Ahmadieh Hala, Azar Sami T
Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
ISRN Endocrinol. 2013;2013:181240. doi: 10.1155/2013/181240. Epub 2013 Jan 17.
Breast cancer is among the most common cancers worldwide. Diabetes is an important chronic health problem associated with insulin resistance, increased insulin level, changes in growth hormones and factors, and activation of mitogen-activating protein kinase (MAPK) pathways, leading to an increased breast cancer risk. This paper looked at the epidemiologic studies of the association between type 2 diabetes and risk of breast cancer and its effect on overall cancer-specific survival. The combined evidence overall supported a modest association between type 2 diabetes and the risk of breast cancer, which was found to be more prevalent among postmenopausal women. Effect of oral diabetics and insulin therapy on breast cancer risk was also evaluated. It was found that metformin and thiazolidinones tended to have a protective role. Metformin therapy trials for its use as an adjuvant for breast cancer treatment are still ongoing. Sulfonylurea and insulin therapy were found to be mildly associated with increased overall cancers. No evidence or studies evaluated the association of DPPIV inhibitors and GLP 1 agonists with breast cancer risk because of their recent introduction into the management of diabetes.
乳腺癌是全球最常见的癌症之一。糖尿病是一个重要的慢性健康问题，与胰岛素抵抗、胰岛素水平升高、生长激素和因子变化以及丝裂原活化蛋白激酶（MAPK）通路激活有关，导致乳腺癌风险增加。本文探讨了2型糖尿病与乳腺癌风险之间关联的流行病学研究及其对总体癌症特异性生存的影响。综合证据总体支持2型糖尿病与乳腺癌风险之间存在适度关联，这种关联在绝经后女性中更为普遍。还评估了口服降糖药和胰岛素治疗对乳腺癌风险的影响。发现二甲双胍和噻唑烷二酮类药物往往具有保护作用。二甲双胍作为乳腺癌治疗辅助药物的治疗试验仍在进行中。发现磺脲类药物和胰岛素治疗与总体癌症增加存在轻度关联。由于二肽基肽酶IV（DPPIV）抑制剂和胰高血糖素样肽1（GLP 1）激动剂最近才被引入糖尿病管理，尚无证据或研究评估它们与乳腺癌风险的关联。
