Body Weight, Central Adiposity, and Fasting Hyperglycemia Are Associated with Tumor Characteristics in a Brazilian Cohort of Women with Breast Cancer

Overview

Journal Nutrients

Date 2022 Nov 26

PMID 36432611

Authors

Clara Gioseffi

Patricia de Carvalho Padilha

Gabriela Villaca Chaves

Livia Costa De Oliveira

Wilza Arantes Ferreira Peres

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to evaluate the association of overweight, obesity, excess central adiposity, hyperglycemia, and diabetes mellitus with tumor characteristics in breast cancer. In this retrospective cohort study that enrolled 2127 women with breast cancer, the independent variables collected were fasting blood glucose, body mass index, central adiposity (waist circumference and waist-to-hip circumference ratio (WHR)), and waist-to-height ratio. The tumor characteristics (infiltrating, ductal grade, hormone receptor-positive (HR+), human epidermal growth factor receptor, triple negative, size, lymph node involvement, and clinical stage) were the dependent variables. Most of the women were postmenopausal (73.5%), with an infiltrating tumor (83.0%), HR+ (82.0%), and overweight or obese (71.0%). For the premenopausal women, obesity was associated with grade 3 ductal tumor (odds ratio (OR): 1.70; 95% confidence interval (95% CI): 1.09-2.66), triple negative (OR: 1.37, 95% CI: 1.08-3.24), and size ≥ 2 cm (OR: 2.20, 95% CI: 1.36-3.56). For the postmenopausal women, obesity was associated with WHR, infiltrating tumor (OR: 1.73, 95% CI: 1.56-1.95), size ≥ 2 cm (OR: 1.38, 95% CI: 1.11-1.71), lymph node involvement (OR: 1.24, 95% CI: 1.02-1.56), and stages III-IV (OR: 1.76, 95% CI: 1.30-2.65). Excess body weight and central adiposity were associated with tumor aggressiveness characteristics in women with breast cancer, confirming the importance of nutritional status.

References

Nagrani R, Mhatre S, Rajaraman P, Soerjomataram I, Boffetta P, Gupta S . Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity. Eur J Cancer. 2016; 66:153-61. PMC: 5040194. DOI: 10.1016/j.ejca.2016.07.022. View

Chen H, Ding A, Wang M . Impact of central obesity on prognostic outcome of triple negative breast cancer in Chinese women. Springerplus. 2016; 5:594. PMC: 4864763. DOI: 10.1186/s40064-016-2200-y. View

Guasch-Ferre M, Salas-Salvado J, Ros E, Estruch R, Corella D, Fito M . The PREDIMED trial, Mediterranean diet and health outcomes: How strong is the evidence?. Nutr Metab Cardiovasc Dis. 2017; 27(7):624-632. DOI: 10.1016/j.numecd.2017.05.004. View

Lohmann A, Soldera S, Pimentel I, Ribnikar D, Ennis M, Amir E . Association of Obesity With Breast Cancer Outcome in Relation to Cancer Subtypes: A Meta-Analysis. J Natl Cancer Inst. 2021; 113(11):1465-1475. PMC: 8562970. DOI: 10.1093/jnci/djab023. View

Cheng E, Kirley J, Cespedes Feliciano E, Caan B . Adiposity and cancer survival: a systematic review and meta-analysis. Cancer Causes Control. 2022; 33(10):1219-1246. PMC: 10101770. DOI: 10.1007/s10552-022-01613-7. View

Browning L, Hsieh S, Ashwell M . A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev. 2010; 23(2):247-69. DOI: 10.1017/S0954422410000144. View

Freedman D, Thornton J, Pi-Sunyer F, Heymsfield S, Wang J, Pierson Jr R . The body adiposity index (hip circumference ÷ height(1.5)) is not a more accurate measure of adiposity than is BMI, waist circumference, or hip circumference. Obesity (Silver Spring). 2012; 20(12):2438-44. PMC: 3477292. DOI: 10.1038/oby.2012.81. View

Ewertz M, Jensen M, Gunnarsdottir K, Hojris I, Jakobsen E, Nielsen D . Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol. 2010; 29(1):25-31. DOI: 10.1200/JCO.2010.29.7614. View

Kerr J, Anderson C, Lippman S . Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol. 2017; 18(8):e457-e471. PMC: 10441558. DOI: 10.1016/S1470-2045(17)30411-4. View

10.

Kim A, Scharf K, Senthil M, Solomon N, Garberoglio C, Lum S . The prevalence of overweight and obesity in a breast clinic population: consideration for weight loss as a therapeutic intervention. Surg Obes Relat Dis. 2013; 10(2):348-53. DOI: 10.1016/j.soard.2013.07.019. View

11.

Healy L, Ryan A, Carroll P, Ennis D, Crowley V, Boyle T . Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Clin Oncol (R Coll Radiol). 2010; 22(4):281-8. DOI: 10.1016/j.clon.2010.02.001. View

12.

Li H, Sun X, Miller E, Wang Q, Tao P, Liu L . BMI, reproductive factors, and breast cancer molecular subtypes: A case-control study and meta-analysis. J Epidemiol. 2017; 27(4):143-151. PMC: 5376312. DOI: 10.1016/j.je.2016.05.002. View

13.

Contiero P, Berrino F, Tagliabue G, Mastroianni A, Di Mauro M, Fabiano S . Fasting blood glucose and long-term prognosis of non-metastatic breast cancer: a cohort study. Breast Cancer Res Treat. 2013; 138(3):951-9. PMC: 3664213. DOI: 10.1007/s10549-013-2519-9. View

14.

Lee C, Huxley R, Wildman R, Woodward M . Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008; 61(7):646-53. DOI: 10.1016/j.jclinepi.2007.08.012. View

15.

. Abridged for Primary Care Providers. Clin Diabetes. 2022; 40(1):10-38. PMC: 8865785. DOI: 10.2337/cd22-as01. View

16.

Vaysse C, Lomo J, Garred O, Fjeldheim F, Lofteroed T, Schlichting E . Inflammation of mammary adipose tissue occurs in overweight and obese patients exhibiting early-stage breast cancer. NPJ Breast Cancer. 2017; 3:19. PMC: 5460134. DOI: 10.1038/s41523-017-0015-9. View

17.

Bougaret L, Delort L, Billard H, Le Huede C, Boby C, de la Foye A . Adipocyte/breast cancer cell crosstalk in obesity interferes with the anti-proliferative efficacy of tamoxifen. PLoS One. 2018; 13(2):e0191571. PMC: 5794086. DOI: 10.1371/journal.pone.0191571. View

18.

Chen K, Zhang J, Beeraka N, Tang C, Babayeva Y, Sinelnikov M . Advances in the Prevention and Treatment of Obesity-Driven Effects in Breast Cancers. Front Oncol. 2022; 12:820968. PMC: 9258420. DOI: 10.3389/fonc.2022.820968. View

19.

Renehan A, Zwahlen M, Egger M . Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer. 2015; 15(8):484-98. DOI: 10.1038/nrc3967. View

20.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View