<p>Biomarkers of Insulin and the Insulin-Like Growth Factor Axis in Relation to Breast Cancer Risk in Chinese Women</p>

Abstract

Background: The interplay between biomarkers of insulin and the insulin-like growth factor (IGF) axis in the context of breast cancer risk is unclear. Methods: We measured the concentrations of insulin, C-peptide, IGF1, and IGF binding protein 3 (IGFBP3) and calculated the homeostasis model assessment of insulin resistance (HOMA-IR) index and the IGF1/IGFBP3 ratio among 2536 patients with breast cancer and 2528 patients with benign breast disease recruited from Ruijin Hospital, Shanghai, China, between 2012 and 2017. Results: Multivariable-adjusted odds ratios (ORs) for breast cancer associated with the highest quartiles versus the lowest quartiles of insulin and IGF factors were 1.45 (95% CI, 1.20-1.75) for insulin, 1.32 (1.08-1.60) for C-peptide, 1.53 (1.26-1.85) for HOMA-IR, and 1.27 (1.05-1.53) for IGF1; these associations did not differ substantially across stratifications of age, body mass index, age at menarche, or menopausal status (all P for interaction >0.05). In the joint analysis, the highest quartile of IGF1 was associated with the greatest risk of breast cancer in the highest quartiles of insulin (OR, 1.77; 95% CI, 1.29-2.44), C-peptide (1.60; 1.17-2.20), and HOMA-IR (1.90; 1.38-2.62), compared with the risks associated with the combination of the lowest quartiles of IGF1 and each insulin factor. In stratification analysis, the positive association between IGF1 and breast cancer was stronger in the highest quartiles of insulin (P[interaction] = 0.29), C-peptide (P[interaction] = 0.020), and HOMA-IR (P[interaction] = 0.075). Conclusion: Our findings indicate effect modifications of insulin, C-peptide, and insulin resistance on the relationship between IGF1 and breast cancer risk in Chinese women.

Association between triglyceride glucose index and breast cancer in 142,184 Chinese adults: findings from the REACTION study

“…Preclinical and clinical studies suggested complex associations between diabetes, especially type 2 diabetes with breast cancer ( 15 ). Our results showed that patients with breast cancer have significantly higher insulin levels than those without breast cancer, which is consistent with the previous evidence ( 7 ). As part of the important causes of diabetes, hyperinsulinemia and IR have been shown to be risk factors for breast cancer ( 4 – 7 , 16 ).…”

Metabolic Syndrome and Breast Cancer: Prevalence, Treatment Response, and Prognosis

“…In addition, hyperinsulinemia associated with insulin resistance is also correlated with a high risk of breast cancer. Zhu et al (46) found that the OR for breast cancer associated with the highest quartile versus the lowest quartile of insulin was 1.45 (95% CI 1.20-1.75). Elevated insulin levels can cause high insulin growth factor-1 (IGF-1) bioavailability, leading to the occurrence and proliferation of breast cancer (10).…”

The relationship between the insulinemic potential of diet and lifestyle and risk of breast cancer: a case-control study among iranian adult women

“…Insulin is a key regulator hormone in cell growth and energy metabolism. Up-regulation of insulin secretion and insulin resistance results in elevated IGF-1 production and bioavailability, resulting in cell proliferation and tumor growth [ 25 ]. It should be noted that dietary insulin indices are related to insulin resistance [ 26 ].…”