Lipid changes during the perioperative period in patients with early breast cancer: a real-world retrospective analysis

Abstract

Background Surgery remains the major treatment for early breast cancer (BC), but surgery itself is also a trauma which might induce alterations in lipid metabolism. The aim of this study was to investigate the changes in lipid profiles and to explore factors associated with lipid changes pre- and postoperation. Methods We retrospectively analyzed the pre- and postoperative serum lipid profiles of 1934 BC patients. Results The levels of triglycerides (TG) (p < 0.001) and low-density lipoprotein cholesterol (LDL) (p < 0.001) were significantly elevated after surgery, while the levels of high-density lipoprotein cholesterol (HDL) (p < 0.001) were significantly decreased. After surgery, 27.76% of patients with preoperative ortholiposis developed dyslipidemia. Postmenopausal BC patients had a higher incidence of dyslipidemia (32.31%) after surgery than premenopausal BC patients (26.07%; p = 0.041). Additionally, patients with BMI > 24 (34.92%) had a higher incidence of dyslipidemia than patients with BMI ≤ 24 (24.84%; p = 0.001). Moreover, the magnitudes of the TG increase (p < 0.001), cholesterol (TC) increase (p = 0.013) and LDL increase (p = 0.015) in the premenopausal group were all greater than those in the postmenopausal group. After adjusting for multiple baseline covariates, preoperative hyperlipidemia and progesterone receptor (PR)-positive status were significantly associated with elevated TG, TC and LDL levels after surgery. Conclusions Serum lipid profiles of BC patients may increase after surgery, especially premenopausal patients. Additionally, postmenopausal and overweight patients may have a higher risk of being diagnosed with dyslipidemia after surgery. Therefore, lipid monitoring, dyslipidemia prevention and corresponding interventions should be taken into consideration during the perioperative period.

The Effect of Home Care on Metabolic Profile and Blood Pressure in Type 2 Diabetic Patients who Underwent General Surgeries

“…[ 16 ] In this regard, He et al , in a study on 1,934 patients, showed that TG and LDL-c levels significantly increased after surgery. [ 13 ] Therefore, the lack of reduction in TG and LDL-c levels in our study may also be somewhat affected by postoperative stress, and studies with longer follow-up periods should be performed.…”

“…Recently, some studies have revealed that the stress response to surgery affects lipid profile. [ 13 14 15 ] The activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis are characteristics of the stress response to surgical trauma. [ 13 ] Furthermore, a rise in glucocorticoid levels has been proposed to be involved in insulin resistance and lipid abnormalities.…”

“…[ 13 14 15 ] The activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis are characteristics of the stress response to surgical trauma. [ 13 ] Furthermore, a rise in glucocorticoid levels has been proposed to be involved in insulin resistance and lipid abnormalities. [ 16 ] In this regard, He et al , in a study on 1,934 patients, showed that TG and LDL-c levels significantly increased after surgery.…”

Effect of Laparatomy and Lipopolysaccharide-Induced Systemic Inflammatory Response on Metabolic Disorders in Rats

“…Важливою медико-біологічною проблемою є порушення системного метаболізму, зокрема, післяопераційна інсулінорезистентність та пов'язана з нею гіперглікемія [7], а також зміни ліпідного спектра крові [8]. Ці метаболічні порушення, на думку авторів, можуть позначатися як на близьких і віддалених результатах операційного втручання, так і на розвитку інших захворювань.…”