Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study

Abstract

Purpose Obesity and insulin resistance have been associated with poor prognosis in breast cancer (BC). The present prospective study aimed to investigate the impact of metabolic syndrome (MetS) and its components on early BC (eBC) patients' outcome. Methods MetS was defined by the presence of 3 to 5 of the following components: waist circumference > 88 cm, blood pressure ≥ 130/≥ 85 mmHg, serum levels of triglycerides ≥ 150 mg/dL, high density lipoprotein < 50 mg/dL and fasting glucose ≥ 110 mg/dL. Seven hundred and seventeen patients with data on ≥ 4 MetS components at BC diagnosis were enrolled. Study population was divided into two groups: patients with < 3 (non-MetS) vs. ≥ 3 components (MetS). Categorical variables were analyzed by Chi-square test and survival data by log-rank test and Cox proportional hazards regression model. Results Overall, 544 (75.9%) and 173 (24.1%) women were categorized as non-MetS and MetS, respectively. MetS patients were more likely to be older, postmenopausal, and insulin-resistant compared to non-MetS patients (p < 0.05). In multivariate analysis, MetS patients had a numerically higher risk of relapse [disease-free survival (DFS), hazard ratio (HR) 1.51, p = 0.07] and a significantly higher risk of death compared to non-MetS patients [overall survival (OS), HR 3.01, p < 0.0001; breast cancer-specific survival (BCSS), HR 3.16, p = 0.001]. Additionally, patients with 1 to 2 components of MetS had an increased risk of dying compared to patients with 0 components (OS, HR 4.90, p = 0.01; BCSS, HR 6.07, p = 0.02). Conclusions MetS correlated with poor outcome in eBC patients. Among patients without full criteria for MetS diagnosis, the presence of 1 or 2 components of the syndrome may predict for worse survival.

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

“…Current evidence suggests that metabolic syndrome and its components are associated with an increased risk of breast cancer recurrence (3,168). A retrospective study conducted by Ewertz et al (29) assessed the events of locoregional recurrence and distant metastasis among 53,816 women with early-stage breast cancer up to 10 years after diagnosis and showed that obesity may have no effect on the risk of local recurrence (P > 0.05) but had a significant association with distant metastasis 5 to 10 years after diagnosis.…”

“…Metabolic syndrome, also known as insulin resistance syndrome or syndrome X, is a type of multifactorial metabolic disease. The definition of MetS takes into account the presence of at least three factors, namely, abdominal obesity/high body mass index (BMI), insulin resistance, hypertension, hypertriglyceridemia, and low high-density lipoprotein (HDL) (3)(4)(5). The prevalence of obesity has increased rapidly in recent years with the number of overweight/obese people almost doubling since the 1980s, representing one-third of the world's population, and the proportion may reach 57.8 percent by 2030 (6,7).…”

“…Asian women are particularly vulnerable to these diseases because they have greater abdominal and visceral fat than white women with similar BMI (9). Previous studies have confirmed that elderly and postmenopausal women are more susceptible to MetS (3). Several cohort studies and meta-analyses have also highlighted the link between MetS and its components and the prevalence, recurrence, and mortality of various cancers, including breast cancer (4,10,11).…”

“…Epidemiological studies have shown that early menarche, postmenopausal weight gain, a high-fat diet, and long-term use of exogenous estrogen are associated with a high risk of breast cancer ( 2 ). Recent studies have also shown that a specific lifestyle characterized by reduced physical activity and fat-rich dietary habits, refined carbohydrates and animal protein, which consequently causes metabolic syndrome (MetS), plays a crucial role in breast cancer initiation ( 1 , 3 ). Metabolic syndrome, also known as insulin resistance syndrome or syndrome X, is a type of multifactorial metabolic disease.…”

The prevalence of hepatic steatosis and metabolic associated fatty liver disease among breast cancer survivors

“…[6] HS is fundamental for the diagnosis of MAFLD, which also emerges in breast cancer patients, leading to adverse outcomes. [7,8] Female breast cancer has surpassed lung cancer as the most commonly diagnosed malignant tumor [9]. Great levels of obesity and physical inactivity, are closely correlated to BC and become a signi cant drive for the trends of growing BC prevalence.…”