title: Effect of weight loss on bone health in overweight/obese postmenopausal breast cancer survivors.
abstract: Current guidelines recommend weight loss in obese cancer survivors. Weight loss, however, has adverse effects on bone health in obese individuals without cancer but this has not been evaluated in breast cancer survivors. We investigated the associations of intentional weight loss with bone mineral density (BMD) and bone turn-over markers in overweight/obese postmenopausal breast cancer survivors. Participants were overweight/obese breast cancer survivors (N = 81) with stage I, II or IIIA disease enrolled in the St. Louis site of a multi-site Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) study; a randomized-controlled clinical trial designed to achieve a sustained ≥7 % loss in body weight at 2 years. Weight loss was achieved through dietary modification with the addition of physical activity. Generalized estimating equations were used to assess differences in mean values between follow-up and baseline. Mean weight decreased by 3 and 2.3 % between baseline and 6-month follow-up, and 12-month follow-up, respectively. There were decreases in osteocalcin (10.6 %, p value < 0.001), PINP (14.5 %, p value < 0.001), NTx (19.2 % p value < 0.001), and RANK (48.5 %, p value < 0.001), but not BALP and CTX-1 levels between baseline and 12-month follow-up. No significant changes occurred in mean T-scores, pelvis and lumbar spine BMD between baseline and 12-month follow-up. A 2.3 % weight loss over 12 months among overweight/obese women with early-stage breast cancer does not appear to have deleterious effect on bone health, and might even have beneficial effect. These findings warrant confirmation, particularly among breast cancer survivors with a larger magnitude of weight loss.
authors.affiliation: Division of Public Health Sciences, and Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, Saint Louis, MO, USA, a.toriola@wustl.edu.
authors.forename: Adetunji T
authors.initials: AT
authors.lastname: Toriola
authors.forename: Jingxia
authors.initials: J
authors.lastname: Liu
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Sonya
authors.initials: S
authors.lastname: Izadi
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Naughton
authors.forename: Anna L
authors.initials: AL
authors.lastname: Schwartz
authors.forename: Kathleen Y
authors.initials: KY
authors.lastname: Wolin
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D015519:Bone Density; D001842:Bone and Bones / Q000502:physiology*; D001943:Breast Neoplasms / Q000503:physiopathology*; D024042:Collagen Type I / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy; D050177:Overweight / Q000503:physiopathology* / Q000628:therapy; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D017698:Postmenopause; D011347:Procollagen / Q000097:blood; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood; D017741:Survivors; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide