Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Jul;182(2):401-409.
doi: 10.1007/s10549-020-05701-7. Epub 2020 Jun 4.

Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study

Giuseppe Buono  1 , Anna Crispo  2 , Mario Giuliano  3   4 , Carmine De Angelis  5   6 , Francesco Schettini  3 , Valeria Forestieri  3 , Rossella Lauria  3 , Michelino De Laurentiis  7 , Pietro De Placido  3 , Carmen Giusy Rea  3 , Carmen Pacilio  7 , Emanuela Esposito  7 , Maria Grimaldi  2 , Flavia Nocerino  2 , Giuseppe Porciello  2 , Aldo Giudice  2 , Alfonso Amore  7 , Anita Minopoli  8 , Gerardo Botti  9 , Sabino De Placido  3 , Meghana V Trivedi  4   10 , Grazia Arpino  3
Affiliations
Observational Study

Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study

Giuseppe Buono et al. Breast Cancer Res Treat. 2020 Jul.

Abstract

Purpose: Obesity and insulin resistance have been associated with poor prognosis in breast cancer (BC). The present prospective study aimed to investigate the impact of metabolic syndrome (MetS) and its components on early BC (eBC) patients' outcome.

Methods: MetS was defined by the presence of 3 to 5 of the following components: waist circumference > 88 cm, blood pressure ≥ 130/≥ 85 mmHg, serum levels of triglycerides ≥ 150 mg/dL, high density lipoprotein < 50 mg/dL and fasting glucose ≥ 110 mg/dL. Seven hundred and seventeen patients with data on ≥ 4 MetS components at BC diagnosis were enrolled. Study population was divided into two groups: patients with < 3 (non-MetS) vs. ≥ 3 components (MetS). Categorical variables were analyzed by Chi-square test and survival data by log-rank test and Cox proportional hazards regression model.

Results: Overall, 544 (75.9%) and 173 (24.1%) women were categorized as non-MetS and MetS, respectively. MetS patients were more likely to be older, postmenopausal, and insulin-resistant compared to non-MetS patients (p < 0.05). In multivariate analysis, MetS patients had a numerically higher risk of relapse [disease-free survival (DFS), hazard ratio (HR) 1.51, p = 0.07] and a significantly higher risk of death compared to non-MetS patients [overall survival (OS), HR 3.01, p < 0.0001; breast cancer-specific survival (BCSS), HR 3.16, p = 0.001]. Additionally, patients with 1 to 2 components of MetS had an increased risk of dying compared to patients with 0 components (OS, HR 4.90, p = 0.01; BCSS, HR 6.07, p = 0.02).

Conclusions: MetS correlated with poor outcome in eBC patients. Among patients without full criteria for MetS diagnosis, the presence of 1 or 2 components of the syndrome may predict for worse survival.

Keywords: Breast cancer; Breast cancer outcome; Metabolic syndrome; Metabolic syndrome components.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study flow chart. Metabolic Syndrome (MetS) was defined by the presence of 3 of the following variables: waist circumference > 88 cm, blood pressure ≥ 130/ ≥ 85 mmHg, triglycerides ≥ 150 mg/dL, HDL < 50 mg/dL and fasting glucose ≥ 110 mg/dL. Patients were excluded from the study if they had missing components that precluded investigators from assessing accurate MetS status as detailed in the flow chart
Fig. 2
Fig. 2
Disease-free Survival (a), Overall Survival (b) and Breast Cancer-Specific Survival (c) according to metabolic syndrome (MetS)
Fig. 3
Fig. 3
Disease-free Survival (a), Overall Survival (b) and Breast Cancer-Specific Survival (c) according to number of MetS components
See this image and copyright information in PMC

References

    1. https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf
    1. Monteiro CA, Moubarac JC, Cannon G, et al. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14:2–28. doi: 10.1111/obr.12107. - DOI - PubMed
    1. Monteiro CA, Moubarac JC, Levy RB, et al. Household availability of ultra-processed foods and obesity in nineteen European countries. Public Health Nutr. 2018 doi: 10.1017/S1368980017001379. - DOI - PMC - PubMed
    1. Zobel EH, Hansen TW, Rossing P, von Scholten BJ. Global changes in food supply and the obesity epidemic. Curr Obes Rep. 2016 doi: 10.1007/s13679-016-0233-8. - DOI - PubMed
    1. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983 doi: 10.1161/01.CIR.67.5.968. - DOI - PubMed

Publication types