High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease

Minicozzi, Pamela; Berrino, Franco; Sebastiani, Federica; Falcini, Fabio; Vattiato, Rosa; Cioccoloni, Francesca; Calagreti, Gioia; Fusco, Mario; Vitale, Maria Francesca; Tumino, Rosario; Sigona, A; Budroni, Mario; Cesaraccio, Rosaria; Candela, Giuseppa; Scuderi, T.; Zarcone, Maurizio; Campisi, Ildegarda; Sant, Milena

doi:10.1016/j.ejca.2013.08.004

Cited by 59 publications

(43 citation statements)

References 31 publications

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“…To date, only a few studies have evaluated the effect of glucose levels on cancer outcome (28-30). Those studies did not adjust for specific cancer risk factors or variables associated with the metabolic syndrome (such as hypertension and hyperlipidemia); focused on individuals without diabetes; did not evaluate the effect of anti-diabetes medications; and did not measure glucose at the time of cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Serum glucose and hemoglobin A1C levels at cancer diagnosis and disease outcome

Boursi

Giantonio

Haynes

et al. 2016

European Journal of Cancer

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Background Despite the lack of scientific data, many cancer patients hold the belief that glucose “feeds” cancer and might affect disease outcome. We aimed to evaluate associations between glucose, hemoglobin A1C (HbA1C), and survival among individuals with diabetes and diabetes associated cancers. Methods Five retrospective cohort studies were conducted in a large population-representative database. The study population included all patients with diabetes and an incident diagnosis of colorectal, breast, bladder, pancreatic and prostate cancers. Exposure of interest was serum glucose or HbA1C levels within 6 months prior to cancer diagnosis. Cox regression model was used to calculate hazard-ratio (HR) and 95% confidence-interval (CI) for overall survival. Analyses were adjusted for cancer-specific confounders. A subgroup analysis was performed among insulin-treated patients. Results Study cohorts included 7,916 individuals with incident cancers and concurrent diabetes. There was no association between HbA1C levels and overall survival in colorectal (HR 1.00, 95%CI 0.95-1.06), breast (HR 1.03, 95%CI 0.95-1.11), bladder (HR 0.94, 95%CI 0.86-1.01), pancreatic (HR 0.98, 95%CI 0.94-1.02), or prostate (HR 1.02, 95%CI 0.96-1.08) cancers. Among diabetes patients treated with insulin, there was increased survival with increasing serum glucose, most prominent for bladder cancer (HRs 0.91, 95%CI 0.84-0.99, per 1 mmol/L increase). Conclusions Higher glucose and HbA1C levels in diabetes patients with incident cancer are not associated with worse overall survival following cancer diagnosis. Among insulin-treated patients, higher glucose levels may be associated with improved survival.

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Section: Introductionmentioning

confidence: 99%

Serum glucose and hemoglobin A1C levels at cancer diagnosis and disease outcome

Boursi

Giantonio

Haynes

et al. 2016

European Journal of Cancer

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“…General consensus exists on the possibility that type 2 diabetes (T2D) may contribute to breast cancer (BC) risk [1][2][3][4][5][6] and prognosis [7][8][9], but the underlying mechanisms are not completely understood. Hyperinsulinemia, insulin resistance (IR) [7,8,10], and enhanced levels of insulin-like growth factor-1 (IGF-1) [11] have all been proposed as the underlying causative mechanisms, mainly on the basis of in vitro and animal studies supporting a role for insulin, insulin receptor, and IGFs in BC initiation [12][13][14] and progression [15].…”

Section: Introductionmentioning

confidence: 99%

Pretreatment Insulin Levels as a Prognostic Factor for Breast Cancer Progression

et al. 2016

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Background. Based on the hypothesis that impaired glucose metabolism might be associated with survival outcomes independently of overt diabetes, we sought to investigate the prognostic value of routinely used glycemic parameters in a prospective study of breast cancer (BC) patients. Patients and Methods. Fasting blood glucose, insulin and HbA 1c levels, and insulin resistance (assessed by the Homeostasis Model Assessment [HOMA] index) at diagnosis were evaluated in 286 nondiabetic BC patients (249 with primary cancer, 37 with metastatic) with respect to those parameters' possible associations with clinicopathological features and survival outcomes. As a control group, 143 healthy women matched in a 2:1 ratio for age, blood lipid levels, and body mass index were also investigated. Results. Fasting blood glucose level (mean 6 SD: 99 6 26 vs. 85 6 15 mg/dL), insulin level (median: 10.0 vs. 6.8 mIU/mL), and HOMA index (median: 2.2 vs. 1.4), but not HbA 1c level, were

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“…Many of these risk factors are not reversible, but some, such as obesity, could be modified. Numerous observational studies have investigated the association between obesity and BC (De Pergola and Silvestris, 2013;Minicozzi et al, 2013;Ronco et al, 2012;Sangrajrang et al, 2013 ;Renehan et al, 2008;Majeed et al, 2014;Xing et al, 2014). However, there is no universal consensus on the relationship between BMI and BC, especially in population-based studies.…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

Bouguerra

Guissouma²,

Labidi³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Previous studies have suggested a link between obesity and breast cancer (BC). However, there is no universal consensus, especially in population based studies. Because only few studies have been conducted on African women, we aimed here to assess the relationship between BMI at time of diagnosis and the BC histopathological features among Tunisian patients according to menopausal status using a hospital-based prospective cohort study. Materials and Methods: Clinical and pathological data were collected from 262 patients stratified on four groups according to their BMI. The relationship between BMI and histopathological features at diagnosis was analysed using univariate and multivariate analysis. Receiver-operating characteristic (ROC) curves were used to evaluate the performance of BMI in predicting of high tumor grade, in comparison to ki-67 index of proliferation. Results: Obesity was correlated with larger tumors, advanced grade and with ER-PRHer2+ BC subtype. An association of BMI with tumor size and tumor grade was observed in both premenopausal and postmenopausal women. Additionally, a significant association between BMI and ER+, ER+PR+Her2+ and ER-PR-Her2+ status was revealed for premenopausal patients, while only ER+PR+Her2+ was associated with BMI for postmenopausal women. Finally, our results showed that compared to Ki67 proliferation index, BMI is a useful prognostic marker of high grade BC tumors. Conclusions: These data are the first to show that in Tunisia obese women suffering from BC have significantly larger tumors and advanced tumor grade and that higher BMI might influence tumor characteristics and behavior.

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High fasting blood glucose and obesity significantly and independently increase risk of breast cancer death in hormone receptor-positive disease

Cited by 59 publications

References 31 publications

Serum glucose and hemoglobin A1C levels at cancer diagnosis and disease outcome

Serum glucose and hemoglobin A1C levels at cancer diagnosis and disease outcome

Pretreatment Insulin Levels as a Prognostic Factor for Breast Cancer Progression

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

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