg/dL)、HbA1c(6.0+/-0.5 mg/dL)、胆固醇(199+/-33.7 mg/dL)和胰岛素(16+/-3.2 mg/dL)均处于正常值上限。54.8%的超重绝经后乳腺癌幸存者被诊断患有 MetS。90.5%的人群 CRP 中度或重度升高(平均 5.1+/-5.3 mg/dL)。

结论

在我们的样本中,超重的乳腺癌幸存者通常患有 MetS 和 CRP 升高,这使他们面临更高的心血管和其他代谢疾病风险。如果在更大的样本中得到复制,这就需要进行密切的医疗监测,以预防和减少与乳腺癌无关的发病率和死亡率。

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