title: A prospective evaluation of clinical and genetic predictors of weight changes in breast cancer survivors.
abstract: BACKGROUND
  Postdiagnosis weight gain in patients with breast cancer has been associated with increased cancer recurrence and mortality. This study was designed to identify risk factors for weight gain and create a predictive model to identify a high-risk population for targeted interventions.
  
  
  METHODS
  The weight of 393 patients with breast cancer from the Northwestern Robert H. Lurie Cancer Center was measured over a 2-year period from diagnosis, with body mass index (BMI) change over 18 months as the primary endpoint. Demographics, clinical factors, treatment methods, as well as tumor characteristics were also recorded; and a lifestyle questionnaire was conducted. Blood samples were genotyped for 16 single nucleotide polymorphisms in FTO, adiponectin pathway genes (ADIPOQ, ADIPOR1), and FNDC5. Serum leptin, adiponectin, and irisin levels also were measured.
  
  
  RESULTS
  Mean ± standard deviation 18-month BMI changes were 0.68 ± 1.42, 0.98 ± 1.62, 0.79 ± 1.74, and -0.44 ± 1.58 kg/m2for patients ages <40, 40 to 49, 50 to 59, and ≥60 years, respectively. The optimal multivariable model for 18-month BMI change contained the predictors age, height, and endocrine therapy, but only age was statistically significant, with a 0.04 kg/m2increase in 18-month BMI change per younger year of age. Single nucleotide polymorphisms in ADIPOR1, FTO, and FNDC5 were associated with 18-month BMI change, and the first 2 remained significant after adjusting for the optimal clinical model (all P < .05).
  
  
  CONCLUSIONS
  Women age 60 years and younger at the time of breast cancer diagnosis who have an obesity genetic risk model are at increased risk for weight gain after treatment and should be targeted for weight-maintenance interventions. Cancer 2017;123:2413-21. © 2017 American Cancer Society.
authors.affiliation: Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.
authors.forename: Maureen
authors.initials: M
authors.lastname: Sadim
authors.affiliation: Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Mathematics, Technical University Munich, Munich, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Selig
authors.affiliation: Department of Mathematics, Technical University Munich, Munich, Germany.
authors.forename: Julie
authors.initials: J
authors.lastname: Paulus
authors.affiliation: Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.
authors.forename: Regina
authors.initials: R
authors.lastname: Uthe
authors.affiliation: Rush University Medical Center School of Medicine, Chicago, Illinois.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Agarwl
authors.affiliation: University of California-Los Angeles Medical Center, Los Angeles, California.
authors.forename: Iram
authors.initials: I
authors.lastname: Dubin
authors.affiliation: Department of Oncology, Attikon University Hospital, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Oikonomopoulou
authors.affiliation: Division of Endocrinology, Department of Medicine, Harvard Medical School, Boston, Massachusetts.
authors.forename: Lesya
authors.initials: L
authors.lastname: Zaichenko
authors.affiliation: Department of Medicine, Stanford Medical Center, Palo Alto, California.
authors.forename: Silvia Aki
authors.initials: SA
authors.lastname: McCandlish
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.affiliation: Division of Endocrinology, Department of Medicine, Harvard Medical School, Boston, Massachusetts.
authors.forename: Christos
authors.initials: C
authors.lastname: Mantzoros
authors.affiliation: Department of Mathematics, Technical University Munich, Munich, Germany.
authors.forename: Donna Pauler
authors.initials: DP
authors.lastname: Ankerst
authors.affiliation: Cancer Treatment Research Center, University of Texas Health Science Center San Antonio, San Antonio, Texas.
authors.forename: Virginia G
authors.initials: VG
authors.lastname: Kaklamani
mesh_terms: D052242:Adiponectin / Q000097:blood / Q000235:genetics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000071516:Alpha-Ketoglutarate-Dependent Dioxygenase FTO / Q000235:genetics; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005353:Fibronectins / Q000097:blood / Q000235:genetics; D005838:Genotype; D006801:Humans; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D011878:Radiotherapy; D054419:Receptors, Adiponectin / Q000235:genetics; D012307:Risk Factors; D017741:Survivors; D015430:Weight Gain / Q000235:genetics*
chemical_list: C499918:ADIPOQ protein, human; C475418:ADIPOR1 protein, human; D052242:Adiponectin; D018943:Anthracyclines; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; C577593:FNDC5 protein, human; D005353:Fibronectins; D020738:Leptin; D054419:Receptors, Adiponectin; D000071516:Alpha-Ketoglutarate-Dependent Dioxygenase FTO; C526492:FTO protein, human
keywords: adiponectin; breast cancer; fat mass and obesity-associated gene (FTO); irisin; weight gain