BACKGROUND & AIMS: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.

译文

背景与目的:乳腺癌患者在治疗过程中体重增加十分普遍。人们对这种体重增加的代谢影响知之甚少。我们旨在表征乳腺癌患者在开始化疗之前的葡萄糖代谢。
方法:在开始化疗之前对I-II期乳腺癌患者(n = 8)进行了评估,并与年龄和体重指数匹配的一组患者以及一组年轻健康的非恶性女性进行了比较。抽取空腹血液样品(分析脂质和细胞因子),并进行口服葡萄糖耐量试验。评估了身体成分,腰围,饮食,心血管健康状况和肌肉力量。
结果:乳腺癌患者的腹部肥胖(平均±SD:94.6±14.0 cm),超重(28.8±6.0 kg / m(2))和血脂异常(甘油三酸酯:1.84±1.17 mM;高密度脂蛋白胆固醇:1.08±0.23)毫米)。与非恶性配对女性相比,患者的空腹葡萄糖和胰岛素浓度相似,但患者的空腹c肽含量更高(2.6±1.2 ng / mL与1.9±0.8 ng / mL,p = 0.005)。与所有非恶性女性相比,口服葡萄糖耐量测试期间患者的葡萄糖升高幅度更大。在葡萄糖耐量测试中,与所有非恶性女性相比,患者的c肽而非胰岛素仍然升高。患者与配对的,非恶性的女性之间在身体组成,血清细胞因子,营养或运动能力方面无差异。
结论:乳腺癌患者在疾病发展的早期就表现出不健康的代谢特征。未来的研究需要检查化学疗法后的潜在机制和潜在的纵向变化。

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