OBESITY IN WOMEN TREATED FOR BREAST CANCER - CONTROVERSIAL OBSERVATIONS ASSOCIATED WITH MENOPAUSAL STATUS AT DIAGNOSIS
Keywords:
BREAST CANCER, OBESITY, MENOPAUSEAbstract
Breast cancer is a polymorphic disease, obesity being an important risk factor. The aim of the study is to assess different clinical, imagistic, biological determinants of fat mass and of gonadotropic axis in breast cancer treated patients according to their menopausal status at diagnosis. Material and methods: Seventy-eight breast cancer female patients were recruited cross-sectionally. All women were at menopause (physiologic or therapeutically induced). Fat mass was assessed by dual-energy X-ray absorptiometry, and immunoassays were used to determine serum hormones levels. Results: Post-menopausal diagnosed women showed statistically significant higher BMI (t=-3.159, p=0.002), abdominal (t=-2.305, p=0.036) and hip circumference (t=-2.683, p=0.009), but not hip/abdominal ratio (t=-0.647, p=0.520); also, they had significantly higher body fat mass (either total, subtotal or trunk fat; p<0.05). No statistically significant differences were observed in fasting glucose (t=-0.800, p=0.426), cholesterol (t=-0.566, p=0.573) nor triglycerides (t=0.969, p=0.336). Insulin levels, however, were significantly increased in post-menopausal group (t=-2.420, p=0.018), and subsequently HOMA-IR index assessing insulin-resistance was significantly increased (t=-2.305, p=0.024). Regarding sex hormones, no statistically significant differences were observed in circulating estrogens (estradiol and estrone) nor androgens (total testosterone and calculated free androgen index). However, for both pre-menopause and post-menopause groups, no statistically significant differences were observed in sex hormones according to weight status (obese vs non-obese). Conclusions: There is significant difference between weight status and risk of breast cancer regarding menopausal status, many reports showing that obesity is a risk factor in post-menopause patients and a protective factor in pre-menopause women, underlying the polymorphism of breast cancer disease.
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