| Objective:To observe the effect of different aromatase inhibitors(AI)on the change of serum lipid level in postmenopausal women with hormone receptor positive breast cancer undergoing postoperative adjuvant endocrine therapy;to explore how to select the appropriate AI therapy strategies in order to reduce the side effects and prevent associated cardiovascular disease.Methods: A total of 159 breast cancer patients with positive hormone receptors undergoing postoperative adjuvant endocrine therapy,who were treated in Affiliated Zhongshan Hospital of Dalian University from January 2010 to November 2017 were retrospectively analyzed in this study.The lipid profiles were collected before and after treatment and detected by chemiluminescence method,including low-density lipids(LDL),total cholesterol(TC),triglycerides(TG)and high-density lipoprotein cholesterol(HDL).Results: Anastrozole group: the LDL levels were(2.79±0.71)mmol/L,(2.88±0.81)mmol/L,(3.11±1.01)mmol/L,(2.91±0.81)mmol/L and(3.31±1.02)mmol/L at pre-treatment,six months,one year,two years and three years,respectively.Compared with pre-treatment group,LDL levels increased by 18.6% at the 3rd year after treatment,and the difference was statistically significant(P=0.02).The TC levels were(5.01±0.75)mmol/L,(5.19±0.75)mmol/L,(5.35±1.03)mmol/L,(5.59±0.89)mmol/L and(5.71±1.02)mmol/L,respectively.The TC level was highest in the third year of therapy,which increased by 14.0%.Compared with pre-treatment group,the TC levels were significantly different among the first year,the second year and the third year(P=0.025,P=0.05,P<0.001,respectively).The TG levels were(1.57±0.81)mmol/L,(1.81±1.02)mmol/L,(1.89±0.83)mmol/L,(1.69±0.79)mmol/L and(1.78±0.78)mmol/L,respectively.Compared with pre-treatment group,the TG level which increased by 20.4% was the highest at the first year of therapy,and the difference was statistically significant(P=0.01).There were no statistical difference in HDL levels at all time points after treatment compared with those before treatment.In letrozole group,the LDL levels were(2.86±0.81)mmol/L,(3.21±0.79)mmol/L,(3.29±0.89)mmol/L,(3.30±0.75)mmol/L and(3.13±0.66)mmol/L at pre-treatment,six months,one year,two years and three years,respectively.Compared with pre-treatment group,the highest increase of LDL level was 15.4% and there was a statistically significant difference at the 1st and 2nd year of therapy(P=0.02,P=0.01,respectively).The TC levels were(4.89±1.40)mmol/L,(5.47±1.13)mmol/L,(5.56±0.99)mmol/L,(5.42±0.91)mmol/L and(5.47±0.84)mmol/L at pre-treatment,six months,one year,two years and three years,respectively.Compared with pre-treatment group,the TC level was highest in the first year of treatment,which increased 13.7%,and there were significant differences among the six month,the first year,the second year and the third year(P=0.02,P=0.001,P=0.013,P=0.009,).There was no statistical difference in TG and HDL levels at each time point after treatment.In exemestane group,there was no statistical difference in LDL levels at each time point after treatment compared with pre-treatment group.The TC levels were(4.88±0.88)mmol/L,(5.13±0.91)mmol/L,(5.17±0.93)mmol/L,(5.47±0.82)mmol/L and(5.49±0.72)mmol/L at pre-treatment,six months,one year,two years and three years,respectively.Compared with pre-treatment group,the highest TC level which increased by 12.5% at the 3rd years treatment and there was a statistical difference among the 2nd and 3rd year after treatment(P=0.02,P<0.01,respectively).There was no statistical difference in TG and HDL levels at each time point after treatment.Compared with the lipid levels among the use of three AIs,no statistical difference was found in LDL levels at various time points before and after treatment.After six months treatment,the TC level in the use of letrozole group was higher than that of the exemestane group,and the difference was statistically significant(P=0.02).There was no significant difference between the other groups.At the 1st year treatment group,the TC level in the use of letrozole group was higher than that of exemestane group(P=0.01).There was no significant difference between the other groups.There was no statistical difference of TC level in each group after 1 years of therapy.There was no statistically significant difference in TG level after half a year of therapy.The TG levels in anastrozole,letrozole and exemestane groups were(1.89±0.83)mmol/L,(1.93±1.05)mmol/L and(1.42±0.68)mmol/L at 1 year of treatment,respectively.The TG levels in anastrozole and letrozole groups were higher than those in exemestane group(P=0.002,P=0.001,respectively),there was no significant difference among the other groups.There was no statistically significant difference in TG levels among the groups after one year treatment.There was no statistical difference in HDL levels at various time points before and after treatment.Conclusion:(1)Taking AI can increase Serum Lipid in breast cancer patiens,LDL and TC levels were increased at the first year,the second year and the third year,TG levels were increased at the first year,There was no difference in HDL levels at each time point after treatment.(2)Compared with non-steroidal AI group,exemestane had the least effect on Serum Lipid at six months and 1 years of treatment.The effect of different AIs on Serum Lipid levels was similar in breast cancer patients with long period of AI-therapy. |
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