HIGH RISK OF METABOLIC DYSFUNCTION IN NON-OBESE BREAST CANCER SURVIVORS 

Daniel Buttros¹, Pedro Paulo Perroni da Silva Filho², Luciana de Araújo Brito Buttros³, Heloisa Maria de Luca Vespoli², Eliana Aguiar Petri Nahás²

¹ Faculdade de Medicina de Botucatu – UNESP|Rio Claro|SP|BRASIL
² Faculdade de Medicina de Botucatu – UNESP|Botucatu|SP|BRASIL
³ Faculdade de Medicina de Botucatu – UNESP|Sorocaba|SP|BRASIL

Objective: To evaluate the metabolic profile of non-obese women with breast cancer compared to non-obese women without cancer. Methodology: A cross-sectional comparative clinical study was carried out with the inclusion of 260 women (according to sample calculation). The main group consisted of 130 women with a body mass index (BMI) < 30kg/m2, with a histological diagnosis of breast cancer, stages I to III, aged between 45-75 years, in amenorrhea &#8805; 12 months and without cardiovascular disease (CVD) established. The control group consisted of 130 women with the same inclusion criteria, without breast cancer. The groups were matched by age, BMI and time since menopause and compared in a 1:1 ratio. Clinical, anthropometric and biochemical data were collected. Women who had three or more diagnostic criteria were considered to have metabolic syndrome (MS): WC > 88 cm; triglycerides (TG) > 150 mg/dL; HDL cholesterol < 50 mg/dL; blood pressure > 130/85 mmHg; glucose >100 mg/dL. For statistical analysis, the Student’s t-test, the Gamma Distribution (asymmetric variables), the Chi-square test and logistic regression (odds ratio-OR) were used. Results: In assessing the factors that affect the metabolic profile, a higher occurrence of MS and blood pressure impairment was observed among women treated for breast cancer when compared to controls (30.8% vs. 20.0%, and 25.4% vs 14.6%, respectively) (p<0.05). A higher proportion of women treated for breast cancer also had higher than desirable levels of total cholesterol and blood glucose in the comparative analysis (56.2% vs 43.1% and 29.2% vs 15.4%, respectively) (p<0 .05). In the risk analysis of metabolic dysfunction, adjusted for age and time since menopause, women with breast cancer had a significantly higher risk for MS (OR=2.76, 95% CI 1.48-5.15), increased blood glucose OR=2.69, 95% CI 1.46-4.96) and blood pressure (OR=3.03, 95% CI 1.51-6.10). In the analysis of the subgroup with BMI <25k/m2, the main group had a higher occurrence of metabolic syndrome when compared to the group without breast cancer (n=53) (17.2% vs 1.9%, respectively, p=0.007) . Women with a BMI<25kg/m2 had significantly higher values for WC (82.6±8.5 vs 79.9±6.4 cm, p=0.048), SBP and DBP (129.2±17.1 and 77. 7 ±8.8 mmHg vs 118.2±15.1 and 73.6±8.8 mmHg, p=0.0002 and p=0.01, respectively) and blood glucose (99.7±32.5 vs 86 .6±7.6 mg/dL, p=0.0002) when compared to women with the same BMI. Conclusion: Non-obese women treated for breast cancer were at high risk for metabolic dysfunction, expressed by the higher prevalence of MS, hypertension and diabetes when compared to women without breast cancer. The risk remains in the subgroup with ideal BMI.

Keywords: breast cancer, metabolic syndrome, diabetes, hypertension, obesity.