title: Associations between cytokine gene variations and self-reported sleep disturbance in women following breast cancer surgery.
abstract: OBJECTIVE
  To attempt to replicate the associations found in our previous study of patients and family caregivers between interleukin 6 (IL6) and nuclear factor kappa beta 2 (NFKB2) and sleep disturbance and to identify additional genetic associations in a larger sample of patients with breast cancer.
  
  
  METHODS
  Patients with breast cancer (n = 398) were recruited prior to surgery and followed for six months. Patients completed a self-report measure of sleep disturbance and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify distinct latent classes of patients with higher and lower levels of sleep disturbance.
  
  
  RESULTS
  Patients who were younger and who had higher comorbidity and lower functional status were more likely to be in the high sustained sleep disturbance class. Variations in three cytokine genes (i.e., IL1 receptor 2 (IL1R2), IL13, NFKB2) predicted latent class membership.
  
  
  CONCLUSIONS
  Polymorphisms in cytokine genes may partially explain inter-individual variability in sleep disturbance. Determination of high risk phenotypes and associated molecular markers may allow for earlier identification of patients at higher risk for developing sleep disturbance and lead to the development of more targeted clinical interventions.
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Emely
authors.initials: E
authors.lastname: Alfaro
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Dhruva
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Langford
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Koetters
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Merriman
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: West
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Dunn
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Janine
authors.initials: J
authors.lastname: Cataldo
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Hamolsky
authors.affiliation: Redwood Regional Medical Group, Santa Rosa, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Elboim
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Kord
authors.initials: K
authors.lastname: Kober
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA; Institute for Human Genetics, University of California, San Francisco, CA, USA.
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA. Electronic address: chris.miaskowski@nursing.ucsf.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016207:Cytokines / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D006801:Humans; D015994:Incidence; D015850:Interleukin-6 / Q000235:genetics*; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D052003:NF-kappa B p52 Subunit / Q000235:genetics*; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D057566:Self Report; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000235:genetics*; D011795:Surveys and Questionnaires
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D052003:NF-kappa B p52 Subunit; C498206:NFKB2 protein, human
keywords: Breast cancer; Cytokine genes; Growth mixture modeling; Insomnia; Sleep disturbance; Symptom trajectories