Is there an association between body mass index and 21-gene recurrence score?

Pomponio, Maria; Burkbauer, Laura; Goldbach, Macy; Keele, Luke; Allison, Kelly C.; Li, Yun R.; Nazarian, Susanna M.; Tchou, Julia

doi:10.1016/j.suronc.2020.01.007

Cited by 4 publications

(5 citation statements)

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“…One noteworthy finding of this study was the significant association patterns of the 21-gene RS and the individual cancerrelated genes with specific metabolic factors and biomarkers of insulin and the IGF1 axis. Our results were partly in line with recent studies that revealed an inverse relationship between BMI and the RS in postmenopausal women with hormone receptorpositive, HER2-negative breast cancer (23), and a higher proportion of RS <11 in obese patients compared with nonoverweight breast cancer patients (24). Moreover, our findings extended previous evidence by illuminating consistent associations between the 21-gene RS and favorable metabolic profiles, including lower levels of BMI, HOMA-IR, insulin, and C-peptide, and higher levels of HDL.…”

Section: Discussionsupporting

confidence: 93%

21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients

et al. 2021

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BackgroundComprehensive investigations of the associations between 21-gene recurrence assay and metabolic profiles in Chinese breast cancer patients are limited.MethodsWe evaluated the relations of the 21-gene recurrence risk score (RS) and the expression of cancer-related genes with metabolic factors and biomarkers of insulin and the insulin-like growth factor (IGF) axis, and examined the interactions between the 21-gene RS and these metabolic profiles on breast cancer recurrence in Chinese women with HR-positive, HER2-negative early-stage breast cancer.ResultsThe 21-gene RS was inversely associated with body mass index ([BMI]β: −0.178 kg/m2; P=0.040), the homeostasis model assessment of insulin resistance index ([HOMA-IR] β: −0.031; P=0.042), insulin (β: −0.036 uIU/ml; P=0.009), and C-peptide (β: −0.021 ug/L; P=0.014) and was positively associated with high-density lipoprotein cholesterol (β: 0.025 mmol/L; P=0.004), which were driven by the relation patterns between specific cancer-related genes and these metabolic profiles. Each 10-unit increase in the 21-gene RS was associated with 28% (95% CI: 5–47%) higher risk of breast cancer recurrence; this association was also observed in patients with favorable metabolic profiles in relevant to an absence of obesity, insulin resistance, hyperglycemia, hypertension, or dyslipidemia (28–44% higher risk) and among women with a low level of insulin, C-peptide, or the IGF1/IGFBP3 ratio (41–155% higher risk).ConclusionsThe 21-gene RS was related to favorable metabolic profiles including lower BMI, HOMA-IR, insulin, and C-peptide, and higher HDL in Chinese breast cancer patients, and its prognostic impact on breast cancer recurrence was more likely to present among patients with relatively favorable metabolic profiles.

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Section: Discussionsupporting

confidence: 93%

21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients

et al. 2021

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“…There were 38 studies 43,45,46,59‐91,211,212 (40 cohorts; 2,361,275 participants) of cancer populations (Table S3); 17 cohorts were in East Asia, 10 cohorts in North America, 7 in Europe, 2 were international cohorts, 2 were in West Asia, and 1 each in South America and Africa. Mean age of participants ranged from 17 to 75 years.…”

Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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SummaryFasting insulin and c‐reactive protein confound the association between mortality and body mass index. An increase in fat mass may mediate the associations between hyperinsulinemia, hyperinflammation, and mortality. The objective of this study was to describe the “average” associations between body mass index and the risk of mortality and to explore how adjusting for fasting insulin and markers of inflammation might modify the association of BMI with mortality. MEDLINE and EMBASE were searched for studies published in 2020. Studies with adult participants where BMI and vital status was assessed were included. BMI was required to be categorized into groups or parametrized as non‐first order polynomials or splines. All‐cause mortality was regressed against mean BMI squared within seven broad clinical populations. Study was modeled as a random intercept. β coefficients and 95% confidence intervals are reported along with estimates of mortality risk by BMIs of 20, 30, and 40 kg/m2. Bubble plots with regression lines are drawn, showing the associations between mortality and BMI. Splines results were summarized. There were 154 included studies with 6,685,979 participants. Only five (3.2%) studies adjusted for a marker of inflammation, and no studies adjusted for fasting insulin. There were significant associations between higher BMIs and lower mortality risk in cardiovascular (unadjusted β −0.829 [95% CI −1.313, −0.345] and adjusted β −0.746 [95% CI −1.471, −0.021]), Covid‐19 (unadjusted β −0.333 [95% CI −0.650, −0.015]), critically ill (adjusted β −0.550 [95% CI −1.091, −0.010]), and surgical (unadjusted β −0.415 [95% CI −0.824, −0.006]) populations. The associations for general, cancer, and non‐communicable disease populations were not significant. Heterogeneity was very large (I2 ≥ 97%). The role of obesity as a driver of excess mortality should be critically re‐examined, in parallel with increased efforts to determine the harms of hyperinsulinemia and chronic inflammation.

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“…Previous studies have suggested that high BMI is associated with low RS in women who are postmenopausal. 16 , 19 In addition, researchers interpreted this correlation based on the theory that enriched adipocytes in women who are obese increase the plasma levels of estradiol and progesterone, 24 , 25 which may curtail the RS by promoting ER and PgR expression in tumors. By contrast, our findings showed an association between high BMI and RS in younger women who were premenopausal.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that a higher BMI was associated with a lower RS in women who were postmenopausal with invasive lobular cancer, 16 which is a principally hormone-driven cancer. 17,18 A study by Pomponio et al 19 suggested that the tumors of women who are postmenopausal with a higher BMI generally have a lower RS, whereas another study reported that the association of BMI with RS interacts with menopausal status, even though patients who are obese are more likely to have an RS less than 11 compared with that of women who are not overweight. 20 We aimed to assess the association between continuous RS and BMI in 2295 patients who had undergone the Oncotype Dx multigene assay after primary surgery.…”

Section: Introductionmentioning

confidence: 99%

Association of Body Mass Index With 21-Gene Recurrence Score Among Women With Estrogen Receptor–Positive, ERBB2–Negative Breast Cancer

et al. 2022

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ImportanceBody mass index (BMI) may affect the 21-gene recurrence score (RS) in patients with ER-positive, ERBB2-negative breast cancer. If high BMI increases genomic risk in ER-positive, ERBB2-negative breast cancer, weight control will become more important.ObjectiveTo assess the association between RS and BMI according to age groups and address BMI as a factor associated with high RS.Design, Setting, and ParticipantsThis cohort study included 2295 patients with ER-positive, ERBB2-negative breast cancer who had undergone a multigene assay between March 29, 2010, and December 31, 2020, in 2 hospitals. All of the study patients were Korean women, and the median follow-up period was 45 months (range, 1-40 months). The correlations between continuous RS and BMI were investigated. A high BMI was defined as a body mass index greater than or equal to 25. In the younger age group (age ≤45 years), a high RS was defined as an RS of greater than 20.ExposuresBody mass index.Main Outcomes and MeasuresThe Pearson correlation coefficient was used to estimate the association between RS and BMI. A multivariable binary logistic model was used to identify high RS.ResultsAmong the 2295 women included (mean [SD] age, 49.8 [4.00] years; range, 22-81 years), 776 were aged 45 years or younger; RS and BMI were weakly correlated (correlation coefficient, 0.119; P &lt; .001) in this younger group. Among them, the proportion of patients with an RS greater than 20 was significantly higher in the high BMI group than in the normal BMI group (45.5% [46 of 101] vs 27.3% [184 of 675]; P &lt; .001). In the multivariable analysis, high BMI was an associated factor for high RS (odds ratio, 2.06; 95% CI, 1.28-3.32; P = .003). The 21-gene multigene assay-guided chemotherapy rate was significantly higher in patients with high BMI (30.7% [31 of 101] vs 20.2% [136 of 674]; P = .02).Conclusions and RelevanceIn this cohort study of women aged 45 years or younger, high BMI was associated with higher RS in those with ER-positive, ERBB2-negative breast cancer; further studies are necessary to examine the underlying mechanisms.

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Is there an association between body mass index and 21-gene recurrence score?

Cited by 4 publications

References 27 publications

21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients

21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Association of Body Mass Index With 21-Gene Recurrence Score Among Women With Estrogen Receptor–Positive, ERBB2–Negative Breast Cancer

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