ASPO Abstracts
The Impact of Lifestyle Intervention and Metformin on Long-term Reductions in Visceral Fat among Women at High Risk for Endometrial Cancer
Category: Lifestyles Behavior, Energy Balance & Chemoprevention, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
Purpose: The strongest link between obesity and cancer exists for endometrial cancer. Obesity increases risk of endometrial cancer through dysregulation of sex hormones and insulin signaling. Excessive accumulation of visceral fat is a major contributor to obesity’s role in cancer. The purpose of this investigation was to assess the joint and independent effects of 16 weeks of lifestyle intervention and metformin on sustained changes in visceral fat at 12-month follow-up among women considered at high risk for developing endometrial cancer. Methods: Obese, postmenopausal women with pre-diabetes were recruited from the community and randomized into four groups for a 16-week intervention using a 2 (metformin 1700 mg/day vs placebo) × 2 (lifestyle- intervention vs no lifestyle-intervention) factorial design. The lifestyle intervention was based on the evidence- based Diabetes Prevention Program (DPP) and consisted of diet and physical activity components. The DPP recommends a low fat diet and portion control to achieve 7% weight-loss. Participants were provided with a pedometer to set daily step goals and monitor step counts, and the opportunity to engage in two supervised exercise sessions per week. Visceral fat area was measured at baseline and 12-month follow-up by whole-body DXA scan. Linear interpolation was used to replace missing values. General linear model with repeated measures was used to assess change in visceral fat area from baseline to 12-months. Results: At 12-month follow up, a significant time × lifestyle intervention interaction (p=0.012) was observed favoring individuals who participated in a 16-week lifestyle intervention (-26.0 ± 25.6 cm2) compared to those who did not (3.8 ± 28.3 cm2). Metformin+lifestyle (n=7) experienced most favorable reduction in visceral fat (-30.4±24.3 cm2), followed by lifestyle (-19.9±28.9 cm2, n=5), placebo (-6.6±17.6 cm2, n=7), and metformin (14.2±34.3 cm2, n=7). No significant interactions were observed for time × metformin (p=0.63) or time × lifestyle × metformin (p=0.15). Conclusions: A 16-week lifestyle intervention with or without metformin promotes reductions in visceral fat area that are sustained after 12 months among women considered at high risk of developing endometrial cancer.
Keywords: visceral fat, endometrial cancer, lifestyle intervention, metformin