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The influence of overweight and insulin resistance on breast cancer risk and tumour stage at diagnosis : A prospective study

Cust, Anne E. ; Stocks, Tanja LU ; Lukanova, Annekatrin ; Lundin, Eva ; Hallmans, Göran ; Kaaks, Rudolf ; Jonsson, Håkan LU and Stattin, Pär (2009) In Breast Cancer Research and Treatment 113(3). p.567-576
Abstract

It is hypothesized that insulin resistance and related metabolic factors may influence breast cancer risk, however the epidemiological evidence remains inconclusive. We conducted a case-control study nested in a prospective cohort in Northern Sweden, to clarify the associations of body mass index (BMI), leptin, adiponectin, C-peptide, and glycated haemoglobin (HbA1c) with breast cancer risk. We also investigated whether these associations may be modified by age at diagnosis, tumour stage, and oestrogen and progesterone receptor status. During follow-up, 561 women developed invasive breast cancer and 561 matched controls were selected. Conditional logistic regression was used to calculate odds ratios (OR) as estimates of relative risk,... (More)

It is hypothesized that insulin resistance and related metabolic factors may influence breast cancer risk, however the epidemiological evidence remains inconclusive. We conducted a case-control study nested in a prospective cohort in Northern Sweden, to clarify the associations of body mass index (BMI), leptin, adiponectin, C-peptide, and glycated haemoglobin (HbA1c) with breast cancer risk. We also investigated whether these associations may be modified by age at diagnosis, tumour stage, and oestrogen and progesterone receptor status. During follow-up, 561 women developed invasive breast cancer and 561 matched controls were selected. Conditional logistic regression was used to calculate odds ratios (OR) as estimates of relative risk, and 95% confidence intervals (CI). The associations of BMI, leptin and HbA1c with breast cancer risk differed significantly according to whether the tumour was diagnosed as stage I or stage II-IV (P heterogeneity all <0.05). These factors were significantly inversely associated with risk in the group of stage I tumours, with ORs for top vs. bottom tertile for BMI of 0.48 (95% CI, 0.30-0.78, P trend = 0.004); leptin, 0.64 (95% CI, 0.41-1.00, P trend = 0.06); and HbA1c, 0.47 (95% CI, 0.28-0.80, P trend = 0.005). For stage II-IV tumours, there was a suggestion of an increased risk with higher levels of these factors. There were no significant differences in the associations of BMI, leptin, adiponectin, C-peptide and HbA1c with breast cancer risk in subgroups of age at diagnosis or tumour receptor status. This prospective study suggests that BMI, leptin and HbA1c influence breast tumour initiation and progression.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adiponectin, Breast cancer, C-peptide, Glycated haemoglobin, Leptin, Obesity, Overweight
in
Breast Cancer Research and Treatment
volume
113
issue
3
pages
10 pages
publisher
Springer
external identifiers
  • pmid:18330696
  • scopus:58549088152
ISSN
0167-6806
DOI
10.1007/s10549-008-9958-8
language
English
LU publication?
no
id
9fc9dd42-fa0b-4c52-90c6-c7ad980a84c8
date added to LUP
2019-05-31 09:20:56
date last changed
2020-01-16 03:57:39
@article{9fc9dd42-fa0b-4c52-90c6-c7ad980a84c8,
  abstract     = {<p>It is hypothesized that insulin resistance and related metabolic factors may influence breast cancer risk, however the epidemiological evidence remains inconclusive. We conducted a case-control study nested in a prospective cohort in Northern Sweden, to clarify the associations of body mass index (BMI), leptin, adiponectin, C-peptide, and glycated haemoglobin (HbA1c) with breast cancer risk. We also investigated whether these associations may be modified by age at diagnosis, tumour stage, and oestrogen and progesterone receptor status. During follow-up, 561 women developed invasive breast cancer and 561 matched controls were selected. Conditional logistic regression was used to calculate odds ratios (OR) as estimates of relative risk, and 95% confidence intervals (CI). The associations of BMI, leptin and HbA1c with breast cancer risk differed significantly according to whether the tumour was diagnosed as stage I or stage II-IV (P <sub>heterogeneity</sub> all &lt;0.05). These factors were significantly inversely associated with risk in the group of stage I tumours, with ORs for top vs. bottom tertile for BMI of 0.48 (95% CI, 0.30-0.78, P <sub>trend</sub> = 0.004); leptin, 0.64 (95% CI, 0.41-1.00, P <sub>trend</sub> = 0.06); and HbA1c, 0.47 (95% CI, 0.28-0.80, P <sub>trend</sub> = 0.005). For stage II-IV tumours, there was a suggestion of an increased risk with higher levels of these factors. There were no significant differences in the associations of BMI, leptin, adiponectin, C-peptide and HbA1c with breast cancer risk in subgroups of age at diagnosis or tumour receptor status. This prospective study suggests that BMI, leptin and HbA1c influence breast tumour initiation and progression.</p>},
  author       = {Cust, Anne E. and Stocks, Tanja and Lukanova, Annekatrin and Lundin, Eva and Hallmans, Göran and Kaaks, Rudolf and Jonsson, Håkan and Stattin, Pär},
  issn         = {0167-6806},
  language     = {eng},
  month        = {02},
  number       = {3},
  pages        = {567--576},
  publisher    = {Springer},
  series       = {Breast Cancer Research and Treatment},
  title        = {The influence of overweight and insulin resistance on breast cancer risk and tumour stage at diagnosis : A prospective study},
  url          = {http://dx.doi.org/10.1007/s10549-008-9958-8},
  doi          = {10.1007/s10549-008-9958-8},
  volume       = {113},
  year         = {2009},
}