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Study on the status of metabolic syndrome components and dyslipidemia among initially diagnosed breast cancer patients and breast cancer patients pre and post chemotherapy

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声明

ABBREVIATIONS

MATERIALS AND METHODS

1.1 STUDY OBJECTIVE

1.2 INCLUSION CRITERIA

1.3 EXCLUSION CRITERIA

1.4 DATA COLLECTION

1.5 STATISTICAL ANALYSIS

2.1 Status of dyslipidemia among breast cancer patients:

2.2 Comparision of the status of lipidemia between breast cancer patients pre and post chemotherapy

2.4 Comparative analysis of the status of body mass index (BMI) in relation to metabolic syndrome among general population and breast cancer patients:

2.5 Status of individual Metabolic syndrome components among general population and breast cancer patients

2.6 Comparative analysis of the general population group and breast cancer patient group when stratified on the basis of the number of metabolic components acquired by both groups

3. DISCUSSION

· Status of dyslipidemia among breast cancer patients:

· Status of chemotherapy induced dyslipidemia among breast cancer females:

· Metabolic syndrome and breast cancer:

· Relationship between abdominal obesity and breast carcinoma:

· Status of blood pressure among breast cancer females:

· Status of hyperglycemia among breast cancer females:

4. Possible mechanism of metabolic syndrome in breast carcinogenesis:

·Hyperinsulinemia, Insulin resistance and Hyperglycemia:

·Adipose tissue:

·The role of estrogen in metabolic syndrome and breast cancer:

·Inflammatory pathway:

参考文献

REVIEW:STUDY ON THE STATUS OF METABOLIC SYNDROME AND DYSLIPIDEMIA AMONG BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY

致谢

Research articles published during the period of master studies

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摘要

BACKGROUND AND PURPOSE
　　The prevalence of risk factors contributing to metabolic syndrome (MetS) is increasing, and numerous components of MetS are associated with increased primary breast cancer (BC) risk. However, less is known about the relationship of metabolic syndrome to BC outcomes. In this paper, we will study the status of blood lipid among breast cancer patients and normal cohorts and also the breast cancer patients before and after undergoing chemotherapy. Also the incidence of metabolic syndrome and its components among normal populace and breast cancer group were comparatively analyzed.
　　METHOD
　　1.The clinical data of 1054 cases of initially diagnosed breast cancer patients and 2484 cases of normal women (as controls) with the reports of their blood lipid levels were collected from the Electronic Medical Records in the Breast Cancer Center of Chongqing and Medical Examination Center of the First Affiliated Hospital of Chongqing Medical University, from July 2015 to October 2016 . The data were comparatively analysed and stratified according to their age. Also the status of lipidemia among 446 breast cancer patients were comparatively analyzed before and after undergoing chemotherapy. We obtained age, sex, pathological diagnosis, menstrual status, and the status of various lipid components in those subejects from our medical record system.
　　2.The clinical data of 605 initially diagnosed breast cancer patients and 3212 general population with the reports of their metabolic components were collected for comparitive analysis from Chongqing Breast Cancer Center of Chongqing and Medical Centre of the First Affiliated Hospital of Chongqing Medical University. In this study we calculated the stauts of BMI and metabolic components and stratified them according to their age between breast cancer group and normal population group.At the end, the metabolic components were also stratified according to the number of components present in those groups.
　　RESULT
　　1.The total incidence of dyslipidemia in breast cancer group was 42.98% (453/1054), which was significantly lower than in normal population (58.30%, 1448/2484) P＜0.01. However, among below 40years age females, dyslipidemia in breast cancer patients (25.58%) was slightly higher than that among normal population group (22.41%,78/348), but no significant statistical difference was observed (p=0.558). With age groups of 40-49years, 50-59 years old and above 60 years old, breast cancer patients had significantly lower incidence 34.88% (150/430), 52.84% (149/282) and 56.81% (121/213) of dyslipidemia compared to the normal population group 49.72%, 74.11% (541/730), 75.35% (382/507) and the difference was statistically significant (p<.001).
　　2.The total serum cholesterol levels (4.47±0.93mmol/L), triglyceride (1.27±1.02mmol/L), high density lipoprotein (1.43±0.36mmol/L) and low density lipoprotein (2.80±0.81mmol/L) were significantly lower in breast cancer group than among normal population (5.01±0.95mmol/L), (1.34±0.95mmol/L), (1.48±0.32mmol/L), (3.19±0.87mmol/L) (p＜0.05).The total cholesterol level among lower than 40years, 40-49 years,50-59years and above 60years old breast cancer patients was significantly lower than the normal population group (P＜0.05); The triglyceride level among 40-49years old breast cancer patients was significantly lower than the normal population group (P＜0.05); HDL-C levels among 40 to 49 years old and 50-59years old patients with breast cancer was significantly lower than the normal population (P＜0.05); LDL-C levels among breast cancer patients aged 40 to 49 years, 50-59 years over 60 years old were significantly lower than the normal population (p＜0.05)
　　3.The pre-chemoetherapeutic incidence of dyslipidemia (45.1%, 201/446) was significantly lower than post-chemotherapy (68.6%,306/446) (p＜0.01). The pre-chemoetherapeutic levels of total cholesterol, triglyceride and LDL-C were significantly lower than post-chemotherapeutic levels (p＜0.05). The pre-chemoetherapeutic HDL-C level was significantly higher than post-chemotherapeutic levels and the difference between them was statistically significant (p ＜0.05), p ＜0.01.
　　4.The prevalence of metabolic syndrome among breast cancer patient group and general population were 32.6% & 18.2%, respectively and the difference between both groups was statistically significant (P＜0.001). This suggests that metabolic syndrome is a risk factor for breast cancer. With age stratification, the rates of metabolic syndrome among breast cancer patients above or below 60 years age were significantly compared to the general population group (P＜0.001). However, in females between 30 to 39 years old, the difference was not statistically significant. Meanwhile with BMI stratification, statistical difference was observed only in the normal BMI subgroup (18.5≤BMI<25) among breast cancer group 85(22.1%) and general population group（10.1%）with metabolic syndrome (P＜0.001). However among other subgroups no statistical difference was observed between breast cancer patients and general population group. Moreover, a trend was observed that with higher the BMI in ascending order （Underweight (BMI<18.5), Normal (18.5≤BMI<25), Preobese (25≤BMI<30) and Obesity (BMI≥30), subjects were more likely to have metabolic syndrome regardless in both the breast cancer patients 0%, 221.%,57.6% and 61.8% and the general population group 1.9%,10.1%,52.7% and 72.4%. This suggests that BMI when reduced could help in preventing metabolic syndrome.
　　5.Breast cancer patients with BMI of 25 or above were more likely to have metabolic syndrome 112(58.3%) in comparision to the patients with BMI below 25 85(22.1%) (OR: 0.203; 95%CI: 0.140-0.295). Thus it suggests that BMI≥25 is a risk factor for breast cancer patients to have metabolic syndrome. Similar results were observed in general population, where BMI of 25 or above were prone to have metabolic syndrome 340(54.5%) compared to without MS 240（10.1%）.
　　6.With relation to metabolic syndrome components, breast cancer patients were more likely to have broader waist circumference, high blood pressure, low HDL –C levels , high fasting blood glucose levels and lower triglyceride levels(460(76.0%),165(27.3%),226(37.4%),151(25.0%) and 517(85.5%)) compared to the general population group (951（29.6%）, 457（14.2%）, 977（30.4%）, 646（20.1%）and 2624（81.7%）). The difference between the two groups were found to be statistically significant (P＜0.05).
　　7.Metabolic components were totally absent in 1246 (38.8%) & 74 (12.2%) cases in general population group and breast cancer group, a single metabolic syndrome component was detected among 851 (26.5%) & 150 (24.8%) cases, two of the components were found in 531 (16.5%) & 184 (30.4%) ,three components or above were found in 584 (18.2%) & 197 (32.6%) cases of general population group and breast cancer patients group, respectively. The difference between the two groups were found to be statistically significant (P＜0.05).

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