Pre-Operative Combination of Normal BMI with Elevated YKL-40 and Leptin but Lower Adiponectin Level Is Linked to a Higher Risk of Breast Cancer Relapse: A Report of Four-Year Follow-Up Study

Adipokines are powerful agents involved in the development of obesity-dependent cancers. This prospective study aimed to investigate the association between pre-treatment body mass index (BMI) and serum YKL-40, leptin, and adiponectin concentrations as well as the plasma activity of tissue factor (TF) and the future prognosis of early, non-metastatic breast cancer (BrC) subjects. The serum levels of YKL-40, leptin, and adiponectin as well as plasma TF activity, anthropometric parameters, and clinicopathological parameters were analysed in 81 treatment-naïve females with invasive BrC. The predictive value of YKL-40, BMI, leptin, adiponectin, and TF was determined with a 95% confidence interval (CI). Kaplan–Meier plots and log-rank and F Cox tests were used to determine the clinical outcomes of progression-free survival (PFS). The median follow-up duration was 44 months with complete follow-up for the first event. Follow-up revealed a significantly higher incidence of disease relapse in BrC patients with a high baseline concentration of YKL-40 (22.22%) and TF activity (21.43%). Body mass index was an independent predictor of survival, with women who were overweight/obese being less prone to relapse (hazard ratio (HR): 0.75; 95% CI: 0.59 to 0.95). The recurrence rates for normal-weight BrC cases was 21.05% versus 7.14% for their overweight counterparts. The receiver operating characteristic analysis showed the strong ability of the analysed biomarkers to predict disease progression, with an area under the receiver operating characteristics (ROC) curve of 0.84 (95% CI, 0.823 to 0.931). In a prospective cohort of invasive BrC patients, overweight/obesity was associated with improved future outcomes. The combination of a normal BMI with high leptin and low adiponectin levels and high TF activity was associated with an increased risk of recurrence and decreased survival.

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Receiver operating characteristic analysis of body mass index to detect increased risk of functional morbidity in Vietnamese rural adults

European Journal of Clinical Nutrition ◽

10.1038/sj.ejcn.1602010 ◽

2004 ◽

Vol 58 (12) ◽

pp. 1594-1603 ◽

Cited By ~ 2

Author(s):

T T Do ◽

M J Dibley ◽

C D'Este

Keyword(s):

Body Mass Index ◽

Receiver Operating Characteristic ◽

Body Mass ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Characteristic Analysis ◽

Increased Risk ◽

Functional Morbidity ◽

Receiver Operating ◽

Rural Adults

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Physical Activity, Weight, and Outcomes in Patients Receiving Chemotherapy for Metastatic Breast Cancer (C40502/Alliance)

JNCI Cancer Spectrum ◽

10.1093/jncics/pkab025 ◽

2021 ◽

Author(s):

Jennifer A Ligibel ◽

Luke Huebner ◽

Hope S Rugo ◽

Harold J Burstein ◽

Debra L Toppmeyer ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Body Mass Index ◽

Metastatic Breast Cancer ◽

Body Mass ◽

Hormone Receptor ◽

Metastatic Breast ◽

Hazard Ratio ◽

First Line ◽

Risk Of Cancer

Abstract Background Obesity and inactivity are associated with increased risk of cancer related- and overall mortality in breast cancer, but there are few data in metastatic disease. Methods CALGB 40502 was a randomized trial of first-line taxane-based chemotherapy for patients with metastatic breast cancer. Height and weight were collected at enrollment. After 299 patients enrolled, the study was amended to assess recreational physical activity (PA) at enrollment using the Nurses’ Health Study Exercise Questionnaire. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using stratified Cox modeling (strata included hormone receptor status, prior taxane, bevacizumab use, and treatment arm). Results 799 patients were enrolled and at the time of data lock, median follow-up was 60 months. At enrollment, median age was 56.7 years, 73.1% of participants had hormone receptor-positive cancers, 42.6% had obesity, and 47.6% engaged in less than 3 metabolic equivalents of task (MET)-hours of PA/week (<1 hour of moderate PA). Neither baseline body mass index nor PA was statistically significantly associated with PFS or OS, although there was a marginally statistically significant increase in PFS (hazard ratio = 0.83, 95% confidence interval [CI] = 0.79, 1.02; p = .08) and OS (hazard ratio = 0.81, 95% CI = 0.65, 1.02; p = .07) in patients who reported PA greater than 9 MET-hours/week vs 0–9 MET-hours/week. Conclusions In a trial of first-line chemotherapy for metastatic breast cancer, rates of obesity and inactivity were high. There was no statistically significant relationship between body mass index and outcomes. More information is needed regarding the relationship between PA and outcomes.

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Subclinical Cardiac Organ Damage in Patients with Moderate to Severe Psoriasis

Journal of Clinical Medicine ◽

10.3390/jcm10112440 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2440

Author(s):

Anja Linde ◽

Eva Gerdts ◽

Kåre Steinar Tveit ◽

Ester Kringeland ◽

Helga Midtbø

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Treatment Initiation ◽

Severity Index ◽

Organ Damage ◽

Left Ventricular ◽

Infliximab Treatment ◽

Increased Risk ◽

Psoriasis Severity

We explored the association between subclinical cardiac organ damage (OD) with comorbidities and psoriasis severity in 53 psoriasis patients on infliximab treatment (age 47 ± 15 years, 30% women) and 99 controls without psoriasis (age 47 ± 11 years, 28% women). Cardiac OD was assessed by echocardiography as the presence of increased left ventricular (LV) relative wall thickness (RWT), LV hypertrophy or dilated left atrium. Psoriasis severity was graded using the psoriasis area and severity index (PASI). The prevalence of hypertension was 66% in psoriasis vs. 61% in controls (p = 0.54) and cardiac OD seen in 51 and 73%, respectively (p = 0.007). Psoriasis was associated with a lower prevalence of cardiac OD (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.13–0.77, p = 0.01) independent of age, sex, smoking, body mass index, and hypertension. Among psoriasis patients, hypertension was associated with increased risk of subclinical cardiac OD (OR 6.88, 95% CI 1.32–35.98, p = 0.02) independent of age, sex, and body mass index. PASI at treatment initiation was associated with a higher RWT at follow-up, independent of sex, age, and hypertension (β 0.36, p = 0.006) while no association with current PASI was found. In conclusion, cardiac OD was less prevalent in psoriasis patients on infliximab treatment than controls. Hypertension was the major covariable for subclinical cardiac OD in psoriasis.

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Risk of primary gastrointestinal cancers following incident non-metastatic breast cancer: a Danish population-based cohort study

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000413 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000413

Author(s):

Kasper Adelborg ◽

Dóra Körmendiné Farkas ◽

Jens Sundbøll ◽

Lidia Schapira ◽

Suzanne Tamang ◽

...

Keyword(s):

Breast Cancer ◽

Colon Cancer ◽

Cohort Study ◽

Metastatic Breast Cancer ◽

Stomach Cancer ◽

Metastatic Breast ◽

Population Based ◽

Gastrointestinal Cancers ◽

Increased Risk

ObjectiveWe examined the risk of primary gastrointestinal cancers in women with breast cancer and compared this risk with that of the general population.DesignUsing population-based Danish registries, we conducted a cohort study of women with incident non-metastatic breast cancer (1990–2017). We computed cumulative cancer incidences and standardised incidence ratios (SIRs).ResultsAmong 84 972 patients with breast cancer, we observed 2340 gastrointestinal cancers. After 20 years of follow-up, the cumulative incidence of gastrointestinal cancers was 4%, driven mainly by colon cancers. Only risk of stomach cancer was continually increased beyond 1 year following breast cancer. The SIR for colon cancer was neutral during 2–5 years of follow-up and approximately 1.2-fold increased thereafter. For cancer of the oesophagus, the SIR was increased only during 6–10 years. There was a weak association with pancreas cancer beyond 10 years. Between 1990–2006 and 2007–2017, the 1–10 years SIR estimate decreased and reached unity for upper gastrointestinal cancers (oesophagus, stomach, and small intestine). For lower gastrointestinal cancers (colon, rectum, and anal canal), the SIR estimate was increased only after 2007. No temporal effects were observed for the remaining gastrointestinal cancers. Treatment effects were negligible.ConclusionBreast cancer survivors were at increased risk of oesophagus and stomach cancer, but only before 2007. The risk of colon cancer was increased, but only after 2007.

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Physical activity modifies the risk of atrial fibrillation in obese individuals: The HUNT3 study

European Journal of Preventive Cardiology ◽

10.1177/2047487318784365 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1646-1652 ◽

Cited By ~ 14

Author(s):

Lars E Garnvik ◽

Vegard Malmo ◽

Imre Janszky ◽

Ulrik Wisløff ◽

Jan P Loennechen ◽

...

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Body Mass Index ◽

Confidence Interval ◽

Body Mass ◽

High Body Mass Index ◽

Overweight And Obesity ◽

Hazard Ratio ◽

Increased Risk

Background Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation. Design The design was a prospective cohort study. Methods This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation. Results During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals. Conclusion Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.

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The impact of baseline body mass index on clinical outcomes in metastatic breast cancer: a prospective study

BMC Research Notes ◽

10.1186/s13104-017-2876-2 ◽

2017 ◽

Vol 10 (1) ◽

Cited By ~ 4

Author(s):

Hiba Alarfi ◽

Maher Salamoon ◽

Mohammad Kadri ◽

Moosheer Alammar ◽

Mhd Adel Haykal ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Metastatic Breast Cancer ◽

Prospective Study ◽

Clinical Outcomes ◽

Body Mass ◽

Metastatic Breast ◽

Baseline Body Mass Index ◽

A Prospective Study ◽

The Impact

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Non metastatic breast cancer and body mass index: High risk relation

Clinical Nutrition ◽

10.1016/j.clnu.2018.06.2024 ◽

2018 ◽

Vol 37 ◽

pp. S292

Author(s):

S. Muller ◽

P. Marques Vidal ◽

P. Ravasco

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Metastatic Breast Cancer ◽

High Risk ◽

Body Mass ◽

Metastatic Breast

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The association of body mass index and adverse clinicopathological characteristics in non-metastatic breast cancer

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_596_20 ◽

2020 ◽

Vol 9 (8) ◽

pp. 4190

Author(s):

Atlal Abusanad ◽

Bashayer Alghamdi ◽

Reema Alghamdi ◽

Raghad Khallaf ◽

Konooz Faisal ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Metastatic Breast Cancer ◽

Body Mass ◽

Metastatic Breast ◽

Clinicopathological Characteristics

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Inflammatory breast cancer and body mass index.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.12.3731 ◽

1998 ◽

Vol 16 (12) ◽

pp. 3731-3735 ◽

Cited By ~ 68

Author(s):

S Chang ◽

A U Buzdar ◽

S D Hursting

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Cancer Patients ◽

Body Mass ◽

Inflammatory Breast Cancer ◽

Menopausal Status ◽

Control Group ◽

Breast Cancer Patients ◽

Increased Risk ◽

High Bmi

PURPOSE No studies have investigated the etiology of inflammatory breast cancer (IBC), the most lethal form of breast cancer. Because high body mass index (BMI) is associated with decreased risk of premenopausal breast cancer but increased risk of postmenopausal breast cancer, we evaluated whether high BMI was a risk factor for IBC. PATIENTS AND METHODS In a case-comparison study, we matched by ethnicity and registration date 68 IBC patients treated at The University of Texas M.D. Anderson Cancer Center from 1985 to 1996 with 143 patients with non-IBC and 134 patients with cancer at sites other than the breast or reproductive tract (non-breast cancer). The non-breast cancer group was used in lieu of a population-based, healthy control group, which was not available. RESULTS IBC patients were younger at menarche and the time of their first live birth than non-IBC and non-breast cancer patients. The proportion of premenopausal IBC patients was higher than the proportion of premenopausal women in the comparison groups, although differences were not significant. There were no differences in height, but IBC patients were heavier (77.6 kg) than non-IBC (70.0 kg) and non-breast cancer patients (68.0 kg). After adjusting for other factors, women in the highest BMI tertile (BMI > 26.65 kg/m2) relative to the lowest tertile (BMI < 22.27) had significantly increased IBC risk (IBC v non-IBC, odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.05 to 5.73; IBC v non-breast cancer, OR = 4.52, 95% CI = 1.85 to 11.04). This association was not significantly modified by menopausal status and was independent of age at menarche, family history of breast cancer, gravidity, smoking status, and alcohol use. CONCLUSION Our investigation showed that high BMI was significantly associated with an increased risk of IBC. This association did not vary by menopausal status, although IBC patients were more likely to be premenopausal. Confirming our findings and identifying other IBC risk factors may provide directions for future research on the aggressive nature of IBC.

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