Determinants of Weight Gain in Women with Early-Stage Breast Cancer

摘要

Weight gain after breast cancer diagnosis is common, and has been associated with poorer prognosis. The goals of the study are to examine weight gain relation to treatment-related changes in sex hormone levels, and in relation to genetic polymorphisms in sex hormone pathways, accounting for potential interactions with energy balance, psychosocial factors, tumor characteristics, cancer treatment, and medication use. A prospective longitudinal study of weight gain is being conducted in 215 stage I to IIIA breast cancer patients. In 264 breast cancer patients, we did not observe any significant weight gain when all participants were considered together, and no weight gain was observed among women treated with AC-based chemotherapy compared to those who did not receive chemotherapy treatment. We examined a number of demographic and lifestyle variables and found that younger women and women in the lowest weight quartile at the time of cancer diagnosis were most likely to gain weight and show increases in percent body fat. Women with higher daily energy intake were also more likely to gain weight. Weight gain and increases in percent body fat were related to increases in circulating C- reactive protein levels, as a marker of inflammation. Women with higher C- reactive protein levels at the time of cancer diagnosis were also more likely to gain percent body fat over the subsequent 12 month period. Declines in cortisol binding globulin levels were related to positive changes in weight and BMI. Of the sex steroids assayed, only FSH and LH were observed to be related to changes in weight and/or body composition. The study will help identify women who are most susceptible to weight gain after being diagnosed with breast cancer.