Diabetes, Overweight and Risk of Postmenopausal Breast Cancer: A Case-Control Study in Uruguay

Abstract

Obese postmenopausal women increase their risk of developing breast cancer (BC), in particular if they display an android-type pattern of adiposity, which is also associated to increased risks of diabetes mellitus, hypertension and cardiovascular disease. In order to explore the associations among anthropometry (body mass index, body composition, somatotype), some specific items of medical history (diabetes, hypertension, dislypidemias, hyperuricemia) and the risk of BC in Uruguayan women, a case-control study was carried out between 2004-2009 at our Oncology Unit. 912 women of ages between 23-69 years (367 new BC cases and 545 non hospitalized, age-matched controls with a normal mammography) were interviewed. Twenty body measurements were taken in order to calculate body composition and somatotype. Patients were queried on socio-demographics, reproductive history, family history of cancer, a brief food frequency questionnaire and on personal history of diabetes, dislypidemias, hyperuricemia, hypertension and gallbladder stones. Uni-and multivariate analyses were done, generating odds ratios (ORs) as an expression of relative risks. A personal history of diabetes was positively associated to BC risk (OR=1.64, 95% CI 1.00-2.69), being higher among postmenopausal women (OR=1.92, 95% CI 1.04-3.52). The risks of BC for diabetes in postmenopausal women with overweight combined with dislypidemia (OR=9.33, 95% CI 2.10-41.5) and high fat/muscle ratio (OR=7.81, 95% CI 2.01-30.3) were significantly high. As a conclusion, a personal history of diabetes and overweight was strongly associated to BC. The studied sample had a subset of high-risk of BC featured by postmenopausal overweight and diabetic women, who also had a personal history of hypertension and/or dyslipidemia. The present results could contribute to define new high risk groups and individuals for primary as well as for secondary prevention, since this pattern linked to the metabolic syndrome is usually not considered for BC prevention.

Risk Factors for Premenopausal Breast Cancer: A Case-control Study in Uruguay

“…Formulas applied to calculate body composition and ST as well as additional details of the techniques were described in our recent paper on diabetes and overweight in postmenopausal BC (Ronco et al, 2012b).…”

Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies

“…Populations differed regarding several risk factors and increased hormone concentrations were positively associated with body mass index (BMI; Chart 2) 38 . The study of Ronco et al was the only one that identified diabetes as a risk factor for BC (Chart 2) 42 . The authors determined the risk of diabetes in combination with overweight, high fat-to-muscle ratio and hypertension (Chart 2) 42 .…”

“…The study of Ronco et al was the only one that identified diabetes as a risk factor for BC (Chart 2) 42 . The authors determined the risk of diabetes in combination with overweight, high fat-to-muscle ratio and hypertension (Chart 2) 42 . In a similar study, Bering et al described a high prevalence of increased body mass index (BMI), high levels by Amadou et al 30 .…”

“…Risk factors were subdivided into four main categories: Lifestyle-related, reproductive, socio economic and environmental risk factors, respectively, a category of history of BC (Chart 2). Several authors have analysed risk factors of all four categories 30,34,37,38,[40][41][42] . Two studies performed in Uruguay for example, included a broad range of different risk factors 41,42 .…”

“…Several authors have analysed risk factors of all four categories 30,34,37,38,[40][41][42] . Two studies performed in Uruguay for example, included a broad range of different risk factors 41,42 . The author's decision to analyse several distinct and unrelated risk factors may have been influenced by the high incidence of BC in Uruguay.…”