Weight and waist-to-hip ratio change pattern during the first five years of survival: data from a longitudinal observational Chinese breast cancer cohort

Change in Metabolic Markers and the Risk of Skin Cancer: Results from the Lifelines Cohort Study in the Netherlands

BACKGROUND

Skin cancers are the most common cancers in Caucasians, and their incidence is rising. Although metabolic and anthropometric markers play a role in cancer development, the relationship between metabolic and anthropometric changes in skin cancer remains unclear. This study aimed to examine possible associations between these changes and the risk of skin cancer.

METHODS

Participants without prior skin cancer history from the Northern Netherlands representative of the general population were included. Histopathology data were obtained from the Dutch Nationwide Pathology Database. Adjusted Cox regression analyzed associations between metabolic changes and time to pathology-confirmed skin cancer incidence over a 7-year follow-up, assessing overall skin cancer risk and subtypes, including melanoma and nonmelanoma skin cancer.

RESULTS

Out of 97,106 participants, 4,195 (4.3%) developed skin cancer. Decrease and increase in body mass index (BMI) were both associated with lower skin cancer risk: adjusted HRs (aHR) of 0.88 (0.80-0.98) and 0.78 (0.72-0.86), respectively. Triglyceride and waist-to-hip ratio decreases were also associated with lower risk: aHR: 0.89 (0.80-0.98) and 0.89 (0.83-0.98), respectively. Increase in Hemoglobin A1c (HbA1c) was associated with a higher risk in individuals below the age of 45 years at baseline: aHR: 1.21 (1.01-1.45). Subtype analysis showed an increase in BMI was associated with lower melanoma risk: aHR: 0.72 (0.58-0.91).

CONCLUSIONS

Changes in BMI and decrease in triglycerides and waist-to-hip ratio are related to lower skin cancer risk, whereas an increase in HbA1c may elevate risk in individuals younger than 45 at baseline. These findings highlight the importance of non-sunlight-related risk factors for skin cancer prevention and the need for further research into underlying mechanisms.

IMPACT

This study contributes to the broader understanding of how metabolic health impacts skin cancer development, offering potential avenues for targeted prevention strategies.

General obesity, abdominal obesity, and the risk of cardiovascular disease including stroke in 5-year breast cancer survivors

BACKGROUND

To assess the association between discrepancies between general obesity and abdominal obesity and the risk of subsequent cardiovascular disease (CVD), including stroke, in breast cancer survivors.

METHODS

We undertook a retrospective cohort study using data from the National Health Insurance Service of South Korea. Among 72,174 5-year breast cancer survivors aged 40 years and above, body mass index (BMI) and waist circumference (WC) were used to determine obesity status. Cox proportional hazards models were used to evaluate the association of obesity and risk of CVD, including stroke.

RESULTS

Compared to those with normal WC and BMI, those who were overweight without abdominal obesity, had abdominal obesity only, and overweight with abdominal obesity, had higher risks of CVD [aHR(95 % CI) 1.23(1.02-1.48), 1.51(1.16-1.95), and 1.55(1.31-1.75), respectively] and total stroke [1.09(0.86-1.38), 1.63(1.20-2.23), and 1.40(1.17-1.68), respectively]. Compared to those overweight, those with abdominal obesity only had a significantly higher risk of ischemic stroke [2.04(1.14-3.65)].

CONCLUSIONS

Breast cancer survivors with higher BMI and/or abdominal obesity were associated with an elevated risk of CVD, including stroke.

A Review of Animal Models for Studying Bone Health in Type-2 Diabetes Mellitus (T2DM) and Obesity

Preclinical research on diabetes and obesity has been carried out in various animal models over the years. These animal models are developed from genetic manipulation that affects their body metabolism, chemical-induced procedures, diet alteration/modifications, or combinations of the aforementioned approaches. The diabetic and obesity animal models have allowed researchers to not only study the pathological aspect of the diseases but also enable them to screen and explore potential therapeutic compounds. Besides several widely known complications such as macrovascular diseases, diabetic neuropathy, nephropathy and retinopathy, type 2 diabetes mellitus is also known to affect bone health. There is also evidence to suggest obesity affects bone health. Therefore, continuous research needs to be conducted to find a remedy or solution to this matter. Previous literature reported evidence of bone loss in animal models of diabetes and obesity. These findings, as highlighted in this review, further augment the suggestion of an inter-relationship between diabetes, obesity and bone loss.

Changes in body composition and subsequent cardiovascular disease risk among 5-year breast cancer survivors

Introduction

Cardiovascular disease (CVD) remains a leading cause of death in breast cancer survivors, a growing population. The aim of this study was to determine whether changes in body composition, commonly observed in breast cancer survivors, is associated with subsequent CVD risk.

Methods

This cohort study used the Korean National Health Insurance Service database. The study population included 73,271 5-year breast cancer survivors aged 40 years or above. To assess changes in body composition and its effect on the risk of CVD, validated prediction equations and multivariate Cox proportional hazards regression were used. Changes in metabolic markers (blood pressure, total cholesterol, and fasting serum glucose) according to changes in body composition were calculated by multiple linear regression.

Results

Having persistently high predicted lean body and appendicular skeletal muscle mass percentages (LBMP and ASMP, respectively) among breast cancer survivors was associated with 32% and 40% lower CVD risks than a persistently low predicted LBMP or ASMP, respectively. Conversely, persistently high predicted body fat mass percentage (BFMP) was associated with a higher CVD risk than persistently low predicted BFMP. Additionally, those with a low to high change in predicted BFMP had a higher risk of CVD than those with persistently low predicted BFMP. Changes in body composition were accompanied by changes in metabolic markers.

Discussion

Maintaining high percentages of lean body and appendicular skeletal muscle mass and preventing an increase in fat mass may be beneficial in preventing CVD in breast cancer survivors.

Higher Level of Sports Activities Participation during Five-Year Survival Is Associated with Better Quality of Life among Chinese Breast Cancer Survivors

Evidence about the association between the level of sports activities participation post-diagnosis and quality of life (QoL) among Chinese women with early-stage breast cancer is limited. A validated modified Chinese Baecke questionnaire was used to prospectively measure sports activities among a breast cancer cohort at four time-points: baseline and 18, 36, and 60 months after diagnosis (sports activities during the previous 12 months before each interview); QoL was measured at the same time. In total, 1289, 1125, and 1116 patients were included in the analyses at 18-, 36- and 60-month follow-up, respectively. The percentages of patients who belonged to no (0 metabolic equivalent of task (MET)-hours per week), low-level (<10 MET-hours/week), and high-level (≥10 MET-hours/week) sports activities group were 20.7%, 45.5%, and 33.8% at 18-month follow-up, respectively; the corresponding figures at 36 and 60 months differed slightly. Using data from the three follow-ups, generalized estimating equation (GEE) analyses showed that higher levels of sports activities participation were associated with better QoL in several items as well as fewer symptoms. The present findings in Chinese women with breast cancer provide important evidence on the beneficial effect of regular participation in sports activities following cancer diagnosis on patients' QoL.