title: An observational study to examine changes in metabolic syndrome components in patients with breast cancer receiving neoadjuvant or adjuvant chemotherapy.
abstract: BACKGROUND
  The authors sought to determine the effect of chemotherapy on the development of metabolic syndrome (MetS) in premenopausal and postmenopausal women undergoing (neo)adjuvant therapy for early-stage breast cancer.
  
  
  METHODS
  A total of 86 women with early-stage (AJCC stage I-III) breast cancer who were free from clinically diagnosed MetS (defined as 3 of 5 components of MetS) were prospectively tested for the presence of the 5 components of MetS within 1 week before initiating and after completing (neo)adjuvant chemotherapy. The 5 components of MetS measured were waist circumference; blood pressure; and fasting levels of blood glucose, triglycerides, and high-density lipoprotein cholesterol. Anthropometrics (body weight, percentage body fat, fat mass), lipid profile (total cholesterol, low-density lipoprotein cholesterol), glucose metabolism (insulin, homeostatic model assessment of insulin resistance, glycated hemoglobin), and inflammation (C-reactive protein) also were examined before initiating and after completing treatment.
  
  
  RESULTS
  The current study included 46 premenopausal and 40 postmenopausal women. All individual MetS components and the overall MetS score were found to be statistically significantly increased (P<.01) after chemotherapy. Body weight, percentage body fat, fat mass, lipids, glucose metabolism, and inflammation also were found to be statistically significantly increased (P<.01).
  
  
  CONCLUSIONS
  A 12-week to 18-week course of chemotherapy appears to statistically significantly increase MetS and related anthropometrics, biomarkers of glucose metabolism, and inflammation in patients with early-stage breast cancer with no preexisting MetS. Lifestyle interventions such as diet and exercise may be preventive approaches for use during chemotherapy to reduce the onset of MetS in patients with breast cancer. Cancer 2016. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Cancer 2016;122:2646-2653. © 2016 American Cancer Society.
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Dieli-Conwright
authors.affiliation: Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Louise
authors.initials: L
authors.lastname: Wong
authors.affiliation: Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Sarah
authors.initials: S
authors.lastname: Waliany
authors.affiliation: Beckman Research Institute, Division of Cancer Etiology, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.affiliation: Department of Clinical Diabetes, Endocrinology and Metabolism, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Behrouz
authors.initials: B
authors.lastname: Salehian
authors.affiliation: Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mortimer
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D008076:Cholesterol, HDL; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000032:analysis; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009367:Neoplasm Staging; D017698:Postmenopause; D017697:Premenopause; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D017741:Survivors; D014280:Triglycerides / Q000378:metabolism; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides; D002097:C-Reactive Protein
keywords: body composition; breast cancer; chemotherapy; glucose metabolism; metabolic syndrome