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Serum Cholesterol Level Changes during Gonadotropin-Releasing Hormone-Agonist Therapy in Premenopausal Female Patients with Breast Cancer

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Objectives: To investigate the changes in cholesterol levels during medical ovarian suppression. Methods: We reviewed the medical records and blood test results of 187 female patients with breast cancer who underwent gonadotropin-releasing hormone (GnRH)-agonist therapy for > 24 weeks at our hospital between 1 January 2018 and 31 December 2020. The study excluded patients in this cohort who had previously been diagnosed with dyslipidemia, diabetes, or had recently received lipid-lowering agents, resulting in a final sample size of 152 participants. The age at diagnosis and preoperative body mass index (BMI) were included as baseline demographics. A generalized additive mixed model was applied to analyze the relationship between the duration of GnRH-agonist treatment and changes in cholesterol levels. Results: The study participants had a mean age of 42.5 ± 5.2 years and a mean preoperative BMI of 23.0 ± 3.6 kg/m2; the mean GnRHagonist therapy duration was 19.3 months (range: 5.6–37.7 months); and the total cholesterol level before GnRH-agonist treatment was 171 mg/dL that was significantly higher at 181 mg/dL (P = 0.03) during the most recent measurement. The total cholesterol level was unaffected by the GnRH-agonist therapy until 19.3 months after which it significantly increased by 1.28 mg/dL per month (P = 0.011). There was no significant effect of age, preoperative BMI, or the glomerular filtration rate on the total cholesterol levels. Conclusions: Long-term GnRH agonist therapy for > 19 months can cause a significant increase in the serum cholesterol levels. To prevent complications, patients receiving the treatment should be informed and monitored for the possible progression of dyslipidemia.

Abstract

Objectives: To investigate the changes in cholesterol levels during medical ovarian suppression. Methods: We reviewed the medical records and blood test results of 187 female patients with breast cancer who underwent gonadotropin-releasing hormone (GnRH)-agonist therapy for > 24 weeks at our hospital between 1 January 2018 and 31 December 2020. The study excluded patients in this cohort who had previously been diagnosed with dyslipidemia, diabetes, or had recently received lipid-lowering agents, resulting in a final sample size of 152 participants. The age at diagnosis and preoperative body mass index (BMI) were included as baseline demographics. A generalized additive mixed model was applied to analyze the relationship between the duration of GnRH-agonist treatment and changes in cholesterol levels. Results: The study participants had a mean age of 42.5 ± 5.2 years and a mean preoperative BMI of 23.0 ± 3.6 kg/m2; the mean GnRHagonist therapy duration was 19.3 months (range: 5.6–37.7 months); and the total cholesterol level before GnRH-agonist treatment was 171 mg/dL that was significantly higher at 181 mg/dL (P = 0.03) during the most recent measurement. The total cholesterol level was unaffected by the GnRH-agonist therapy until 19.3 months after which it significantly increased by 1.28 mg/dL per month (P = 0.011). There was no significant effect of age, preoperative BMI, or the glomerular filtration rate on the total cholesterol levels. Conclusions: Long-term GnRH agonist therapy for > 19 months can cause a significant increase in the serum cholesterol levels. To prevent complications, patients receiving the treatment should be informed and monitored for the possible progression of dyslipidemia.

참고문헌 (26)

  1. Yao H, "Triple-negative breast cancer : is there a treatment on the horizon?", Oncotarget, 8, pp.1913~1924 (2017)
  2. Early Breast Cancer Trialists᾽ Collaborative Group(EBCTCG), "Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival : an overview of the randomised trials", Lancet, 365, pp.1687~1717 (2005)
  3. Schmid P, "Leuprorelin acetate every-3-months depot versus cyclophosphamide, methotrexate, and fluorouracil as adjuvant treatment in premenopausal patients with node-positive breast cancer : the TABLE study", J Clin Oncol, 25, pp.2509~2515 (2007)
  4. Pagani O, "Adjuvant exemestane with ovarian suppression in premenopausal breast cancer", N Engl J Med, 371, pp.107~118 (2014)
  5. Francis PA, "Tailoring adjuvant endocrine therapy for premenopausal breast cancer", N Engl J Med, 379, pp.122~137 (2018)
  6. Rocca WA, "Bilateral oophorectomy and accelerated aging : cause or effect?", J Gerontol A Biol Sci Med Sci, 72, pp.1213~1217 (2017)
  7. Wang K, "Comparison of changes in lipid profiles of premenopausal women with early-stage breast cancer treated with different endocrine therapies", Sci Rep, 12, pp.22650~ (2022)
  8. Kang YK, "The effects of endocrine therapies on lipid profiles in Chinese young women with early breast cancer", Front Oncol, 11, pp.759595~ (2021)
  9. Walsh EM, "Management of hormone receptor-positive, HER2-negative early breast cancer", Semin Oncol, 47, pp.187~200 (2020)
  10. Crew KD, "Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer", J Clin Oncol, 25, pp.3877~3883 (2007)
  11. Matthews A, "Long term adjuvant endocrine therapy and risk of cardiovascular disease in female breast cancer survivors : systematic review", BMJ, 363, pp.k3845~ (2018)
  12. Podfigurna-Stopa A, "Premature ovarian insufficiency : the context of long-term effects", J Endocrinol Invest, 39, pp.983~990 (2016)
  13. Garg R, "Association of atherosclerosis with dyslipidemia and co-morbid conditions : a descriptive study", J Nat Sci Biol Med, 6, pp.163~168 (2015)
  14. Phan BAP, "Dyslipidemia in women : etiology and management", Int J Womens Health, 6, pp.185~194 (2014)
  15. Kim KI, "Dyslipidemia in older adults and management of dyslipidemia in older patients", J Lipid Atheroscler, 4, pp.1~6 (2015)
  16. Weingärtner O, "Relationship between cholesterol synthesis and intestinal absorption is associated with cardiovascular risk", Atherosclerosis, 210, pp.362~365 (2010)
  17. Verschuren WM, "Serum total cholesterol and longterm coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study", JAMA, 274, pp.131~136 (1995)
  18. Ipsen DH, "Dyslipidemia : obese or not obese-that is not the question", Curr Obes Rep, 5, pp.405~412 (2016)
  19. Kannel WB, "Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study", Ann Intern Med, 74, pp.1~12 (1971)
  20. Jensen JT, "Ovarian lipid metabolism modulates circulating lipids in premenopausal women", J Clin Endocrinol Metab, 102, pp.3138~3145 (2017)
  21. Knauff EA, "Lipid profile of women with premature ovarian failure", Menopause, 15, pp.919~923 (2008)
  22. Chu MC, "Elevated basal FSH in normal cycling women is associated with unfavourable lipid levels and increased cardiovascular risk", Hum Reprod, 18, pp.1570~1573 (2003)
  23. Torosyan N, "Dyslipidemia in midlife women : approach and considerations during the menopausal transition", Maturitas, 166, pp.14~20 (2022)
  24. Matthews KA, "Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition?", J Am Coll Cardiol, 54, pp.2366~2373 (2009)
  25. Caleffi M, "Effect of tamoxifen on oestrogen binding, lipid and lipoprotein concentrations and blood clotting parameters in premenopausal women with breast pain", J Endocrinol, 119, pp.335~339 (1988)
  26. Ntukidem NI, "Estrogen receptor genotypes, menopausal status, and the lipid effects of tamoxifen", Clin Pharmacol Ther, 83, pp.702~710 (2008)

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