title: A metabolic phenotyping approach to understanding relationships between metabolic syndrome and breast tumour responses to chemotherapy.
abstract: OBJECTIVE
  Breast cancer is associated with adverse outcomes in patients with the metabolic syndrome phenotype. To study this further, we examined the relationship between serum metabolite levels and the components of metabolic syndrome with treatment outcomes in breast cancer.
  
  
  METHODS
  A total of 88 women with measurable breast cancer were studied; their serum metabolites as assessed by (1)H nuclear magnetic resonance spectroscopy, blood pressure, lipids, glucose, body mass index and waist circumference were recorded and correlated with treatment response.
  
  
  RESULTS
  We identified metabolic syndrome in approximately half of our cohort (42 patients) and observed a significant trend (P = 0.03) of increased incidence of metabolic syndrome in partial response (33.3%), stable disease (42.9%) and progressive disease groups (66.1%). High blood sugar predicted a poor response (P < 0.001). Logistic regression of metabonomic data demonstrated that high lactate (P = 0.03) and low alanine (P = 0.01) combined with high glucose (P = 0.01) were associated with disease progression.
  
  
  CONCLUSIONS
  Metabolic syndrome is commonly observed in metastatic breast cancer and these patients have poorer outcomes. These data, which support our previous findings, suggest that high blood glucose as part of metabolic syndrome is associated with a poor response in breast cancer. They also validate new therapeutic approaches that focus on metabolism.
authors.affiliation: Section of Oncology, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK. j.stebbing@imperial.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Stebbing
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: B
authors.initials: B
authors.lastname: North
authors.forename: T J
authors.initials: TJ
authors.lastname: Athersuch
authors.forename: A
authors.initials: A
authors.lastname: Zebrowski
authors.forename: D
authors.initials: D
authors.lastname: Pchejetski
authors.forename: R C
authors.initials: RC
authors.lastname: Coombes
authors.forename: J K
authors.initials: JK
authors.lastname: Nicholson
authors.forename: H C
authors.initials: HC
authors.lastname: Keun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D001794:Blood Pressure; D001943:Breast Neoplasms / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D017698:Postmenopause; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides