Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: A nested case–control study

Abstract

Background and aims The increase in breast cancer incidence over recent decades has been accompanied by an increase in the frequency of metabolic syndrome. Several studies suggest that breast cancer risk is associated with the components of metabolic syndrome (high serum glucose and triglycerides, low HDL-cholesterol, high blood pressure, and abdominal obesity), but no prospective study has investigated risk in relation to the presence of explicitly defined metabolic syndrome. We investigated associations between metabolic syndrome, its components, and breast cancer risk in a nested case-control study on postmenopausal women of the ORDET cohort. Methods and results After a median follow-up of 13.5 years, 163 women developed breast cancer; metabolic syndrome was present in 29.8%. Four matched controls per case were selected by incidence density sampling, and rate ratios were estimated by conditional logistic regression. Metabolic syndrome (i.e. presence of three or more metabolic syndrome components) was significantly associated with breast cancer risk (rate ratio 1.58 [95% confidence interval 1.07–2.33]), with a significant risk increase for increasing number of components (P for trend 0.004). Among individual metabolic syndrome components, only low serum HDL-cholesterol and high triglycerides were significantly associated with increased risk. Conclusions This prospective study indicates that metabolic syndrome is an important risk factor for breast cancer in postmenopausal women. Although serum HDL-cholesterol and triglycerides had the strongest association with breast cancer, all components may contribute to increased risk by multiple interacting mechanisms. Prevention or reversal of metabolic syndrome by life-style changes may be effective in preventing breast cancer in postmenopausal women.

Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

“…Indeed, serum total estradiol levels have been shown to be related to BMI, with an inverse U-shape before 17,18 and a linear increase after menopause. 12 Furthermore, the possible relationship between central obesity and breast cancer risk is consistent with a role of insulin resistance in pre-and postmenopausal women, 12,13,19,20 as central obesity is a predictor of insulin resistance independently of general obesity. 13 To clarify potential associations between various anthropometric measures and breast cancer risk according to menopausal status and to the hormone receptor status of the cancer, we used data from the large French prospective E3N cohort that provided detailed information on HC, WC, WHR, height, weight and BMI.…”

Metabolic syndrome affects breast cancer risk in postmenopausal women: National Cancer Institute of Naples experience

“…Women were asked to answer a questionnaire about chronic diseases, tobacco use, alcohol abuse, food intake, physical activity grade, parity, age of menarche, menopausal status, oral contraceptive use, hormonal therapy use, personal and familial history of cancer. According to the NCEP ATP III, 10 women presenting three disorders were diagnosed with low grade MS, 5 whereas women presenting more than three disorders (four or five) were diagnosed with high grade MS. Chi-squared test and logistic regression analyses (OR and 95% CI) were used to confirm the association between MS and breast cancer and to calculate the risk. Statistical significance was considered at p < 0.05. outcomes of our study suggest that visceral adiposity, with android fat distribution, hyperinsulinemia and free androgen fraction increasing in postmenopausal women contribute to breast carcinogenesis.…”

“…[4][5][6][7] Physical inactivity and saturated fatty diet contribute to the spread of overweight and obesity. [7][8][9] Central body fat and insulin resistance in overweight and obese women appear to be crucial in determining MS. 10 MS, according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), can be defined as the presence of at least three of postmenopausal women show the highest incidence of breast cancer in the female population and are often affected by metabolic syndrome.…”

High-Density Lipoprotein-Cholesterol, Daily Estradiol and Progesterone, and Mammographic Density Phenotypes in Premenopausal Women

“…On the basis of recent observations (11,25,29) and biologic mechanisms hypothesized (1, 7,30), the main aim of this exploratory hypothesis generating study was to explore whether differences in HDL-C, alone or in combination with cyclic estrogen and progesterone, assessed both in serum and in saliva, were associated with mammographic density phenotypes among premenopausal women.…”