2008—2012年荔湾区水痘流行病学特征分析

目的了解荔湾区2008—2012年水痘疫情的流行情况,为制定水痘疫情防制措施提供科学依据。方法对2008—2012年荔湾区报告的水痘病例及水痘暴发数据,采用Excel2003软件整理后,进行描述性流行病学分析,并结合当前有关文献资料提出今后水痘防制的建议。结果 2008—2012年广州市荔湾区共报告水痘5 814例,年均发病率为129.46/10万。年发病率为83.50/10万~165.33/10万,其间2008年最高,2012年最低;全区22条街都有病例发生;全年12个月均有病例发生,呈冬春季高发态势;发病主要集中在儿童和青少年,学生占42.89%;男女比例为1.4∶1,报告病例中20岁以下者4 690例,占总数80.67%(4 690/5 814);集体单位聚集性疫情13起,其中暴发疫情4起。结论荔湾区近年水痘疫情主要发生在冬春季节,学生和托幼儿童及散居儿童是水痘的高发人群。建议加强普及防控水痘基本知识,提高水痘疫苗第1剂接种率,落实应急接种的同时,开展水痘疫苗第2剂接种程序的研讨,确保水痘疫情的有效控制,保护公众健康。     

2008—2012年麻疹减毒活疫苗的质量分析

目的对中国2008—2012年连续5年麻疹减毒活疫苗(简称麻疹疫苗)的批签发情况进行总结,评价其麻疹疫苗的总体质量。方法通过对送检样品的资料审查和关键项目的实验室检定,采用趋势分析法对病毒滴度等进行分析和比较,回顾麻疹疫苗质量的整体情况。结果中国麻疹疫苗整体质量较好,批签发通过率为98.6%。疫苗关键指标数据稳定,病毒滴度100%符合国家标准,其中8批疫苗病毒滴度由于超过警戒线企业主动撤检。结论中国麻疹减毒活疫苗的质量稳中有升。国家疫苗批签发程序对确保上市疫苗的质量发挥重要作用,趋势分析在批签发中的应用更加严格保证了上市疫苗的安全性和有效性。     

Mediterranean Dietary Pattern and Risk of Breast Cancer

Background

A Mediterranean diet has a recognized beneficial effect on health and longevity, with a protective influence on several cancers. However, its association with breast cancer risk remains unclear.

Objective

We aimed to investigate whether adherence to a Mediterranean dietary pattern influences breast cancer risk.

Design

The Swedish Women’s Lifestyle and Health cohort study includes 49,258 women aged 30 to 49 years at recruitment in 1991–1992. Consumption of foods and beverages was measured at enrollment using a food frequency questionnaire. A Mediterranean diet score was constructed based on the consumption of alcohol, vegetables, fruits, legumes, cereals, fish, the ratio of unsaturated to saturated fat, and dairy and meat products. Relative risks (RR) for breast cancer and specific tumor characteristics (invasiveness, histological type, estrogen/progesterone receptor status, malignancy grade and stage) associated with this score were estimated using Cox regression controlling for potential confounders.

Results

1,278 incident breast cancers were diagnosed. Adherence to a Mediterranean dietary pattern was not statistically significantly associated with reduced risk of breast cancer overall, or with specific breast tumor characteristics. A RR (95% confidence interval) for breast cancer associated with a two-point increment in the Mediterranean diet score was 1.08 (1.00–1.15) in all women, and 1.10 (1.01–1.21) and 1.02 (0.91–1.15) in premenopausal and postmenopausal women, respectively. When alcohol was excluded from the Mediterranean diet score, results became not statistically significant.

Conclusions

Adherence to a Mediterranean dietary pattern did not decrease breast cancer risk in this cohort of relatively young women.     

乳腺癌转移相关基因的筛选与生物信息学分析

乳腺癌是女性最常见的恶性肿瘤,转移与复发是乳腺癌患者死亡的主要原因. 研究与乳腺癌细胞转移相关的分子靶点对预防乳腺癌术后复发、提高疗效有重要意义. 本研究以3组乳腺癌转移相关的基因表达谱数据(GSE2034, GSE2603, GSE12276)为分析材料,采用GeneSpring软件筛选乳腺癌原发瘤与转移瘤芯片数据的差异表达基因,结合生物信息学工具PATHER、STRING、pSTIING和文献挖掘工具iHOP对差异基因及其相互作用关系进行分析. 结果显示,共筛选出乳腺癌转移共同差异基因147个,其中表达上调93个,表达下调54个. 这些差异基因主要涉及细胞周期与增殖、细胞粘附、细胞迁移、血管形成及信号转导等生物通路和生物过程. 差异基因编码蛋白间的相互作用主要集中在14个蛋白,且在更为复杂的网络图谱中仍可见其中9个基因（CXCR4、MMP1、MMP2、MMP3、CTGF、COL1A1、MEF2C、PTGS2及SPARC）在重要的节点位置. 文献挖掘发现,COL1A1基因可能为新发现的乳腺癌转移候选基因,为乳腺癌转移的发病机制提供新的思路,也为转移性乳腺癌的分子诊断和个体化治疗奠定基础.     

2012‒2014年杭州市HBsAg、HCVAb、HIV及TP感染情况分析

摘要：目的 统计分析2012年～2014年浙江大学医学院附属第一医院就诊患者中HBsAg、HCV、HIV及TP感染情况,了解期间来院患者四种病原体的感染情况,为临床安全提供参考依据。方法 回顾性分析2012年～2014年我院住院患者血清中HBV、HCV、HIV和TP感染状况。结果 2012年至2014年共统计214 935人次,HBsAg阳性率为13.08%,HCV阳性率为0.51%,HIV阳性率为0.37%,TP阳性率为2.44%。各年份间HBsAg差异有统计学意义（HbsAg：χ2=55.74,P<0.0001;HCV：χ2=2.24,P=0.327;HIV：χ2=2.67,P=0.26;TP：χ2=2.65,P=0.27）。不同性别之间,HBsAg、HIV或TP阳性率差异有统计学意义（HBsAg：χ2=2680.6,P<0.0001;HCV：χ2=2.69,P=0.101;HIV：χ2=344.3,P<0.0001;TP：χ2=192.4,P<0.0001）;不同年龄段之间,HBsAg、HCV、HIV及TP阳性率差异有统计学意义（HbsAg：χ2=3036.1,P<0.0001;HCV：χ2=59.45,P<0.0001;HIV：χ2=246.06,P<0.0001;TP：χ2=636.80,P<0.0001）。结论 开展术前四项检测,有助于及时了解患者情况,明确人群感染情况,对制定感染的预防及治疗措施,避免院内感染的发生具有十分重要的意义。     

Health Behaviors of Breast Cancer Survivors with Hypertension: A Propensity Analysis of KNHANES III-V (2005-2012)

ObjectiveThis study examines health behaviors of breast cancer survivors with hypertension and compares them with those of non-cancer individuals with hypertension.MethodsIn this cross-sectional study, a total of 10,996 hypertensive adults (≥ 19 years) who participated in the 2005-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were considered. Data on alcohol consumption, smoking, physical activity, antihypertensive medication adherence, self-reported diet control, and sodium intake were collected through self-report questionnaire. A total of 64 breast cancer survivors with hypertension and 10,932 non-cancer participants with hypertension were identified. To better compare health behaviors of the two groups, 56 breast cancer survivors and 280 non-cancer participants were selected through the 1:5 nearest available matching based on estimated propensity scores. Multivariate analysis was conducted to determine any differences between the two groups.ResultsAccording to multivariate analysis, breast cancer survivors with hypertension (n = 56) were significantly less likely to consume alcohol (odds ratio (OR): 3.75; 95% confidence interval (CI): 1.06-13.29) but significantly more likely to have sodium intake of more than 2400 mg (OR: 2.98; 95% CI: 1.27-6.97) than the propensity-matched control group (n = 280). There was no significant difference in other health behaviors between the two groups.ConclusionsBreast cancer survivors require active interventions for healthy behaviors related to the management of comorbid conditions such as hypertension to reduce the risk of cardiovascular disease and improve their overall survival rate.     

浙江省环杭州湾产业带湿地时空动态

基于RS和GIS技术手段,采用土地利用动态变化的空间分析方法,对1990—2005年浙江省经济发展最活跃的环杭州湾产业带湿地的时空动态进行了研究.结果表明：研究期间,环杭州湾产业带内湿地与其他土地利用/覆被类型以及湿地内部地类之间的转化频繁,突出表现为湿地与农用地之间相互转化、建设用地占用湿地和杭州湾沿岸滩涂湿地转化为养殖水面;比较利益驱动和耕地占补平衡政策的双重影响,决定了环杭州湾产业带湿地时空动态的内在机制,即在水产养殖相对于传统农业的比较利益驱动下,大量内陆地区的农用地和杭州湾沿岸的滩涂湿地被开垦成养殖水面,而建设用地的迅速扩展、土地资源的紧张以及耕地占补平衡政策的实施导致湿地资源被侵占.     

A Comprehensive Analysis of CXCL12 Isoforms in Breast Cancer1,2

CXCL12-CXCR4-CXCR7 signaling promotes tumor growth and metastasis in breast cancer. Alternative splicing of CXCL12 produces isoforms with distinct structural and biochemical properties, but little is known about isoform-specific differences in breast cancer subtypes and patient outcomes. We investigated global expression profiles of the six CXCL12 isoforms, CXCR4, and CXCR7 in The Cancer Genome Atlas breast cancer cohort using next-generation RNA sequencing in 948 breast cancer and benign samples and seven breast cancer cell lines. We compared expression levels with several clinical parameters, as well as metastasis, recurrence, and overall survival (OS). CXCL12-α, -β, and -γ are highly co-expressed, with low expression correlating with more aggressive subtypes, higher stage disease, and worse clinical outcomes. CXCL12-δ did not correlate with other isoforms but was prognostic for OS and showed the same trend for metastasis and recurrence-free survival. Effects of CXCL12-δ remained independently prognostic when taking into account expression of CXCL12, CXCR4, and CXCR7. These results were also reflected when comparing CXCL12-α, -β, and -γ in breast cancer cell lines. We summarized expression of all CXCL12 isoforms in an important chemokine signaling pathway in breast cancer in a large clinical cohort and common breast cancer cell lines, establishing differences among isoforms in multiple clinical, pathologic, and molecular subgroups. We identified for the first time the clinical importance of a previously unstudied isoform, CXCL12-δ.     

乳腺癌免疫组化检测在乳腺癌患者诊治中的意义分析

目的：探讨免疫组化检测在乳腺癌患者诊治中的价值。方法：随机选取2011年1月-2013年1月的68例经过空心穿刺活捡并病理确诊的乳腺癌患者为研究对象,均采用免疫组化检测ER、PR、P53、Bcl-2,全部采用CEF化疗方案治疗3个月后手术治疗,再运用免疫组化SP法检测化疗前后乳腺癌组织中以上指标的阳性表达率情况。结果：ER、PR化疗前后比较无统计学意义（P〉0．05）;而P53、Bcl-2比较有明显的差异性（P〈0．05）;ER、PR的阴性和阳性和疗效情况无明显差异性,而P53、Bcl-2的阴性和阳性表达和化疗的效果有明显的差异性,P〈0．05,具有统计学意义。结论：免疫组化检测中ER、PR对乳腺癌化疗前后无明显差异性,而化疗可通过抑制P53的表达来抑制乳腺癌增值并通过升高Bcl-2表达来调整肿瘤细胞分化。     

近30年中国陆地生态系统NDVI时空变化特征

气候变化已明显影响到陆地植被的活动,但在不同生态系统间存在差异,研究不同陆地生态系统归一化植被指数(NDVI)的时空变化特征,不仅可揭示各生态系统植被活动对气候变化的响应规律,而且可为我国不同生态区制定应对气候变化的策略和生态文明建设提供科学依据。基于1982—2012年GIMMS NDVI3g和中国陆地生态系统类型数据,利用一元线性回归、集合经验模态分解和相关分析等方法,研究了近30年中国各陆地生态系统NDVI的时空变化特征,分析了其与气候事件的关系。结果表明,近30年中国植被活动显著上升,年平均归一化植被指数(ANDVI)的上升幅度为0.0029/10a(P0.05),年最大归一化植被指数(MNDVI)的上升幅度为0.0076/10a(P0.01);植被活动显著增强的区域主要是分布在东部季风区的农田和森林生态系统,显著下降的区域主要是分布于西北的荒漠生态系统和东北的森林生态系统;尽管ANDVI和MNDVI线性趋势的显著性有所差异,但农田、森林、草地和水体与湿地生态系统的NDVI总体呈非稳定的上升趋势,上升过程中伴随着较大波动,荒漠生态系统的NDVI呈下降趋势,植被退化显著;与线性趋势不同,各生态系统植被活动的残差趋势包含"上升—下降"两个阶段,并相继于20世纪90年代到21世纪初发生转折;上述5类生态系统的植被活动存在不同尺度的周期特征,年际周期波动特征(1.9—7.6a)比较显著,而年代际周期(10.7a和22.2a)的显著性相对较差;各生态系统的空间异质性在趋强过程中存在2.1—7.1a的年际周期节律;海洋与大气环流的短周期脉动与各生态系统植被活动的周期性节律有着明显关联,ENSO事件和太阳活动是推动植被活动周期性振荡的重要因素。     

Road Traffic Injury Trends in the City of Valledupar,Colombia. A Time Series Study from 2008 to 2012

Objective

To analyze the behavior temporal of road-traffic injuries (RTI) in Valledupar, Colombia from January 2008 to December 2012.

Methodology

An observational study was conducted based on records from the Colombian National Legal Medicine and Forensic Sciences Institute regional office in Valledupar. Different variables were analyzed, such as the injured person’s sex, age, education level, and type of road user; the timeframe, place and circumstances of crashes and the vehicles associated with the occurrence. Furthermore, a time series analysis was conducted using an auto-regressive integrated moving average.

Results

There were 105 events per month on an average, 64.9% of RTI involved men; 82.3% of the persons injured were from 18 to 59 years of age; the average age was 35.4 years of age; the road users most involved in RTI were motorcyclists (69%), followed by pedestrians (12%). 70% had up to upper-secondary education. Sunday was the day with the most RTI occurrences; 93% of the RTI occurred in the urban area. The time series showed a seasonal pattern and a significant trend effect. The modeling process verified the existence of both memory and extrinsic variables related.

Conclusions

An RTI occurrence pattern was identified, which showed an upward trend during the period analyzed. Motorcyclists were the main road users involved in RTI, which suggests the need to design and implement specific measures for that type of road user, from regulations for graduated licensing for young drivers to monitoring road user behavior for the promotion of road safety.     

乳腺癌发生的特征基因筛选及模式识别

本文选取癌症基因组图谱数据库的乳腺癌样本作为数据集,在全基因组的水平上研究乳腺癌病人从正常到发病Ⅰ期基因表达的变化,寻找与乳腺癌发病密切相关的特征基因,建立乳腺癌发生的模式识别分类方法,为乳腺癌预防及早期诊断提供理论支持.研究中,综合利用相关性、t检验、置信区间等统计学方法,建立乳腺癌发生特征基因筛选方法,获得与乳腺癌发生具有显著性差异的特征基因336个.通过机器学习方法建模,得到的分类准确率能达到98%以上,与之前乳腺癌相关的研究相比,准确率更高.同时采用KEGG(kyoto encyclopedia of genes and genomes)通路分析得到与基因显著相关(P0.05)的通路有8个,GO(gene ontology)基因功能富集分析显示与基因显著相关(P0.05)的功能有18个.最后对映射在8个通路中的一部分基因进行简要功能分析,说明了其在调控水平上的密切关系,表明识别的特征基因在乳腺癌的发生过程中有重要的作用,这对了解乳腺癌发病机理以及乳腺癌的早期诊断非常重要.     

A Multivariate Model to Measure the Effect of Treatments in Survival to Breast Cancer

An homogeneous Markov process in continuous time with three states (no relapse, relapse, and death) to model the influence of treatments in relapse and survival times to breast cancer is considered. Different treatments such as chemotherapy, radiotherapy, and hormonal therapy, and combinations of these were applied to a cohort of 300 patients after surgery. All patients were seen longitudinally every month. The treatments are introduced as covariates by means of transition intensity, thus providing three covariates. The likelihood function is built from the data and the parameters estimated. Original computational programmes are constructed using the MATHEMATICA and MATLAB programmes, by means of which we estimate the parameters, calculate the transition probability functions, plot the graphs of the survival curves, and fit the survival curves to treatments obtained from the model with the corresponding empirical functions.     

鼠源性人乳腺癌单链抗体库的构建与乳腺癌相关抗体的筛选

目的:获得乳腺癌的噬菌体呈现型单链抗体(scFv)库,筛选与乳腺癌细胞特异结合的抗体,为乳腺癌的诊断和治疗奠定基础。方法:用乳腺癌细胞系MCF-7、T47D、MDA-MB-435免疫BALB/c小鼠,取脾脏提取总RNA,用RT-PCR分别扩增抗体重、轻链可变区(VH和VL)基因,经Linker连接形成scFv基因片段。将scFv基因片段与噬菌粒载体pCANTAB5E的连接产物转化大肠杆菌TG1。用辅助噬菌体M13KO7进行超感染,获得重组噬菌体抗体。选用乳腺癌细胞系MCF-7和人正常肝细胞系HL02做正负差异的筛选细胞,通过5轮筛选,随机挑取克隆,经phage-ELISA筛选特异性结合MCF-7细胞的scFv。结果:构建了1个库容为1.3×106的单链抗体库。筛选到2株与MCF-7细胞有较高结合活性的噬菌体-单链抗体scFv-873和scFv-874。数据库搜索表明这2株单链抗体基因是与以往抗体序列不同的新基因。用Westernblot检测了这2株单链抗体在琥珀密码子非抑制型菌株TOP10中的表达情况。结论:筛选到2个与乳腺癌细胞结合特异性较好的单链抗体,为乳腺癌的诊断和治疗研究奠定了基础。     

A Prognostic Analysis of Male Breast Cancer (MBC) Compared with Post-Menopausal Female Breast Cancer (FBC)

Background

Male breast cancer (MBC) is known to be rare compared with female breast cancer (FBC) and to account for only 1% of all breast cancers. To date, male patients diagnosed with breast cancer are normally treated based on the guidelines for FBC. Specifically, studies have found that diagnosing and treating MBC patients under the guidelines for the treatment of post-menopausal FBC are more favorable than are those of pre/peri-menopausal FBC from a physiological perspective because MBC and post-menopausal FBC patients show high estrogen receptor (ER) expression in the tumor and low estrogen expression in the body. In this medical study, we aimed to examine whether MBC actually has the same prognosis as post-menopausal FBC.

Method

We identified MBC patients who were diagnosed as operable and who completed clinical treatment and we used follow-up data that were collected from January 2001 to January 2011. Each MBC patient was paired with four FBC patients who were diagnosed within the same period (two were pre/peri-menopausal, and two were post-menopausal). We compared disease-free survival (DFS) and overall survival (OS) among three groups, i.e., pre/peri-menopausal FBC (group A), post-menopausal FBC (group B) and MBC (group M), using the Kaplan-Meier method and a Cox proportional hazards regression model. We also evaluated the clinical characteristics of breast cancer patients using t-tests and chi-square tests. We used ten consecutive years of data that were collected at Zhejiang Provincial Cancer Hospital.

Results

We identified 91 MBC cases for group M, 182 FBC cases for group A and 182 FBC cases for group B. The median follow-up period was 112 months. MBC cases were much more frequently ER positive than those of group A and group B (p<0.01); a similar trend was also found for progesterone (PR)-positive cases (p<0.01). The MBC group showed much lower human epidermal growth factor receptor-2 (HER2) expression than did the other groups (p<0.01). The 10-year OS rates were 79.1% for group M (72/91), 79.1% (144/182) for group A, and 87.9% (160/182) for group B, log-rank test indicated that group M had similar mean OS time as group A and group B (GourpM vs group A: p = 0.709; group M vs group B: p = 0.042). The Cox proportional hazards regression model indicated that pre/peri-menopausal FBC had similar DFS (hazard ratio (HR) = 0.706, p = 0.262) and OS (HR = 1.029, p = 0.941) values compared with MBC, whereas post-menopausal FBC had higher DFS (HR = 0.454, p = 0.004) and OS (HR = 0.353, p = 0.003) values than did MBC.

Conclusion

Based on this study, we can conclude that MBC displayed higher ER- and PR-positive expression and lower HER2-positive expression than both post-menopausal and pre/peri-menopausal FBC. However, the DFS and OS values of MBC were similar to those of pre/peri-menopausal FBC and were worse than were those of post-menopausal FBC.     

Differential Network Analysis Applied to Preoperative Breast Cancer Chemotherapy Response

In silico approaches are increasingly considered to improve breast cancer treatment. One of these treatments, neoadjuvant TFAC chemotherapy, is used in cases where application of preoperative systemic therapy is indicated. Estimating response to treatment allows or improves clinical decision-making and this, in turn, may be based on a good understanding of the underlying molecular mechanisms. Ever increasing amounts of high throughput data become available for integration into functional networks. In this study, we applied our software tool ExprEssence to identify specific mechanisms relevant for TFAC therapy response, from a gene/protein interaction network. We contrasted the resulting active subnetwork to the subnetworks of two other such methods, OptDis and KeyPathwayMiner. We could show that the ExprEssence subnetwork is more related to the mechanistic functional principles of TFAC therapy than the subnetworks of the other two methods despite the simplicity of ExprEssence. We were able to validate our method by recovering known mechanisms and as an application example of our method, we identified a mechanism that may further explain the synergism between paclitaxel and doxorubicin in TFAC treatment: Paclitaxel may attenuate MELK gene expression, resulting in lower levels of its target MYBL2, already associated with doxorubicin synergism in hepatocellular carcinoma cell lines. We tested our hypothesis in three breast cancer cell lines, confirming it in part. In particular, the predicted effect on MYBL2 could be validated, and a synergistic effect of paclitaxel and doxorubicin could be demonstrated in the breast cancer cell lines SKBR3 and MCF-7.     

乳腺癌患者预后的相关因素分析

目的:探讨影响乳腺癌患者预后的相关因素。方法:回顾性分析2008年1月~2009年2月我院收治的81例乳腺癌患者的临床、病理及随访资料。结果:所有患者均手术治疗并经病理证实,年龄45岁以上的乳腺癌患者的五年生存率为82.6%,显著高于45岁及其以下者(45.7%,P0.05);肿瘤直径为3 cm及其以下的乳腺癌患者的五年生存率为81.5%,显著高于肿瘤直径为3 cm以上者(40.7%,P0.05);无淋巴结转移的乳腺癌患者五年生存率明显高于有淋巴结转移的乳腺癌患者(P0.05);I期、II期、Ⅲ期、Ⅳ期的乳腺癌患者五年生存率分别为93.8%、73.0%、52.9%、0%,不同临床分期的乳腺癌患者的五年生存率比较差异均有统计学意义(P0.05)。结论:乳腺癌的治疗以手术为主,年龄、肿瘤大小、淋巴结转移、临床分期与患者的预后密切相关。     

Spatiotemporal Cluster Patterns of Hand,Foot, and Mouth Disease at the County Level in Mainland China, 2008-2012

Background

Hand, foot, and mouth disease (HFMD) is known to be a highly contagious childhood illness. In recent years, the number of reported cases of HFMD has significantly increased in mainland China. This study aims at the epidemiological features, spatiotemporal patterns of HMFD at the county/district level in mainland China.

Methods

Data on reported HFMD cases for each county from 1 January 2008 to 31 December 2012 were obtained from the Chinese Center for Disease Control and Prevention. Cluster analysis, spatial autocorrelation, and retrospective scan methods were used to explore the spatiotemporal patterns of the disease.

Results

The annual incidences varied greatly among the counties, ranging from 0 to 74.31‰ with the median of 5.42‰ (interquartile range: 1.54‰–13.55‰) during 2008–2012 in mainland China. Counties close to provincial capital cities generally had higher incidences than rural counties. A seasonal distribution was observed between the northern and southern China, of which dual epidemic were shown in southern China and usually only one in northern China. Based on the global and local spatial autocorrelation analysis, we found that the spatial distribution of HFMD was presented a significant clustering pattern for each year (P<0.001), and hotspots of the disease were mostly distributed in coastal provinces of China. The retrospective scan statistic further identified the dynamics of spatiotemporal clustering areas of the disease, which were mainly distributed in the counties of eastern and southern China, as well as provincial capitals and their surrounding counties.

Conclusions

The spatiotemporal clustering areas of the disease identified in this way were relatively stable, and imminent public health planning and resource allocation should be focused within those areas.     

Weight Loss Interventions for Breast Cancer Survivors: Impact of Dietary Pattern

Body weight management is not emphasized in clinical practice guidelines for breast cancer survivors, reflecting the lack of evidence that weight loss improves prognosis. Even if this situation changes, the optimal design for weight loss interventions is unclear. We conducted a 6-month non-randomized, controlled weight loss intervention in 249 post-menopausal breast cancer survivors. This paper reports effects on two secondary endpoints, change in body weight and composition. Participants were predominantly non-Hispanic whites (89%) with a mean age of 54.9 ± 9.2 years, a mean BMI of 29.0 ± 2.6 kg/m: ² and an average of 43 ± 5% body fat. Two dietary interventions, low fat or low carbohydrate, were investigated and consisted of a 42 day cycle of menus and recipes. Weight loss counseling and anthropometric assessment were provided at monthly clinic visits. One hundred ninety-two women completed the trial (77% retention). In comparison to the nonintervention control, both intervention arms achieved significant decreases in body weight (12.5%), body fat (27.5%), waist circumference (9.5%), and hip circumference (7.8%) (all p < 0.001) with minimal effects on lean mass (1.3% decrease). Median time to 5 and 10% weight loss was 2 (95% confidence interval = 1 to 3) and 4 (95% confidence interval = 3 to 5) months, respectively, and 23% of participants experienced ≥ 15% weight loss. Loss of body weight and fat mass was rapid and substantial irrespective of dietary approach when a structured program was provided with monthly anthropometric assessment and weight loss counseling.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01315483","term_id":"NCT01315483"}}NCT01315483