Metabolic syndrome (MetS) is a common feature in obesity, comprising a cluster of abnormalities including abdominal fat accumulation, hyperglycemia, hyperinsulinemia, dyslipidemia, and hypertension, leading to diabetes and cardiovascular diseases (CVD). Intake of carbohydrates (CHO), particularly a sugary diet that rapidly increases blood glucose, triglycerides, and blood pressure levels is the predominant determining factor of MetS. Complex CHO, on the other hand, are a stable source of energy taking a longer time to digest. In particular, resistant starch (RS) or soluble fiber is an excellent source of prebiotics, which alter the gut microbial composition, which in turn improves metabolic control. Altering maternal CHO intake during pregnancy may result in the child developing MetS. Furthermore, lifestyle factors such as physical inactivity in combination with dietary habits may synergistically influence gene expression by modulating genetic and epigenetic regulators transforming childhood obesity into adolescent metabolic disorders. This review summarizes the common pathophysiology of MetS in connection with the nature of CHO, intrauterine nutrition, genetic predisposition, lifestyle factors, and advanced treatment approaches; it also emphasizes how dietary CHO may act as a key element in the pathogenesis and future therapeutic targets of obesity and MetS.

Background and aims: Aberrant insulin-like growth factor (IGFs) signaling is directly implicated in oncogenesis and metastasis in various solid tumors including breast cancer. Targeting the IGF axis may provide an insight into the mechanism of cancer stemness and therapy resistance. The present study aims to explore the association of the circulatory levels of these proteins in aggressive triple-negative breast cancer (TNBC) in Bangladesh. Methods: A total of 165 BC patients were recruited in the present study where 42 were TNBC subjects (selected based on their complete hormonal profile). Data were collected from retrospective information. Anthropometric and biochemical parameters were measured by standard methods. Serum IGF1, IGFBP1, and insulin were estimated by ELISA. Results: TNBC subjects showed significantly higher levels of circulatory IGF1 (185 vs 145, p=0.004), while patients who had distant metastasis showed increased levels of IGF1, IGFBP1, and alkaline phosphatase (ALP) [178 vs 153, p=0.001; 6.44 vs 3.05, and 140 vs 88, p<0.05; metastatic vs non-metastatic BC respectively]. In addition, serum IGF1 was positively associated with serum insulin levels and IGFBP1 was associated with ALP, SGPT, CA15.3, and duration of OCP (p<0.05). In multivariate regression, IGF1 was found to be a significant predictor of breast cancer survival after adjusting confounding variables. Conclusion: High serum levels of IGF1 may contribute to metastasis in basal breast cancer in a Bangladeshi population. These results need to be confirmed in larger TNBC survivor cohorts. Citation Format: Salima Akter, Mithila Faruque, Hajara Akhter, Mousumi Bhowmik, Mohammad Nazmul Hasan, Lipika Sultana, Imran Khan, Mamun Mia, Md. Mustafizur Rahman, Habib Sadat Chaudhury, Islam S. Rafiqul, Kamrun Nahar, Tae Gyu Choi, Sung Soo Kim. Circulatory insulin-like growth factor 1 predicts metastasis in triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1526.