In a pilot study, a metabolite profile was identified that may predispose patients with breast cancer to weight gain during treatment.1 The study results were recently published in the British Journal of Cancer.

“Breast cancer treatment has metabolic side effects, potentially affecting risk of cardiovascular disease (CVD) and recurrence,” the study authors wrote. “We aimed to compare alterations in serum metabolites and lipoproteins during treatment between recipients and nonrecipients of chemotherapy, and describe metabolite profiles associated with treatment-related weight gain.”

A total of 60 patients with early stage (I or II) breast cancer who underwent surgery and then were treated per national guidelines were included in the pilot study. Serum samples were obtained before surgery and after surgery at 2 time points: 6 and 12 months. MR spectroscopy and mass spectrometry were used to analyze serum samples for metabolites and lipoproteins.

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The patients who received chemotherapy had significantly different metabolite and lipoprotein profiles at 6 months after surgery from patients who did not receive chemotherapy (P < .001). At 6 months after surgery, patients who received chemotherapy were found to have elevated quantities of kynurenine, asymmetric dimethylarginine, 2 phosphatidylcholines, alpha-aminoadipic acid, hexoses, and sphingolipids. Patients who received chemotherapy also had increased very-low-density lipoprotein and small dense low-density lipoprotein but decreased high-density lipoprotein at 6 months after surgery.

Patients who gained weight had lower quantities acylcarnitines, phosphatidylcholines, lyso-phosphatidylcholines, and sphingolipids at baseline; these patients also had an inflammatory lipid profile.

“Chemotherapy recipients exhibit metabolic changes associated with inflammation, altered immune response and increased risk of CVD,” the study authors concluded. “Altered lipid metabolism may predispose for treatment-related weight gain.”

The study authors encouraged validation of their findings in larger studies.


  1. Madssen TS, Thune I, Flote VG, et al. Metabolite and lipoprotein responses and prediction of weight gain during breast cancer treatment. Br J Cancer. 2018;119(9):1144-1154. doi: 10.1038/s41416-018-0211-x