The influence of overweight and insulin resistance on breast cancer risk and tumour stage at diagnosis : a prospective study
Identifieur interne : 008024 ( Main/Exploration ); précédent : 008023; suivant : 008025The influence of overweight and insulin resistance on breast cancer risk and tumour stage at diagnosis : a prospective study
Auteurs : Anne E. Cust [Australie, France] ; Tanja Stocks [Suède] ; Annekatrin Lukanova [Allemagne] ; Eva Lundin [Suède] ; Göran Hallmans [Suède] ; Rudolf Kaaks [Allemagne] ; Hakan Jonsson [Suède] ; P R Stattin [Suède]Source :
- Breast cancer research and treatment [ 0167-6806 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Prospective.
English descriptors
- KwdEn :
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 (HbAlc) 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 HbAlc with breast cancer risk differed significantly according to whether the tumour was diagnosed as stage I or stage II-IV (Pheterogencity 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, Ptrend = 0.004); leptin, 0.64 (95% CI, 0.41-1.00, Ptrend = 0.06); and HbAlc, 0.47 (95% CI, 0.28-0.80, Ptrend = 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 HbAlc with breast cancer risk in subgroups of age at diagnosis or tumour receptor status. This prospective study suggests that BMI, leptin and HbAlc influence breast tumour initiation and progression.
Affiliations:
- Allemagne, Australie, France, Suède
- Auvergne-Rhône-Alpes, Bade-Wurtemberg, District de Karlsruhe, Nouvelle-Galles du Sud, Rhône-Alpes, Victoria (État)
- Heidelberg, Lyon, Melbourne, Sydney
- Université de Melbourne, Université de Sydney
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Cust</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Centre for MEGA Epidemiology, The University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>School of Public Health, The University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Nutrition and Hormones Unit, International Agency for Research on 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University</s1><s2>UmeÅ</s2><s3>SWE</s3><sZ>5 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>UmeÅ</wicri:noRegion></affiliation></author><author><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Division of Cancer Epidemiology, German Cancer Research Center</s1><s2>Heidelberg</s2><s3>DEU</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Jonsson, Hakan" sort="Jonsson, Hakan" uniqKey="Jonsson H" first="Hakan" last="Jonsson">Hakan Jonsson</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Radiation Sciences, Oncology, UmeÅ University</s1><s2>UmeÅ</s2><s3>SWE</s3><sZ>7 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>UmeÅ</wicri:noRegion></affiliation></author><author><name sortKey="Stattin, P R" sort="Stattin, P R" uniqKey="Stattin P" first="P R" last="Stattin">P R Stattin</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Surgical and Perioperative Sciences, Urology and Andrology, UmeÅ University</s1><s2>901 85 UmeÅ</s2><s3>SWE</s3><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>901 85 UmeÅ</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adipokine</term><term>Adiponectin</term><term>Breast cancer</term><term>C-Peptide</term><term>Clinical stage</term><term>Diagnosis</term><term>Hemoglobin A1c</term><term>Insulin</term><term>Insulin resistance</term><term>Leptin</term><term>Nutritional status</term><term>Obesity</term><term>Overweight</term><term>Peptide hormone</term><term>Prospective</term><term>Risk factor</term><term>Target tissue resistance</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Surcharge pondérale</term><term>Résistance tissu cible</term><term>Insuline</term><term>Insulinorésistance</term><term>Cancer du sein</term><term>Facteur risque</term><term>Stade clinique</term><term>Diagnostic</term><term>Prospective</term><term>Adiponectine</term><term>Peptide C</term><term>Hormone peptide</term><term>Hémoglobine A1c</term><term>Leptine</term><term>Adipokine</term><term>Obésité</term><term>Etat nutritionnel</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Prospective</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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 (HbAlc) 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 HbAlc with breast cancer risk differed significantly according to whether the tumour was diagnosed as stage I or stage II-IV (P<sub>heterogencity</sub> 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<sub>trend</sub> = 0.004); leptin, 0.64 (95% CI, 0.41-1.00, P<sub>trend</sub> = 0.06); and HbAlc, 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 HbAlc with breast cancer risk in subgroups of age at diagnosis or tumour receptor status. This prospective study suggests that BMI, leptin and HbAlc influence breast tumour initiation and progression.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>Suède</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Bade-Wurtemberg</li><li>District de Karlsruhe</li><li>Nouvelle-Galles du Sud</li><li>Rhône-Alpes</li><li>Victoria (État)</li></region><settlement><li>Heidelberg</li><li>Lyon</li><li>Melbourne</li><li>Sydney</li></settlement><orgName><li>Université de Melbourne</li><li>Université de Sydney</li></orgName></list><tree><country name="Australie"><region name="Victoria (État)"><name sortKey="Cust, Anne E" sort="Cust, Anne E" uniqKey="Cust A" first="Anne E." last="Cust">Anne E. Cust</name></region><name sortKey="Cust, Anne E" sort="Cust, Anne E" uniqKey="Cust A" first="Anne E." last="Cust">Anne E. Cust</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Cust, Anne E" sort="Cust, Anne E" uniqKey="Cust A" first="Anne E." last="Cust">Anne E. Cust</name></region></country><country name="Suède"><noRegion><name sortKey="Stocks, Tanja" sort="Stocks, Tanja" uniqKey="Stocks T" first="Tanja" last="Stocks">Tanja Stocks</name></noRegion><name sortKey="Hallmans, Goran" sort="Hallmans, Goran" uniqKey="Hallmans G" first="Göran" last="Hallmans">Göran Hallmans</name><name sortKey="Jonsson, Hakan" sort="Jonsson, Hakan" uniqKey="Jonsson H" first="Hakan" last="Jonsson">Hakan Jonsson</name><name sortKey="Lundin, Eva" sort="Lundin, Eva" uniqKey="Lundin E" first="Eva" last="Lundin">Eva Lundin</name><name sortKey="Stattin, P R" sort="Stattin, P R" uniqKey="Stattin P" first="P R" last="Stattin">P R Stattin</name></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Lukanova, Annekatrin" sort="Lukanova, Annekatrin" uniqKey="Lukanova A" first="Annekatrin" last="Lukanova">Annekatrin Lukanova</name></region><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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