title: A comprehensive metabolic evaluation reveals impaired glucose metabolism and dyslipidemia in breast cancer patients early in the disease trajectory.
abstract: OBJECTIVE
  Weight gain in breast cancer patients during treatment is prevalent; the metabolic implications of this weight gain are poorly understood. We aimed to characterize glucose metabolism in breast cancer patients near the initiation of chemotherapy.
  
  
  METHODS
  Stage I-II breast cancer patients (n = 8) were evaluated near the initiation of chemotherapy and compared with a group of age- and body mass index-matched, as well as a group of young healthy, non-malignant females. Fasting blood samples (analyzed for lipids and cytokines) were taken and an oral glucose tolerance test was performed. Body composition, waist circumference, diet, cardiovascular fitness and muscle strength were evaluated.
  
  
  RESULTS
  Breast cancer patients were abdominally obese (mean ± SD: 94.6 ± 14.0 cm), overweight (28.8 ± 6.0 kg/m(2)) and dyslipidemic (triacylglycerides: 1.84 ± 1.17 mM; high-density lipoprotein cholesterol: 1.08 ± 0.23 mM). Compared to non-malignant matched females, fasting glucose and insulin concentrations were similar but fasting c-peptide was greater in patients (2.6 ± 1.2 ng/mL vs. 1.9 ± 0.8 ng/mL, p = 0.005). Glucose was elevated to a greater extent in patients during the oral glucose tolerance test compared with all non-malignant females. During the glucose tolerance test, c-peptide, but not insulin, remained elevated in patients compared with all non-malignant females. No differences in body composition, serum cytokines, nutrition or exercise capacity between patients and matched, non-malignant females emerged.
  
  
  CONCLUSIONS
  Breast cancer patients present with unhealthy metabolic features early in the disease trajectory. Future investigations need to examine the underlying mechanisms and the potential longitudinal changes following chemotherapy.
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
authors.forename: Kirsten E
authors.initials: KE
authors.lastname: Bell
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Di Sebastiano
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Vance
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Rhona
authors.initials: R
authors.lastname: Hanning
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mitchell
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
authors.forename: Joe
authors.initials: J
authors.lastname: Quadrilatero
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
authors.forename: Caryl
authors.initials: C
authors.lastname: Russell
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Joel A
authors.initials: JA
authors.lastname: Dubin
authors.affiliation: Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada.
authors.forename: Mala
authors.initials: M
authors.lastname: Bahl
authors.affiliation: Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Califaretti
authors.affiliation: Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Campbell
authors.affiliation: Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada. Electronic address: mmourtza@uwaterloo.ca.
authors.forename: Marina
authors.initials: M
authors.lastname: Mourtzakis
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000097:blood* / Q000150:complications / Q000628:therapy; D002096:C-Peptide / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D016207:Cytokines / Q000097:blood; D015930:Diet Records; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength; D009765:Obesity / Q000097:blood / Q000150:complications; D055105:Waist Circumference; D015430:Weight Gain; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D008076:Cholesterol, HDL; D016207:Cytokines; D007328:Insulin
keywords: Body composition; Cytokines; Exercise; Insulin; Nutrition; c-Peptide