Metabolic abnormalities and survival among patients with non-metastatic breast cancer

BMC Cancer

Research

Wendy Y. Chen¹  Elizabeth A. Mittendorf²  Elizabeth M. Cespedes Feliciano³  Alexa S. Zimbalist³  Charles Quesenberry³  Bette J. Caan³  Deborah A. R. Dillon⁴ 

[1] Channing Division of Network Medicine, Brigham and Women’s Hospital, 02115, Boston, MA, USA;Department of Medical Oncology, Dana Farber Cancer Institute, 02215, Boston, MA, USA;Division of Breast Surgery, Brigham and Women’s Hospital, 02215, Boston, MA, USA;Breast Oncology, Dana-Farber Brigham Cancer Center, 02215, Boston, MA, USA;Harvard Medical School, 02215, Boston, MA, USA;Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 5Th Floor, 94612, Oakland, CA, USA;Harvard Medical School, 02215, Boston, MA, USA;Department of Pathology, Brigham and Women’s Hospital, 02115, Boston, MA, USA;

关键词: Breast cancer;    Metabolic dysregulation;    Dyslipidemia;    Hyperglycemia;    Breast cancer survival;    Prognosis;   

DOI  :  10.1186/s12885-022-10430-9

 received in 2022-09-01, accepted in 2022-12-09,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundResearch on the impact of metabolic abnormalities on breast cancer prognosis is limited by small samples and assessment of laboratory values at a single time point, often prior to cancer diagnosis and treatment. In this population-based cohort, time-updated laboratory values were adjusted for cancer treatment to assess the association between metabolic risk factors (glucose, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides) and breast cancer survival.Methods13,434 women diagnosed with stage I-III breast cancer from 2005-15 at Kaiser Permanente were included. All outpatient fasting glucose, HDL-C, LDL-C, and triglyceride values from diagnosis through 2019 or death were extracted from electronic medical records. Risk of breast cancer-specific mortality was evaluated with Cox proportional hazards models adjusted for metabolic labs, demographics, body mass index, diabetes, dyslipidemia and anti-hypertensive medications, tumor characteristics (stage, ER and HER2 receptor status) and cancer treatment (use of chemotherapy, tamoxifen, and aromatase inhibitors).ResultsMean (SD) age at diagnosis was 62.3 (11.8) years. Over a median follow-up of 8.6 years, 2,876 patients died; 1,080 of breast cancer. Patients with low HDL-C (≤ 45 vs. > 45 mg/dL) had higher breast cancer-specific mortality (HR, 1.77; 95% CI, 1.53-2.05), as did those with elevated fasting glucose (> 99 vs. 60-99 mg/dL) (HR, 1.19; 95% CI, 1.03-1.37). Elevated levels of triglycerides and LDL-C were not associated with breast cancer-specific mortality.ConclusionsHigh fasting glucose and low HDL-C evaluated over time after cancer diagnosis were associated with higher breast cancer mortality independent of cancer treatments and changes in other metabolic risk factors. Future studies should address whether pharmacologic or lifestyle treatment of glucose and lipids after breast cancer diagnosis can optimize survival outcomes.

【 授权许可】

CC BY   
© The Author(s) 2022

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Fig. 1