title: Favorable changes in serum estrogens and other biologic factors after weight loss in breast cancer survivors who are overweight or obese.
abstract: BACKGROUND
  Obesity is associated with an increased risk for recurrence and all-cause mortality in breast cancer survivors. Excess adiposity is associated with increased estrogen, insulin, and leptin, and with decreased sex hormone binding globulin (SHBG) concentrations, which may promote breast cancer progression and recurrence. This study aimed to assess the effects of weight loss on these factors.
  
  
  METHODS
  Breast cancer survivors who were overweight or obese (n = 220) and who were enrolled in a weight loss intervention study provided baseline and follow-up blood samples and weight data. Serum estrogens, SHBG, insulin, and leptin were measured at baseline, 6 months, and 18 months.
  
  
  RESULTS
  Weight loss of ≥5% of initial weight decreased leptin and insulin compared with those who did not achieve that amount of weight loss (P < .0001). Weight loss also increased SHBG at 6 and 18 months (P < .01). Postmenopausal women who lost ≥5% of body weight at 6 months had lower estrone (P = .02), estradiol (P = .002), and bioavailable estradiol (P = .001) concentrations than women who did not lose at least 5% of body weight, and weight loss at 18 months was significantly related to a change in serum bioavailable estradiol concentration (P = .02).
  
  
  CONCLUSIONS
  Favorable changes in estrogens, SHBG, insulin, and leptin were observed in association with weight loss in these women who were overweight or obese and who had been diagnosed and treated for breast cancer. Weight loss appears to have favorable effects on hormonal and biologic factors associated with increased risk for recurrence and poorer prognosis.
authors: Department of Family and Preventive Medicine and Cancer Prevention and Control Program, University of California, San Diego, La Jolla, CA, USA. clrock@ucsd.edu
authors: Cheryl L
authors: CL
authors: Rock
authors: Chetna
authors: C
authors: Pande
authors: Shirley W
authors: SW
authors: Flatt
authors: Carl
authors: C
authors: Ying
authors: Bilge
authors: B
authors: Pakiz
authors: Barbara A
authors: BA
authors: Parker
authors: Kathryn
authors: K
authors: Williams
authors: Wayne A
authors: WA
authors: Bardwell
authors: Dennis D
authors: DD
authors: Heath
authors: Jeanne F
authors: JF
authors: Nichols
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood* / Q000150:complications; D004967:Estrogens / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000150:complications / Q000628:therapy*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D004967:Estrogens; D007328:Insulin; D020738:Leptin; D012738:Sex Hormone-Binding Globulin
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