Research article
Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study
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* Corresponding authors: Sang W Oh osw6021@yahoo.co.kr - Jungsil Ro jungsro@ncc.re.kr
- † Equal contributors
1 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
2 Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Chongno-Gu, Seoul, 110-746, Korea
3 Department of Breast and Endocrine Surgery, College of Medicine, Korea University, 126-1 Anam-Dong 5-Ga, Seongbuk-Gu, Seoul, 136-705, Korea
4 Department of Family Medicine, Inje University Ilsan Paik Hospital, 2240 Daehwa-Dong, Ilsanseo-Gu, Goyang, Gyeonggi-Do, 411-706, Korea
5 Department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4458, USA
6 Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center, 809 MadAu-Dong, Ilsan-Gu, Goyang-Si, Gyeonggi-Do, 411-769, Korea
7 Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 809 Madu-Dong, Ilsan-Gu, Goyang-Si, Gyeonggi-Do, 411-769, Korea
Breast Cancer Research 2011, 13:R34 doi:10.1186/bcr2856
Published: 30 March 2011Abstract
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.