title: DEXA measures of body fat percentage and acute phase proteins among breast cancer survivors: a cross-sectional analysis.
abstract: BACKGROUND
  C-reactive protein (CRP) and Serum amyloid A protein (SAA) increases with systemic inflammation and are related to worse survival for breast cancer survivors. This study examines the association between percent body fat and SAA and CRP and the potential interaction with NSAID use and weight change.
  
  
  METHODS
  Participants included 134 non-Hispanic white and Hispanic breast cancer survivors from the Health, Eating, Activity, and Lifestyle Study. Body fat percentage, measured with Dual Energy X-ray Absorptiometer (DEXA), and circulating levels of CRP and SAA were obtained 30 months after breast cancer diagnosis.
  
  
  RESULTS
  Circulating concentrations of CRP and SAA were associated with increased adiposity as measured by DEXA after adjustment for age at 24-months, race/ethnicity, dietary energy intake, weight change, and NSAID use. Survivors with higher body fat ≥35% had significantly higher concentrations of CRP (2.01 mg/l vs. 0.85 mg/l) and SAA (6.21 mg/l vs. 4.21 mg/l) compared to non-obese (body fat < 35%). Women who had gained more than 5% of their body weight since breast cancer diagnosis had non-statistically significant higher geometric mean levels of CRP and SAA. Mean levels of CRP and SAA were higher among obese women who were non-users of NSAIDs compared to current users; the association with SAA reached statistical significance (Mean SAA = 7.24, 95%CI 6.13-8.56 for non-NSAID; vs. 4.87; 95%CI 3.95-6.0 for NSAID users respectively).
  
  
  CONCLUSIONS
  Breast cancer survivors with higher body fat had higher mean concentrations of CRP and SAA than women with lower body fat. Further assessment of NSAID use and weight control in reducing circulating inflammatory markers among survivors may be worthwhile to investigate in randomized intervention trials as higher inflammatory markers are associated with worse survival.
authors.affiliation: Department of Preventive Medicine, Room 418D 2001 Soto Street, MC9239, Los Angeles, CA 90089, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Dee
authors.forename: Roberta
authors.initials: R
authors.lastname: McKean-Cowdin
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Cornelia
authors.initials: C
authors.lastname: Ulrich
authors.forename: Richard N
authors.initials: RN
authors.lastname: Baumgartner
authors.forename: Anne
authors.initials: A
authors.lastname: McTiernan
authors.forename: Kathy
authors.initials: K
authors.lastname: Baumgartner
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
mesh_terms: D015502:Absorptiometry, Photon; D000209:Acute-Phase Proteins / Q000032:analysis*; D000273:Adipose Tissue / Q000502:physiology*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry* / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000209:Acute-Phase Proteins