Serum apelin levels and body composition changes in breast cancer patients treated with an aromatase inhibitor

J BUON. 2016 Nov-Dec;21(6):1419-1424.


Purpose: The adipose tissue plays a role in carcinogenesis with the adipokines it generates. Apelin is an anti-obesigenic adipokine, and assumes roles in both vascularization and tumor cell proliferation. The present study aimed to investigate changes in apelin levels, in postmenopausal breast cancer (BC) patients receiving aromatase inhibitors (AIs).

Methods: Forty early-stage postmenopausal BC patients treated with AIs with no history of chemotherapy administration were included in the study. At the beginning, we measured serum apelin levels in postmenopausal BC patients who were receiving AIs and healthy women of similar age and normal body mass index (BMI) (control group). We evaluated changes in the body composition, serum lipid profile and serum apelin levels at the beginning and the 12th month through anthropometric measurements and bioelectric impedance analysis.

Results: Forty subjects with postmenopausal BC had a median age of 57 years (range 44-82)). BC patients exhibited significantly higher apelin levels and body mass index (BMI) scores compared to the control group (p=0.0001, p=0.0001, respectively). The 12th month's measurements indicated reduced apelin levels in 24 patients (60%) and increased apelin levels in 16 patients (40%) compared to the initial figures. With respect to the parameters, the patients with reduced apelin levels had significantly different waist-to-hip ratio (WHR) and fat mass scores compared to those with higher apelin levels (p=0.008, p=0.047, respectively).

Conclusion: This study showed that postmenopausal BC patients had high levels of apelin and high BMI scores. This finding suggests that apelin promoted carcinogenesis particularly in obese individuals. The massive and metabolic changes observed in the fat tissues of the postmenopausal BC patients receiving AIs will especially affect the BC-associated outcome.

MeSH terms

  • Adiposity / drug effects*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Apelin
  • Aromatase Inhibitors / therapeutic use*
  • Body Mass Index
  • Breast Neoplasms / blood
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / physiopathology
  • Case-Control Studies
  • Electric Impedance
  • Female
  • Humans
  • Intercellular Signaling Peptides and Proteins / blood*
  • Lipids / blood
  • Middle Aged
  • Neoplasm Staging
  • Postmenopause
  • Time Factors
  • Treatment Outcome
  • Waist-Height Ratio


  • APLN protein, human
  • Antineoplastic Agents, Hormonal
  • Apelin
  • Aromatase Inhibitors
  • Intercellular Signaling Peptides and Proteins
  • Lipids