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Fluctuations in depression and anxiety predict dysregulated leptin among obese breast cancer survivors

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Abstract

Purpose

Leptin influences inflammation and tumor growth and leptin signaling is often dysregulated among obese breast cancer survivors. This leads to a lack of satiety and, ultimately, risk for further weight gain. Breast cancer survivors also experience high rates of depression and anxiety, which are linked to leptin production. This study examined how a woman’s anxiety and depressive symptoms, in combination with their obesity status, were associated with leptin.

Methods

Breast cancer survivors (n = 200, stages 0–IIIa) completed a baseline visit before treatment and two follow-up visits, 6 and 18 months after treatment ended. Women completed anxiety and depression measures, and blood samples provided leptin data at each visit. This study related fluctuations in a survivor’s own depression and anxiety (i.e., within-person effects), as well as average effects of depression and anxiety (i.e., between-person effects) to changes in leptin depending on BMI.

Results

Obese survivors’ leptin was significantly higher at visits when they had higher anxiety and depression symptoms than their own average level of symptoms. In contrast, within-person fluctuations in depression and anxiety were not related to leptin levels among non-obese survivors. No significant between-person effects of depression or anxiety on leptin emerged.

Conclusions

Leptin is a critical risk factor for recurrence and further health consequences. Our findings highlight how psychological health influences leptin production among breast cancer survivors.

Implications for Cancer Survivors

These results highlight a biological pathway that may facilitate further weight gain and health risks among distressed, obese breast cancer survivors.

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Funding

This work was supported in part by National Institute of Health grants CA131029, UL1TR0000090, CA016058, K05 CA172296, and T32 CA229114.

Author information

Authors and Affiliations

  1. Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, USA

    Megan E. Renna, M. Rosie Shrout, Annelise A. Madison & Janice K. Kiecolt-Glaser

  2. Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA

    Megan E. Renna, Stephen P. Povoski, Doreen M. Agnese & William E. Carson III

  3. Department of Psychology, The Ohio State University, Columbus, OH, USA

    Annelise A. Madison

  4. Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA

    Lisa M. Jaremka

  5. Northwell Health Cancer Institute & Center for Personalized Health, New York, NY, USA

    Catherine M. Alfano

  6. Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA

    Stephen P. Povoski, Doreen M. Agnese & William E. Carson III

  7. Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA

    Janice K. Kiecolt-Glaser

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  1. Megan E. Renna
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Correspondence to Megan E. Renna.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of The Ohio State University’s institutional research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Renna, M.E., Shrout, M.R., Madison, A.A. et al. Fluctuations in depression and anxiety predict dysregulated leptin among obese breast cancer survivors. J Cancer Surviv 15, 847–854 (2021). https://doi.org/10.1007/s11764-020-00977-6

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  • DOI: https://doi.org/10.1007/s11764-020-00977-6

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