Abstract
Obesity among breast cancer survivors is associated with increased risk for recurrence and mortality. The hormone ghrelin plays a role in initiating appetite and thus regulating body weight. This study aims to determine the effect of a lifestyle intervention on ghrelin levels in breast cancer survivors with a body mass index (BMI) ≥ 25 kg/m2. The Lifestyle, Exercise, and Nutrition (LEAN) study was a 6-month randomized trial, examining the effectiveness of a weight loss intervention versus usual care in 151 breast cancer survivors with BMI ≥ 25 kg/m2. Ghrelin was measured in fasting baseline and 6-month blood samples. Baseline associations between ghrelin, body composition, and blood biomarkers were examined. Six-month change in ghrelin was compared between study arms. Ghrelin measurements were available for 149 women. At baseline, ghrelin was correlated with age (r = 0.28, p < 0.001) and inversely correlated with weight (r = −0.18, p = 0.03), lean body mass (r = −0.18, p = 0.02), and leptin (r = −0.18, p = 0.03). Over 6 months, ghrelin increased by 144 pg/mL (7.2%) in the intervention and decreased by 466 pg/mL (32.5%) in the usual care (p = 0.07). Among all women, greater weight loss was associated with an increase in ghrelin (p = 0.01). These findings indicate that weight loss, achieved through a lifestyle intervention, is associated with higher ghrelin levels in breast cancer survivors which may be informative for developing sustainable weight loss programming for this population. Future research should investigate the long term impacts of lifestyle interventions on ghrelin levels in the context of weight maintenance and weight regain.
Highlights
In 2019, the American Cancer Society estimated that there were approximately 3,861,520 breast cancer survivors living in the United States with this number expected to increase to 4,957,960 by 20301
Among breast cancer patients, the focus has been on the 975 women assessed for eligibility, 151 women were randomized, impact of therapies such as chemotherapy on ghrelin levels24. 149 had baseline blood samples
Studies examining the role of circulating ghrelin levels on weight loss and weight maintenance have primarily been conducted in the setting of surgical interventions and less so in lifestyle weight loss interventions[10,15,16,17,19,20]
Summary
In 2019, the American Cancer Society estimated that there were approximately 3,861,520 breast cancer survivors living in the United States with this number expected to increase to 4,957,960 by 20301. The increase in female breast cancer survival rates is partially attributable to widespread mammography use and improvements in treatments[1]. As the population of breast cancer survivors grows, it becomes increasingly important to understand the specific needs associated with cancer survivorship. Weight gain among women with breast cancer is a common problem. Obesity and posttreatment gain in adipose tissue places breast cancer survivors at an elevated risk for recurrence and breast cancer-specific mortality for decades[7]. Research has shown that every 5 kg increase in weight is associated with a 13% increase in breast cancer-specific mortality[8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
