乳腺癌患者体重管理治疗的使用和随后的心血管事件

IF 3 3区 医学 Q2 ONCOLOGY
Margaux Wooster, Ling Chen, Melissa K Accordino, Claire Sathe, Jason D Wright, Dawn L Hershman
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引用次数: 0

摘要

目的:超重和肥胖乳腺癌(BC)幸存者面临更高的复发和全因死亡率风险,包括心血管疾病(CVD)。体重管理疗法(WMT)可以减少心血管事件(CVE)。我们评估了BC幸存者WMT的趋势和CVE的发生率。方法:我们使用MarketScan数据库进行了一项回顾性队列研究,包括接受乳房手术的侵袭性BC(2009 -2021)超重和肥胖患者(18-95岁)。排除既往的减肥手术或继发性癌症。根据体重状况和WMT对患者进行分类,包括营养咨询、药物治疗和减肥手术。我们使用描述性统计、单变量分析与WMT接收和CVE率相关的因素,并使用多变量逻辑回归模型来确定WMT相关因素。结果:我们确定了35,206例患者:18.8%超重,53.7%肥胖I/II/未明确,27.4%肥胖III级。WMT的使用率分别为5.3%、6.4%和9.6% (p)。结论:在BC患者中,WMT随着时间的推移而增加,最显著的是减肥药的使用。WMT与较低的CVE发生率相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utilization of weight management treatment and subsequent cardiovascular events among patients with breast cancer.

Purpose: Overweight and obese breast cancer (BC) survivors face higher risks of recurrence and all-cause mortality, including from cardiovascular disease (CVD). Weight management therapy (WMT) may reduce cardiovascular events (CVE). We assessed trends in WMT in BC survivors and evaluated rates of CVE.

Methods: We conducted a retrospective cohort study using the MarketScan Database, including overweight and obese patients (18-95 years) with invasive BC (2009 -2021), who underwent breast surgery. Exclusions were prior bariatric surgery or secondary cancers. Patients were categorized by weight status and by WMT, including nutrition counseling, medications, and bariatric surgery. We utilized descriptive statistics, univariate analysis for factors associated with WMT receipt and rates of CVE, and a multivariable logistic regression model to determine WMT-associated factors.

Results: We identified 35,206 patients: 18.8% overweight, 53.7% obese class I/II/unspecified, and 27.4% obese class III. WMT was utilized by 5.3%, 6.4%, and 9.6%, respectively (p < 0.001). Among 2,484 patients who received WMT, 72.7% had nutrition counseling, 26.7% received weight loss medication, and 4.9% underwent bariatric surgery. From 2009 to 2021, WMT use increased from 3.7% to 11.3% (p < 0.001), and use of weight loss medication increased from 0.3% to 5.1% (p < 0.001). Factors associated with receipt of WMT included younger age, greater degree of obesity, more recent year of surgery, lumpectomy, higher comorbidity score, and prior WMT. CVE incidence was lower in WMT recipients (0.8% vs.1.3%, p = 0.02).

Conclusion: In patients with BC, WMT has increased over time, and most markedly weight loss medication use. WMT is associated with lower incidence of CVE.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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