Fat body Mass Tied to Vertebral Fractures in breast cancer patients on aromatase inhibitors and denosumab

The research, conducted at the Breast Unit of the ASST Spedali Civili of Brescia, investigated the association between dual x-ray absorptiometry (DXA)-measured fat body mass (FBM) and vertebral fracture (VF) progression in patients receiving aromatase inhibitors (AIs) in combination with denosumab.

The study included 237 postmenopausal women with EBC undergoing adjuvant treatment with AIs and denosumab. Participants were enrolled between September 2014 and June 2018, with data analysis conducted in June 2022. Patients received adjuvant therapy with AIs and denosumab (60 mg every 6 months).

Key Findings:

• VF progression occurred in 4.4% of patients.

• Factors associated with VF progression included a history of clinical fractures, Fracture Risk Assessment Tool (FRAX) score for major fractures, percentage of FBM, and android fat.

• An inverse association was observed with the appendicular lean mass index-FBM ratio.

• Independent Variables: Multivariable analysis identified percentage of FBM and FRAX score as independent variables associated with VF progression.

The study suggests that baseline FBM is an independent factor for VF progression in patients with EBC undergoing adjuvant AIs and denosumab therapy. This observation opens the door to considering diet and exercise as potential synergistic elements in the management of bone health for these patients.

The study's findings provide valuable insights into the complex interplay between body composition and bone health in postmenopausal women with EBC undergoing specific adjuvant therapies. The identification of FBM as an independent factor for VF progression highlights the potential for holistic interventions, including lifestyle modifications, to complement medical treatments in managing bone health in this patient population.

Reference:

Cosentini, D., Pedersini, R., Di Mauro, P., Zamparini, M., Schivardi, G., Rinaudo, L., Di Meo, N., Del Barba, A., Cappelli, C., Laganà, M., Alberti, A., Baronchelli, M., Guerci, G., Laini, L., Grisanti, S., Simoncini, E. L., Farina, D., Mazziotti, G., Berruti, A., … Bone Health Group of the ASST Spedali Civili, Brescia. Fat body mass and vertebral fracture progression in women with breast cancer. JAMA Network Open,2024;7(1):e2350950. https://doi.org/10.1001/jamanetworkopen.2023.5095