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Metabolic Factors May Play a Role in Risk for Breast Cancer PHILADELPHIA -- July 3, 2009 -- Physiological changes associated with the metabolic syndrome may play a role in the risk of postmenopausal breast cancer, according to a study published in the journal Cancer Epidemiology, Biomarkers & Prevention. The metabolic syndrome is characterised by elevated insulin levels, and in recent years scientists have proposed that insulin may contribute directly or indirectly to the development of breast cancer. Researchers suspect that the metabolic syndrome could influence the risk for breast cancer by affecting interrelated hormones, such as insulin, estrogen, cytokines, and growth factors. “This study suggests that having the metabolic syndrome itself or some of its components may increase a woman’s risk of postmenopausal breast cancer. However, much more work is needed to understand the role of these metabolic factors and their interplay with better established breast cancer risk factors, such as reproductive and hormonal factors,” said Geoffrey C. Kabat, PhD, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York. Studies to date have evaluated individual components of the metabolic syndrome and breast cancer, with inconsistent results, according to Dr. Kabat. Dr. Kabat and colleagues assessed whether women who met the criteria of having the metabolic syndrome were at greater risk for postmenopausal breast cancer. In the longitudinal study, the researchers used existing data from the Women’s Health Initiative, a large, national study designed to assess major causes of chronic disease in women. Participants included postmenopausal women aged 50 to 79 years at enrollment who had repeated measurements of components of metabolic syndrome over an 8-year period. These included blood levels of glucose, HDL-cholesterol and triglycerides, as well as waist girth and blood pressure Results showed a modest positive association of having the metabolic syndrome as a whole, according to Dr. Kabat. Of the 4,888 women with baseline measurements who did not have diabetes, 165 incident cases of breast cancer were diagnosed during the follow-up period. Presence of the metabolic syndrome at baseline was not associated with breast cancer risk. However, in analyses that made use of the repeated measurements, “women who had the metabolic syndrome during the 3 to 5 years prior to breast cancer diagnosis had roughly a doubling of risk,” he said. Findings also showed significant associations with elevated blood glucose levels, triglycerides, and diastolic blood pressure. For diastolic blood pressure, the result was stronger, with more than a 2-fold increased risk (relative risk = 2.4). Generally, for both triglycerides and glucose the relative risk was about 1.7 for all breast cancer. “We know a great deal about breast cancer, but we can’t identify who is likely to get it. The effect of different variables associated with increased glucose and insulin levels needs to be evaluated further in larger studies,” Dr. Kabat said. “We need to deepen our understanding of these different interrelated behaviors and physiological factors to see how they affect breast cancer.” SOURCE: American Association for Cancer Research E-mail this page to a friend or colleague! To print, use this version