Ismail, Ahmad Karimi
(2016)
Association between nutritional status and serum leptin among newly diagnosed breast cancer patients in Hospital Universiti Sains Malaysia (Hospital USM) : a case control study.
Masters thesis, Universiti Sains Malaysia.
Abstract
Breast cancer incidences are increasing worldwide. In Malaysia, the most commonly
diagnosed cancer among Malaysian women is breast cancer about 29.9% of new cancer
cases and The National Cancer Registry (2006) reported that there were 3,525 female
breast cancer cases in Malaysia. Various studies reported that excessive body weight
might increase the risk of breast cancer and obese people have higher serum leptin level.
This study was carried out to investigate the relationship between nutritional status and
serum leptin among newly diagnosed breast cancer patients in Hospital USM. This case
control study involved 46 newly diagnosed breast cancer patients who were not
undergone any treatment a n d 4 6 c o n t r o l s aged between 20-70 years. Informed
consent was obtained from each study subject. Nutritional parameters used were
macronutrient intake as assessed by 1-day dietary records(1DDR), anthropometry
(weight, height, waist & hip circumference, body mass index, BMI) and body
composition data (bio-electrical impedance ,BIA). Serum Leptin were measured by
immunoassay using Human Leptin ELISA Kit (AssayMax Human Leptin,
Cat.No:EL2001-1; AssayPro, USA). Overall, early menarche were at high risk of getting
breast cancer by 3 folds [Crude OR 2.9 (95% CI=0.2-1.0)] (p < 0.05) as compared to
those who were menarche after 12 years old. Being menopause might increase breastcancer risk by 3 folds [Crude OR 3.0 (95% CI=1.2-7.0)] (p < 0.05) when compared with
pre-menopause study subjects. The BMI of breast cancer patients (24.5 ± 3.8 kg/m2) and
controls (23.2 ± 4.8kg/m2) were not differed statistically (p>0.05). Percentage of body
fat (measured by BIA) for cases (36.2 ± 8.7 %) were significantly higher compared with
controls (31.2 ± 8.5%) (p<0.05) and subjects with BIA more than 32% were at higher
risk of getting breast cancer by 6 folds [Crude OR =5.9 (95% CI=2.4-14.4)] (p < 0.05)
compared with subjects BIA less 32%. Furthermore, 72% of breast cancer cases had
abdominal obesity (WHR more than 0.85) compared to controls (22%) and the study
result had shown study subjects with abdominal obesity have eight time higher risk of
getting breast cancer as compared to those with waist to hip ratio less 0.85 [Crude OR=
8.0 (95% CI=3.2-20.4)](p < 0.05). Energy intake of cases (1397.0±311.0 kcal/d) were
significantly lower than controls (1693.7±379.5 kcal/d) (p<0.05).The proportion of
energy derived from protein in breast cancer cases was higher as the recommended
nutrient intake for Malaysians (RNI) 2005. Serum leptin level was significantly higher in
breast cancer cases (18.1 ± 4.63 ng/ml) as compared to controls (14.7 ± 4.43 ng/ml)
(p<0.05). Positive relationship had been found between serum leptin level and BIA,
waist and WHR, supporting the evidence that obesity was related to high leptin levels in
breast cancer. In conclusion, early menarche (before 12 years old), menopause and
obesity especially abdominal obesity increased breast cancer risk. Serum leptin could be
an indicator for breast cancer risk.
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