Med Arh. 2014 Feb; 68(1): 19-21
Metabolic Syndrome in Mexican Women
Survivors of Breast Cancer: A Pilot Study at a
Carlos Manuel Ortiz-Mendoza1, Tania Angélica de-la-Fuente-Vera2, Ernesto Pérez-Chávez2
Department of Surgery, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City1
Department of General Surgery, Hospital General Tacuba, ISSSTE, Mexico City2
Corresponding author: Carlos Manuel Ortiz-Mendoza, MD. Servicio de Oncología Quirúrgica, Hospital General Tacuba, ISSSTE,
Lago Ontario 119, Colonia Tacuba, CP 11410, Delegación Miguel Hidalgo, México DF. Telephone and fax: (01 55) 52 65 29 49, E-mail:
Introduction: According to developed countries’ studies, in breast cancer survivors there is a high prevalence of metabolic syndrome;
however, in Mexico data is lacking about this issue. Goal: To explore if metabolic syndrome occurs in Mexican women survivors of breast
cancer. Material and methods: At a second-level general hospital, women with breast cancer with a surviving >2 years were studied. The
analysis involved their demographic and anthropometric features, blood pressure measurement, time of surviving, besides fasting blood
levels of lipids and glucose. Results: The sample consisted of 100 women; 42% were obese (body mass index ≥30 kg/m2). The sample´s
mean age was 60 years with a mean surviving time of 6.5 years. Their mean glucose level was 122 mg/dL and triglycerides 202 mg/dL.
There were 33% with blood pressure ≥130/85mm Hg or diagnosis of hypertension. Fifty-seven percent had glucose >99 mg/dL or diagno-
sis of diabetes mellitus, and 58% had triglycerides >149 mg/dL. Metabolic syndrome occurred in 57% of obese women. Conclusion: Our
results suggest that metabolic syndrome occurs in more than 50% of obese Mexican women survivors of breast cancer.
Key words: Body Mass Index, Cancer, Metabolic Syndrome, Mexico/Epidemiology, Obesity.
Breast cancer is a public-health problem in Mexico (1,
2). This neoplasm is the main cause of cancer´s death in
women older than 25-years of age (2, 3). However, thanks
to best multidisciplinary oncologic treatments the number
of breast cancer survivors is rising (4). Due to rising of sur-
vivors, their health´s quality is an essential research area
(4, 5). Particularly, is pertinent to study one of the leading
causes of morbidity in these survivors, cardiovascular dis-
eases, which main source is metabolic syndrome (6, 7).
Metabolic syndrome, with several different definitions,
is a cluster of disorders characterized by insulin resis-
tance, hypertension, dyslipidemia, functional endothe-
lium disorders, and obesity (8). Obesity is the main risk
factor for metabolic syndrome (8). Due to obesity rising in
Mexico, the diseases associated to it have been increased,
including cancer and metabolic syndrome (3)].
According to developed countries’ studies, metabolic
syndrome is frequent in breast cancer survivor (8). Nev-
ertheless, in Mexico, it is unknown if metabolic syndrome
occurs in breast cancer survivors.
Given the increase of breast cancer survivors in Mexi-
co, we explored in a pilot study the metabolic syndrome´s
frequency in this population.
3. PATIENTS AND METHODS
It was a prospective study, from May-2011 to May-2012.
We studied women with breast cancer diagnosis with a
surviving >2 years. In all women survivors, we recorded
blood pressure (BP), weight and height; with the last two
data, body mass index (BMI) was calculated: weight in ki-
lograms divided by square height in meters (kg/m2). Ad-
ditionally, we collected demographic information, cancer
stage, affected breast, cancer treatments received, time of
survival, second primary carcinomas, and other diseases
such as hypertension (HP), diabetes mellitus (DM), and
dyslipidemia (triglycerides >149mg/dL or total cholester-
ol >199mg/dL). Posteriorly, women were sent to the lab-
oratory for fasting serum levels determination of glucose,
total cholesterol and triglycerides.
DM was diagnosed if women used insulin or oral hy-
poglycemic drugs or fasting serum glucose ≥126 mg/dL.
HP was diagnosed by use of antihypertensive drugs or BP
values ≥130/85mm Hg. Dyslipidemia was diagnosed by
fibrates or statins use or fasting total triglycerides >149
mg/dL or cholesterol >199 mg/dL. Metabolic syndrome
was diagnosed when there were simultaneously three of
the next features: obesity (BMI ≥30kg/m2), previous DM
diagnosis or serum glucose levels greater than 99mg/dL,
Med Arh. 2014 Feb; 68(1): 19-21
Received: December 18th 2013 | Accepted: January 15th 2014
© AVICENA 2014
Metabolic Syndrome in Mexican Women Survivors of Breast Cancer: A Pilot Study at a General Hospital
Med Arh. 2014 Feb; 68(1): 19-21
prior diagnosis of hypertriglyceridemia or triglycerides
>149 mg/dL, or previous diagnosis of HP or BP ≥130/85
Values are expressed in absolute numbers or percentag-
es. We analyze the variables with “χ2” Pearson or Fisher’s
exact tests; the last was used if any of the values in the 2x2
table was ≤5. The association between obesity and meta-
bolic syndrome was assessed using the odds ratio with a
95% confidence interval. We used the program OpenEpi
version 2 (www.openepi.com); all p values <0.05 were sta-
The sample consisted of 100 women; the Table 1 show
their mean values. Forty-two percent had cholesterol
>199 mg/dL plus triglycerides >149 mg/dL. Thirty-three
percent had previous HP diagnosis or BP ≥130/85 mm
Hg. Table 2 shows detailed sample´s characteristics.
Seven percent had a secondary primary carcinoma; the
most common was metachronous contralateral breast
cancer. In 57% of obese women occurred metabolic syn-
drome; see Table 3.
We noted at a second-level general hospital that 57%
of Mexican obese women survivors of breast cancer had
metabolic syndrome. The metabolic syndrome frequen-
cy in general population of the United States of America
(USA) is 24.6%, in Europe 30.9%, and in Mexico 36% (8,9).
In a study of USA, 54% of obese women breast cancer sur-
vivors (n=40) present this syndrome (10).
We assume that causes of metabolic syndrome occur-
rence in this population were the prevalence of obesity
(42%), hypertriglyceridemia (58%) and of fasting glucose
The obesity´s prevalence in Mexican general population
is 29.9% (11,12,13), and in the USA is 32% (14). In Mexi-
co City, obesity occurs in 38.5-41% of women aged 50-59
years (11,12). In Mexican women with recent diagnosis of
breast cancer 70% have overweight or obesity (15), while in
the population of survivors evaluated this occurred in 82%.
In Mexican general population, their mean value of tri-
glyceride is 131.5 mg/dL, and hypertriglyceridemia occurs
in 27.5% (16,17). Hence, in our sample, the dyslipidemia
frequency and mean value (202 mg/dL) was higher. In
USA´s breast cancer survivors, their mean triglyceride’s
value is 129 mg/dL (10).
In Mexican general population, the glucose intolerance
occurs in 20-24.6%, and it is closely associated to obesity
(18). Thus, the observed proportion of cases with glucose
intolerance (39%) was higher, and it is consistent with the
Abbreviations: SD=Standard deviation.
Table I. Patients’ Mean Values. (n=100)
38 – 96
2.1 – 26
19 – 47
71 – 427
129 – 360
58 – 690
30 – 39
40 – 49
50 – 59
60 – 69
70 – 79
3 – 4
5 – 6
7 – 8
9 – 10
18.3 – 24.9
25 – 29.9
DM + HP
Abbreviations: BMI=Body mass index. DM=Diabetes melli-
tus. HP=Hypertension. NE=No specified.
Table II. Patients´ Characteristics Detailed. (n=100)
Metabolic Syndrome in Mexican Women Survivors of Breast Cancer: A Pilot Study at a General Hospital Download full-text
Med Arh. 2014 Feb; 68(1): 19-21
prevalence of obesity noted. Additionally, in our sample
57% present fasting glucose >99mg/dL or diagnosis of
DM. In a study in USA, glucose intolerance was reported
in 54.8% of breast cancer survivors, but diabetic survivors
were excluded (10).
We must point out that cardiovascular disease risk con-
ferred by metabolic syndrome may increase with breast
cancer treatment. Thus, 93% of women received anthracy-
cline chemotherapy and 56% radiotherapy, and both may
cause cardiotoxicity with subsequent mortality increase
(19,20). This could explain why only 10% of our sample
survived more than 10 years. If our findings are confirmed
by other researchers in Mexico, it will be necessary try to
identify obesity and metabolic syndrome in regular onco-
logic evaluations of breast cancer survivors.
It is important to extend this research to another hospi-
tals and regions of Mexico to confirm our findings about
metabolic syndrome. Also, investigate other disorders
induced by this syndrome in these survivors, such as:
cardiovascular mortality, glucose intolerance with sub-
sequent development of DM, and appearance of second
Study limitations are: the sample was centered to only
one hospital, a large proportion of diabetic patients ana-
lyzed, and that we did not evaluate the waist circumfer-
ence. Notwithstanding, our findings have literature sup-
Metabolic syndrome occurred in more than 50% of
obese breast cancer survivors given obesity´s prevalence
in this sample. If our results are confirmed in obese wom-
en survivors of breast cancer across Mexico, it will be es-
sential the systematic detection of obesity and metabolic
syndrome during their regular oncologic evaluations
CONFILCT OF INTEREST: NONE DECLARED
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Syndrome n (%)
≥30 4224 (57) 0.001
25-29.9 409 (23) 0.52
Abbreviations: BMI=Body mass index. OR=Odds ratio. CI=-
Table III. Metabolic Syndrome According to BMI. (n=100).