Metabolically defined body size and body shape phenotypes and risk of postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background Excess body fatness and hyperinsulinemia are both associated with an increased risk of postmenopausal breast cancer. However, whether women with high body fatness but normal insulin levels or those with normal body fatness and high levels of insulin are at elevated risk of breast cancer is not known. We investigated the associations of metabolically defined body size and shape phenotypes with the risk of postmenopausal breast cancer in a nested case–control study within the European Prospective Investigation into Cancer and Nutrition. Methods Concentrations of C‐peptide—a marker for insulin secretion—were measured at inclusion prior to cancer diagnosis in serum from 610 incident postmenopausal breast cancer cases and 1130 matched controls. C‐peptide concentrations among the control participants were used to define metabolically healthy (MH; in first tertile) and metabolically unhealthy (MU; >1st tertile) status. We created four metabolic health/body size phenotype categories by combining the metabolic health definitions with normal weight (NW; BMI < 25 kg/m2, or WC < 80 cm, or WHR < 0.8) and overweight or obese (OW/OB; BMI ≥ 25 kg/m2, or WC ≥ 80 cm, or WHR ≥ 0.8) status for each of the three anthropometric measures separately: (1) MHNW, (2) MHOW/OB, (3) MUNW, and (4) MUOW/OB. Conditional logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). Results Women classified as MUOW/OB were at higher risk of postmenopausal breast cancer compared to MHNW women considering BMI (OR = 1.58, 95% CI = 1.14–2.19) and WC (OR = 1.51, 95% CI = 1.09–2.08) cut points and there was also a suggestive increased risk for the WHR (OR = 1.29, 95% CI = 0.94–1.77) definition. Conversely, women with the MHOW/OB and MUNW were not at statistically significant elevated risk of postmenopausal breast cancer risk compared to MHNW women. Conclusion These findings suggest that being overweight or obese and metabolically unhealthy raises risk of postmenopausal breast cancer while overweight or obese women with normal insulin levels are not at higher risk. Additional research should consider the combined utility of anthropometric measures with metabolic parameters in predicting breast cancer risk.
Source: Cancer Medicine
DOI: 10.1002/cam4.5896
Authors: Y. Mahamat‐Saleh, S. Rinaldi, R. Kaaks, C. Biessy, E. M. Gonzalez‐Gil, N. Murphy, C. Le Cornet, J. M. Huerta, S. Sieri, A. Tjønneland, L. Mellemkjær, M. Guevara, K. Overvad, A. Perez‐Cornago, S. Tin Tin, L. Padroni, V. Simeon, G. Masala, A. May, E. Monninkhof, S. Christakoudi, A. K. Heath, K. Tsilidis, A. Agudo, M. B. Schulze, J. Rothwell, C. Cadeau, S. Severi, E. Weiderpass, M. J. Gunter, L. Dossus
Institutions: Centre international de recherche sur le cancer, German Cancer Research Center, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Copenhagen, Danish Cancer Society, Instituto de Salud Pública de Navarra, Navarre Institute of Health Research, Aarhus University, University of Oxford, University of Turin, University of Campania "Luigi Vanvitelli", Utrecht University, University Medical Center Utrecht, King's College London, Imperial College London, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, University of Potsdam, German Institute of Human Nutrition, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Centre de recherche en Epidémiologie et Santé des Populations
Language: English
Topic: Cancer Risks and Factors
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,070
Funders: World Health Organization, Deutsches Krebsforschungszentrum, Centre International de Recherche sur le Cancer, Danish Cancer Society Research Center, Cancer Research UK, National Institute for Health and Care Research, Imperial College London, Institut National de la Santé et de la Recherche Médicale, Bundesministerium für Bildung und Forschung, Cancerfonden, Fondation ARC pour la Recherche sur le Cancer, Ligue Contre le Cancer, Vetenskapsrådet, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Institut Gustave-Roussy, Cancer Research UK Manchester Centre, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, NIHR Imperial Biomedical Research Centre, School of Public Health, Imperial College London
Awards: G1192877484, G1437520050, G2131326840, G2235605558, G2409987178, G2572521044, G2742323354, G3216658785, G3747421453, G375319704, G382879149, G4089957676, G4187108342, G4213141252, G4303038735, Health of vegetarians, G459595259, G4879533352, G5271742736, G5783272435, G5990830295, G6022976577, G6085534252, G6442500046, G6766485657, G7106695023, G7426181285, G7597388277, G7646326732, G8050896463, G8164184896, G8279237360, G8846336397, G8959392569, G8978728421
OpenAlex ID: W4366988680