Weight Regain and Breast Cancer-Related Biomarkers Following an Exercise Intervention in Postmenopausal Women

Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1260-1269. doi: 10.1158/1055-9965.EPI-20-1652. Epub 2021 Mar 18.

Abstract

Background: Epidemiologic studies have reported associations between weight fluctuations and postmenopausal breast cancer risk; however, the biological markers involved in this association are unknown. This study aimed to explore the associations between breast cancer-related biomarkers and weight regain following exercise-induced weight loss.

Methods: From the 400 participants included in the Breast Cancer and Exercise Trial in Alberta, a total of 214 lost weight during the intervention and had follow-up blood samples, body composition, and covariate measurements. Outcomes were measured at baseline, 12 months (end of the study), and 24 months (follow-up).

Results: During follow-up, weight regain was 1.80 kg [95% confidence interval (CI): -0.40-3.90], and was significantly associated with increases in estradiol [treatment effect ratio (TER) = 1.03; 95% CI, 1.01-1.04], estrone (TER = 1.02; 95% CI, 1.01-1.03), free estradiol (TER = 1.04; 95% CI, 1.02-1.05), the homeostatic model assessment for insulin resistance (TER = 1.03; 95% CI, 1.02-1.05), and insulin (TER = 1.03; 95% CI, 1.01-1.04), and decreases in sex hormone-binding globulin (SHBG; TER = 0.98; 95% CI, 0.97-0.99) levels. Nonstatistically significant associations were found for glucose and C-reactive protein. Furthermore, a statistically significant linear trend of increasing levels for all biomarkers, and decreasing SHBG, across weight regain categories was found.

Conclusions: These results suggest that weight regain following exercise-induced weight loss is associated with breast cancer-related biomarker changes in postmenopausal women.

Impact: These findings provide evidence to support the importance of developing effective strategies to prevent weight regain and, consequently, decrease postmenopausal breast cancer risk via changes in adiposity-related biomarkers.

Trial registration: ClinicalTrials.gov NCT01435005.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood*
  • Biomarkers, Tumor / metabolism
  • Body Composition
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / prevention & control*
  • Estradiol / blood
  • Estradiol / metabolism
  • Estrone / blood
  • Estrone / metabolism
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Postmenopause / blood
  • Postmenopause / metabolism
  • Sex Hormone-Binding Globulin / analysis
  • Sex Hormone-Binding Globulin / metabolism
  • Weight Gain
  • Weight Loss

Substances

  • Biomarkers, Tumor
  • SHBG protein, human
  • Sex Hormone-Binding Globulin
  • Estrone
  • Estradiol

Associated data

  • ClinicalTrials.gov/NCT01435005