The Impact Of Obesity, Metabolic Status, And Physical Fitness On Metabolic Health In Breast Cancer Survivors

PURPOSE: Breast cancer survivors face a higher risk of hormonal imbalances due to treatment, increasing their susceptibility to diabetes and metabolic disorders. While physical fitness is crucial for cancer prognosis, studies on its interaction with obesity and metabolic status remain limited. Therefore, this study examines the associations between body composition, metabolic status, and physical fitness in breast cancer survivors. METHODS: A total of 152 breast cancer survivors aged ≥19 years and ≥ 1 year post-treatment were classified into four groups based on BMI (≥23 kg/m2) and metabolic health (NCEP criteria): Normal Weight Metabolically Healthy (NWMH), Normal Weight Metabolically Unhealthy (NWMU), Overweight Metabolically Healthy (OWMH), and Overweight Metabolically Unhealthy (OWMU). Measurements included body composition, metabolic profiles, and physical fitness (flexibility, lower body strength, cardiorespiratory fitness, muscular endurance, and relative handgrip strength). Age and menopause status-adjusted ANCOVA were used to compare group differences, and linear regression was conducted to identify fitness parameters most strongly associated with insulin levels. RESULTS: OWMU had significantly higher weight (66.40 ± 0.86 kg vs. 53.28 ± 0.86 kg, p < .05), BMI (26.27 ± 0.27 kg/m2 vs. 20.70 ± 0.27 kg/m2, p < .05), and fat percentage (36.92 ± 0.72% vs. 27.74 ± 0.72%, p < .05) compared to NWMH. Insulin levels were significantly higher in OWMU than NWMH (10.33 ± 0.87 μU/mL vs. 5.49 ± 0.79 μU/mL, p < .05), along with a greater HOMA-IR score (2.61 ± 0.24 vs. 1.31 ± 0.22, p < .05). OWMU had lower cardiorespiratory fitness than NWMH (29.98 ± 0.39 ml/kg/min vs. 33.74 ± 0.35 ml/kg/min, p < .05). Regression analysis identified cardiorespiratory fitness (β = -0.64, p < .001) as a significant predictor of insulin levels. CONCLUSION: Metabolic risks in breast cancer survivors vary by obesity and metabolic status, with higher physical fitness mitigating these risks. Tailored fitness interventions considering individual metabolic health and obesity are crucial for managing metabolic risks and improving overall health in this population. Supported by: This work was supported by the National Cancer Center Grant(NCC- the National Cancer Center, Korea(NCC-2411880-2)