Characterization of Metabolic Syndrome Risk Factors and Health-Related Behaviors in Korean Patients With Breast Cancer by Abdominal Obesity Status

10.1097/jnr.0000000000000345

Hye-Jin KIM；Hee-Seung KIM；Hye-Ryoung KIM；Yang-Sook YOO；Byung Joo SONG

breast cancer ； abdominal obesity ； metabolic syndrome ； dietary habits ； exercise

The Journal of Nursing Research

28卷2期（2020 / 04 / 01）

1 - 10-003

英文

Background: Breast cancer is the second most prevalent malignancy among Korean women. Changes in lifestyle during and after remission of breast cancer tend to increase abdominal visceral fat, leading to increased risks of metabolic syndrome and chronic diseases. Purpose: This cross-sectional study examined the differences in metabolic syndrome risk factors and health-related behaviors between abdominally obese and nonabdominally obese groups of Korean patients with breast cancer. Methods: The participants were assigned to nonabdominal obesity (waist circumference ＜ 85 cm, n = 77) and abdominal obesity (waist circumference ≥ 85 cm, n = 59) groups, and a questionnaire was used to assess the prevalence of risk factors of metabolic syndrome and health-related behaviors in each. The chi-square test and t test were used to analyze the data. Results: The average age was 54.2 years in the abdominal obesity group and 51.3 years in the nonabdominal obesity group. The average blood pressure and fasting blood glucose levels were higher in the abdominal obesity than the nonabdominal obesity group (117.3/76.3 vs. 108.9/70.4 mmHg, respectively [p = .001]; 96.9 and 90.1 mg/dl, respectively [p = .007]). High-density lipoprotein cholesterol was lower in the abdominal obesity than the nonabdominal obesity group (55.4 and 62.5 mg/dl, respectively [p = .005]), whereas triglycerides were higher in the abdominal obesity than the nonabdominal obesity group (151.6 and 111.3 mg/dl, respectively [p = .006]). The prevalence of metabolic syndrome in the abdominal obesity and nonabdominal obesity groups were 42.4% and 9.1%, respectively (p = .001). Moreover, eating habits differed between the two groups, with the frequency of vegetable consumption lower in the abdominal obesity than the nonabdominal obesity group (p = .040) and the frequencies of salty and sweet food consumption and of overeating higher in the abdominal obesity than the nonabdominal obesity group. The percentage of participants who exercised for 30 minutes three times per week was 52.5% in the abdominal obesity group and 71.4% in the nonabdominal obesity group (p = .024). Conclusions/Implications for Practice: This observational study found more metabolic syndrome risk factors in the abdominal obesity group than the nonabdominal obesity group. Consumption of sweet foods and overeating were higher and the frequencies of vegetable intake and exercise were lower in the abdominal obesity group. These findings suggest that female abdominally obese patients with breast cancer exhibit health-related behaviors that require improvement and better management. Interventional programs should be developed based on the findings of this study to reduce cancer recurrence and mortality in patients with breast cancer.

1. Lai, Y. H.(2016).Perspectives on cancer survivorship: Care and challenges.The Journal of Nursing Research,24(2),190-192.
   連結：
2. Bae, Y. J.(2012).Evaluation of nutrient and food intake status, and dietary quality in Korean female adults according to obesity: Based on 2007–2009 Korean National Health and Nutrition Examination Survey.Korean Journal of Nutrition,45(2),140-149.
3. Bering, T.,Mauricio, S. F.,Silva, J. B.,Correia, M. I.(2015).Nutritional and metabolic status of breast cancer women.Nutrición Hospitalaria,31(2),751-758.
4. Berrino, F.,Villarini, A.,Traina, A.,Bonanni, B.,Panico, S.,Mano, M. P.,Pasanisi, P.(2014).Metabolic syndrome and breast cancer prognosis.Breast Cancer Research and Treatment,147(1),159-165.
5. Boyle, T.,Vallance, J. K.,Buman, M. P.,Lynch, B. M.(2017).Reallocating time to sleep, sedentary time, or physical activity: Associations with waist circumference and body mass index in breast cancer survivors.Cancer Epidemiology, Biomarkers, & Prevention,26(2),254-260.
6. Bulló, M.,Garcia-Aloy, M.,Martínez-González, M. A.,Corella, D.,Fernández-Ballart, J. D.,Fiol, M.,Salas-Salvadó, J.(2011).Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk.Preventive Medicine,53(3),155-161.
7. Chang, H. S.(2010).A study on weight control behaviour, eating habits and health-related life habits according to obesity degree by body fat percentage among middle-aged women in Gunsan City.Korean Journal of Community Nutrition,15(2),227-239.
8. Cheraghi, Z.,Poorolajal, J.,Hashem, T.,Esmailnasab, N.,Doosti, I. A.(2012).Effect of bodymass index on breast cancer during premenopausal and postmenopausal periods: A meta-analysis.PLoS ONE,7(12),e51446.
9. Cohen, J.(1988).Statistical power analysis for the behavioral sciences.Hillsdale, NJ:Lawrence Earlbaum Associates.
10. Demark-Wahnefried, W.,Peterson, B. L.,Winer, E. P.,Marks, L.,Aziz, N.,Marcom, P. K.,Rimer, B. K.(2001).Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy.Journal of Clinical Oncology,19(9),2381-2389.
11. Dieli-Conwright, C. M.,Mortimer, J. E.,Schroeder, E. T.,Courneya, K.,Demark-Wahnefried, W.,Buchanan, T. A.,Bernstein, L.(2014).Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: Rationale, design, and methods.BMC Cancer,14,238.
12. Fan, H.,Li, X.,Zheng, L.,Chen, X.,Ian, Q.,Wu, H.,Liu, Z.(2016).Abdominal obesity is strongly associated with cardiovascular disease and its risk factors in elderly and very elderly community-dwelling Chinese.Scientific Reports,6,21521.
13. Faul, F.,Erdfelder, E.,Lang, A. G.,Buchner, A.(2007).GPower 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behavior Research Methods,39(2),175-191.
14. Genuth, S.,Alberti, K. G.,Bennett, P.,Buse, J.,DeFronzo, R.,Kahn, R.,Expert Committee on the Diagnosis and Classification of Diabetes Mellitus(2003).Follow-up report on the diagnosis of diabetes mellitus.Diabetes Care,26(11),3160-3168.
15. George, S. M.,Bernstein, L.,Smith, A. W.,Neuhouser, M. L.,Baumgartner, K. B.,Baumgartner, R. N.,Ballard-Barbash, R.(2014).Central adiposity after breast cancer diagnosis is related to mortality in the health, eating, activity, and lifestyle study.Breast Cancer Research and Treatment,146(3),647-655.
16. Healy, L. A.,Ryan, A. M.,Carroll, P.,Ennis, D.,Crowley, V.,Boyle, T.,Reynolds, J. V.(2010).Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer.Clinical Oncology,22(4),281-288.
17. Kim, G. D.,Chung, B. Y.,Kim, K. H.,Byun, H. S.,Choi, E. H.(2013).Comparison of climacteric symptoms and cognitive impairment in breast cancer survivors and healthy women.Asian Oncology Nursing,13(1),11-17.
18. Kim, H. S.,Kim, H. R.(2013).Comparison of the metabolic syndrome risk factors, physical activity, and diet habits between the fifties and sixties in postmenopausal women.Journal of Korean Biological Nursing Science,15(3),133-138.
19. Kim, J. Y.,Cui, X. G.,Shin, H. J.,Kim, K. S.,Jung, Y. S.(2014).Body mass index and response to neoadjuvant chemotherapy in Korean breast cancer.Journal of Breast Disease,2(1),1-7.
20. Kim, M. K.,Lee, W. Y.,Kang, J. H.,Kang, J. H.,Kim, B. T.,Kim, S. M.,Lee, K. Y.(2014).2014 clinical practice guidelines for over-weight and obesity in Korea.Endocrinology and Metabolism,29(4),405-409.
21. Korean Society for the Study of Obesity(2012).Obesity treatment guideline 2012.Seoul, ROK:Author.
22. Kwan, M. L.,John, E. M.,Caan, B. J.,Lee, V. S.,Bernstein, L.,Cheng, I.,Wu, A. H.(2014).Obesity and mortality after breast cancer by race/ethnicity: The California breast cancer survivorship consortium.American Journal of Epidemiology,179(1),95-111.
23. Kwan, M. L.,Weltzien, E.,Kushi, L. H.,Castillo, A.,Slattery, M. L.,Caan, B. J.(2009).Dietary patterns and breast cancer recurrence and survival among women with early-stage breast cancer.Journal of Clinical Oncology,27(6),919-926.
24. Lahmann, P. H.,Hoffmann, K.,Allen, N.,van Gils, C. H.,Khaw, K. T.,Tehard, B.,Riboli, E.(2004).Body size and breast cancer risk: Findings from the European Prospective Investigation into Cancer and Nutrition (EPIC).International Journal of Cancer,111(5),762-771.
25. Li, X.,Liu, Z. L.,Wu, Y. T.,Wu, H.,Dai, W.,Arshad, B.,Kong, L. Q.(2018).Status of lipid and lipoprotein in female breast cancer patients at initial diagnosis and during chemotherapy.Lipids in Health and Disease,17(1),018-91.
26. Lim, U.,Ernst, T.,Buchthal, S.,Latch, M.,Albright, C. L.,Wilkens, L. R.,Marchand, L. L.(2011).Asian women have greater abdominal and visceral adiposity than Caucasian women with similar body mass index.Nutrition & Diabetes,1(5),e6.
27. Maurea, N.,Coppola, C.,Ragone, G.,Frasci, G.,Bonelli, A.,Romano, C.,Iaffaioli, R. V.(2010).Women survive breast cancer but fall victim to heart failure: The shadows and lights of targeted therapy.Journal of Cardiovascular Medicine,11(12),861-868.
28. Mottillo, S.,Filion, K. B.,Genest, J.,Joseph, L.,Pilote, L.,Poirier, P.,Eisenberg, M. J.(2010).The metabolic syndrome and cardio-vascular risk a systematic review and meta-analysis.Journal of the American College of Cardiology,56(14),1113-1132.
29. Nahm, F. S.(2015).Understanding effect sizes.Hanyang Medical Reviews,35(1),40-43.
30. National Cancer Institute. (2015). Cancer stat facts: Female breast cancer. Retrieved from https://seer.cancer.gov/statfacts/html/breast.html
31. National Cholesterol Education Program Adult Treatment Panel III(2002).Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report.Circulation,106(25),3143.
32. Oh, C. M.,Won, Y. J.,Jung, K. W.,Kong, H. J.,Cho, H.,Lee, J. K.,The Community of Population-Based Regional Cancer Registries(2016).Cancer statistics in Korea: Incidence, mortality, survival, and prevalence in 2013.Cancer Research and Treatment,48(2),436-450.
33. Oh, E. J.,Joh, H. K.,Lee, R.,Do, H. J.,Oh, S. W.,Lym, Y. L.,Cho, D. Y.(2008).Relations between the dietary habits and components of the metabolic syndrome in premenopausal women.Journal of the Korean Academy of Family Medicine,29(10),746-776.
34. O'Neill, S.,O'Driscoll, L.(2015).Metabolic syndrome: A closer look at the growing epidemic and its associated pathologies.Obesity Reviews,16(1),1-12.
35. Park, E. H.,Min, S. Y.,Kim, Z.,Yoon, C. S.,Jung, K. W.,Nam, S. J.,Hur, M. H.(2017).Basic facts of breast cancer in Korea in 2014: The 10-year overall survival progress.Journal of Breast Cancer,20(1),1-11.
36. Patterson, R. E.,Flatt, S. W.,Saquib, N.,Rock, C. L.,Caan, B. J.,Parker, B. A.,Pierce, J. P.(2010).Medical comorbidities predict mortality in women with a history of early stage breast cancer.Breast Cancer Research and Treatment,122(3),859-865.
37. Redig, A. J.,Munshi, H. G.(2010).Care of the cancer survivor: Metabolic syndrome after hormone-modifying therapy.The American Journal of Medicine,123(1),87.e1-87.e6.
38. Rock, C. L.,Doyle, C.,Demark-Wahnefried, W.,Meyerhardt, J.,Courneya, K. S.,Schwartz, A. L.,Gansler, T.(2012).Nutrition and physical activity guidelines for cancer survivors.CA: a Cancer Journal for Clinicians,62,243-274.
39. Seo, J. S.,Park, H. A.,Kang, J. H.,Kim, K. W.,Cho, Y. G.,Hur, Y. I.,Park, Y. R.(2014).Obesity and obesity-related lifestyles of Korean breast cancer survivors.Korean Journal of Health Promotion,14(3),93-102.
40. Stewart, B. W.,Wild, C. P.(2014).World cancer report 2014.Lyon, France:International Agency for Research on Cancer.
41. Zhu, S.,Wang, Z.,Heshka, S.,Heo, M.,Faith, M. S.,Heymsfield, S. B.(2002).Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: Clinical action thresholds.The American Journal of Clinical Nutrition,76(4),743-749.

1. Yu-Hsuan CHANG,Yin-Fan CHANG,Shiow-Ching SHUN,Min-Hsin CHEN(2023).Feasibility of Different Exercise Modalities for Community-Dwelling Residents With Physical Inactivity: A Randomized Controlled Trial.The Journal of Nursing Research,31(6),1-11.