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Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study

Oh SW, Park CY, Lee ES, Yoon YS, Lee ES, Park SS, Kim Y, Sung NJ, Yun YH, Lee KS, Kang HS, Kwon Y, Ro J - Breast Cancer Res. (2011)

Bottom Line: Leptin did not show any associations (P for trend >0.05).These findings were not observed in the case of ER/PR-positive patients.Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.

Affiliation: Center for Obesity, Nutrition, and Metabolism, Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 814 Siksa-Dong, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, 410-773, Korea. osw6021@yahoo.co.kr

ABSTRACT

Introduction: Several in vitro studies have suggested the effects of adipokines and insulin resistance on breast cancer cell proliferation and survival. However, little is known about the clinical significance of these findings.

Methods: We examined associations between breast cancer recurrence and adiponectin, leptin, insulin resistance, and metabolic syndrome (MetS) in a cohort of 747 patients from 2001 to 2004.

Results: Adjusted hazard ratios showed an inverse trend across the quartiles for serum adiponectin concentration in estrogen receptor (ER)/progesterone receptor (PR) -negative patients (P for trend = 0.027) but not in ER/PR-positive patients. Compared to the highest quartile for adiponectin level, the lowest quartile showed a hazard ratio of 2.82 (1.03 to 7.68). Homeostasis model assessment for insulin resistance (HOMA-IR) showed a positive trend for recurrence in the ER/PR-negative group (P for trend = 0.087) and a negative trend in the ER/PR-positive group (P for trend = 0.081). Leptin did not show any associations (P for trend >0.05). A linear trend was observed with the number of components of MetS in ER/PR-negative patients (P for trend = 0.044). This association disappeared when adjusted for adiponectin and HOMA-IR.

Conclusions: Adiponectin and HOMA-IR have prognostic significance in breast cancer recurrence and interventions related to these factors may protect against recurrence in ER/PR-negative patients. These findings were not observed in the case of ER/PR-positive patients. Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.

Kaplan-Meier cumulative recurrence curves for breast cancer patients in the estrogen receptor/progesterone receptor positive group. The P-values for trend were calculated using the log-rank test for trend across the quartiles of adiponectin, leptin, HOMA-IR, and insulin. The hatch marks on the curves indicate times when patients were censored.
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Figure 2: Kaplan-Meier cumulative recurrence curves for breast cancer patients in the estrogen receptor/progesterone receptor positive group. The P-values for trend were calculated using the log-rank test for trend across the quartiles of adiponectin, leptin, HOMA-IR, and insulin. The hatch marks on the curves indicate times when patients were censored.

Mentions: In the ER/PR-negative group, serum adiponectin concentrations showed an inverse association with breast cancer recurrence according to the log-rank test for trend (P for trend = 0.009; Figure 1). HOMA-IR values showed a positive trend with borderline significance in the ER/PR-negative group (P-value for trend = 0.078), whereas insulin levels did not (P-value for trend = 0.450). Contrary to this finding, inverse associations for HOMA-IR and insulin with cancer recurrence were observed in the ER/PR-positive group with borderline significance (P for trend = 0.096 and 0.078; Figure 2).

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Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study

Oh SW, Park CY, Lee ES, Yoon YS, Lee ES, Park SS, Kim Y, Sung NJ, Yun YH, Lee KS, Kang HS, Kwon Y, Ro J - Breast Cancer Res. (2011)

Kaplan-Meier cumulative recurrence curves for breast cancer patients in the estrogen receptor/progesterone receptor positive group. The P-values for trend were calculated using the log-rank test for trend across the quartiles of adiponectin, leptin, HOMA-IR, and insulin. The hatch marks on the curves indicate times when patients were censored.
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Figure 2: Kaplan-Meier cumulative recurrence curves for breast cancer patients in the estrogen receptor/progesterone receptor positive group. The P-values for trend were calculated using the log-rank test for trend across the quartiles of adiponectin, leptin, HOMA-IR, and insulin. The hatch marks on the curves indicate times when patients were censored.
Mentions: In the ER/PR-negative group, serum adiponectin concentrations showed an inverse association with breast cancer recurrence according to the log-rank test for trend (P for trend = 0.009; Figure 1). HOMA-IR values showed a positive trend with borderline significance in the ER/PR-negative group (P-value for trend = 0.078), whereas insulin levels did not (P-value for trend = 0.450). Contrary to this finding, inverse associations for HOMA-IR and insulin with cancer recurrence were observed in the ER/PR-positive group with borderline significance (P for trend = 0.096 and 0.078; Figure 2).

Bottom Line: Leptin did not show any associations (P for trend >0.05).These findings were not observed in the case of ER/PR-positive patients.Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.

Affiliation: Center for Obesity, Nutrition, and Metabolism, Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 814 Siksa-Dong, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, 410-773, Korea. osw6021@yahoo.co.kr

ABSTRACT

Background:

Introduction: Several in vitro studies have suggested the effects of adipokines and insulin resistance on breast cancer cell proliferation and survival. However, little is known about the clinical significance of these findings.

Methods: We examined associations between breast cancer recurrence and adiponectin, leptin, insulin resistance, and metabolic syndrome (MetS) in a cohort of 747 patients from 2001 to 2004.

Results: Adjusted hazard ratios showed an inverse trend across the quartiles for serum adiponectin concentration in estrogen receptor (ER)/progesterone receptor (PR) -negative patients (P for trend = 0.027) but not in ER/PR-positive patients. Compared to the highest quartile for adiponectin level, the lowest quartile showed a hazard ratio of 2.82 (1.03 to 7.68). Homeostasis model assessment for insulin resistance (HOMA-IR) showed a positive trend for recurrence in the ER/PR-negative group (P for trend = 0.087) and a negative trend in the ER/PR-positive group (P for trend = 0.081). Leptin did not show any associations (P for trend >0.05). A linear trend was observed with the number of components of MetS in ER/PR-negative patients (P for trend = 0.044). This association disappeared when adjusted for adiponectin and HOMA-IR.

Conclusions: Adiponectin and HOMA-IR have prognostic significance in breast cancer recurrence and interventions related to these factors may protect against recurrence in ER/PR-negative patients. These findings were not observed in the case of ER/PR-positive patients. Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.

View Similar Images In: Results  - Collection
View Article: Pubmed Central - HTML -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=3219197&rFormat=json&query=null&req=5