The Influence Factors Of Dyslipidemia In Postmenopausal Breast Cancer Patients During Standardized Treatment

Objective:To investigate the influence factors of dyslipidemia in postmenopausal breast cancer patients during Standardized treatment and to explore the influence of aromatase inhibitors on patients' blood lipid.Methods:456 postmenopausal breast cancer patients' clinical and pathological data were analyzed,these patients were diagnosed from June 2011 to June 2014 in Center of Diagnosis and Treatment of Breast Disease of The Affiliated Hospital of Qingdao University.1.Collecting patients' General information,including age of onset of breast cancer,height,weight,smoking and drinking history,history of diabetes and hypertension;Collecting patients' Clinical and pathological information,including chemotherapy regimen,ER,RP,lymph node status,pathological classification,endocrine therapy drugs,lipid-lowering drugs,blood lipid status before the diagnosis of breast cancer,and blood lipid status in the latest follow-up.2.Logistic regression was used for multivariate analysis to explore the relationship between various indicators and dyslipidemia in postmenopausal breast cancer patients,and obtain independent risk factors of dyslipidemia in the systematic treatment of postmenopausal breast cancer patients.3.Using the T-test to analyze the difference of blood lipid between patients treated with and without non-steroidal AI.4.Analyzing the changing regulation of blood lipid with the non-steroidal AI' using time.Result:1.All the 456 postmenopausal breast cancer patients involved in this study had normal blood lipid levels before treatment,213 patients had dyslipidemia after 5-8 years of systematic treatment,the abnormal rate was 46.71%.Multiple factors analysis showed that increasing age of onset of breast cancer,increasing BMI index,taking nonsteroidal AI drugs can increase dyslipidemia risk,taking lipid-lowering drugs can reduce the risk,they are independent factors in the dyslipidemia in postmenopausal breast cancer patients' treatment(P<0.05).2.Among the 456 patients,251 patients had taken non-steroidal AI.After using nonsteroidal AI,the patients' mean TG level was 1.96±1.07mmol/L,and the mean TG level of not using was 1.64 ± 1.21mmol/L,the difference was statistically significant(P<0.05).After using nonsteroidal AI,the patients' mean LDL level was 3.87±0.77mmol/L,and the mean LDL level of not using was 2.92± 1.03mmol/L,the difference was statistically significant(P<0.05).After using nonsteroidal AI,the patients' mean HDL level was 1.21±0.34mmol/L,and the mean HDL level of not using was 1.28±0.31mmol/L.The difference was statistically significant(P<0.05).After using nonsteroidal AI,the patients' mean TC level was 5.61±1.19mmol/L,and the mean TC level of not using was 5.17±1.06mmol/L,the difference was statistically significant(P <0.05).3.In 142 patients who had finished 5 years' nonsteroidal AI treatment.The mean TC levels were(4.89±0.97)mmol/L?(5.53±0.85)mmol/L?(5.57±0.62)mmol/L?(5.48±1.42)mmol/L?(5.51±0.92)mmol/L and(5.49±1.14)mmol/L,at pre-treatment?one year?two years?three years?four years and five years respectively,The highest increase appeared in the first year which was 0.64mmol/L,all differences were statistically significantcompared with pre-treatment.The LDL levels were(3.08±0.84)mmol/L?(3.44±1.42)mmol/L?(3.49±0.70)mmol/L?(3.57±1.10)mmol/L?(3.58±1.03)mmol/L and(3.62±0.77)mmol/L,at pre-treatment?one year?two years?three years?four years and five years respectively,The highest increase appeared in the first year which was0.36mmol/L,all the differences were statistically significant compared with pre-treatment.The HDL levels were(1.36±0.43)mmol/L?(1.34±0.39)mmol/L?(1.32±0.32)mmol/L?(1.29±0.48)mmol/L?(1.28±0.38)mmol/L?(1.27±0.46)mmol/L,at pre-treatment?one year?two years?three years?four years and five years respectively,all the differences were not statistically significant compared with pre-treatment.The TG levels were(1.57±0.75)mmol/L?(1.79±1.33)mmol/L?(1.86±0.95)mmol/L?(1.74±1.18)mmol/L?(1.81±0.64)mmol/L?(1.76±1.12)mmol/L,at pre-treatment?one year?two years?three years?four years and five years respectively,The highest increase appeared in the first year which was 0.22mmol/L,the second and the fourth years' changes were statistically significant compared with pre-treatment.Conclusion:1.Onset age of breast cancer,BMI,duration of nonsteroidal AI drugs are independent risk factors of dyslipidemia in systematic treatment of postmenopausal breast cancer patients.Increasing onset age of breast cancer,increaseing BMI and prolonging duration of non-steroidal AI drugs will lead to an increased risk of dyslipidemia(P <0.05).2.For postmenopausal breast cancer patients,with the increase of non-steroidal AI‘using time,TC,LDL,TG also change Significantly.The maximal variation was in the first year.When using non-steroidal AI drugs,patients should monite blood lipid level closely especially in the first year,particularly the old with high body mass index.Once occur abnormal blood lipid fluctuation,they should accepte clinical treatment timely,to avoid the occurrence of adverse events..