Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy.
Division of Oncology, University Hospital "Maggiore della Carità", 28100 Novara, Italy.
Biomolecules. 2021 Jan 19;11(1):125. doi: 10.3390/biom11010125.
Breast cancer (BC) is the most common neoplasm in women. Many clinical and preclinical studies investigated the possible relationship between host metabolism and BC. Significant differences among BC subtypes have been reported for glucose metabolism. Insulin can promote tumorigenesis through a direct effect on epithelial tissues or indirectly by affecting the levels of other modulators, such as the insulin-like growth factor (IGF) family of receptors, sex hormones, and adipokines. The potential anti-cancer activity of metformin is based on two principal effects: first, its capacity for lowering circulating insulin levels with indirect endocrine effects that may impact on tumor cell proliferation; second, its direct influence on many pro-cancer signaling pathways that are key drivers of BC aggressiveness.
In the present review, the interaction between BC, host metabolism, and patients' prognosis has been reviewed across available literature evidence.
Obesity, metabolic syndrome, and insulin resistance are all involved in BC growth and could have a relevant impact on prognosis. All these factors act through a pro-inflammatory state, mediated by cytokines originated in fat tissue, and seem to be related to a higher risk of BC development and worse prognosis.
乳腺癌（BC）是女性最常见的肿瘤。许多临床和临床前研究都探讨了宿主代谢与 BC 之间的可能关系。葡萄糖代谢在 BC 亚型之间存在显著差异。胰岛素可以通过直接作用于上皮组织或通过影响其他调节剂（如胰岛素样生长因子（IGF）受体家族、性激素和脂肪因子）的水平间接促进肿瘤发生。二甲双胍的潜在抗癌活性基于两个主要作用：首先，它降低循环胰岛素水平的能力具有间接的内分泌作用，可能影响肿瘤细胞的增殖；其次，它直接影响许多促进癌症的信号通路，这些通路是 BC 侵袭性的关键驱动因素。
在本综述中，回顾了现有文献证据中 BC、宿主代谢和患者预后之间的相互作用。
肥胖、代谢综合征和胰岛素抵抗都与 BC 的生长有关，并可能对预后有重大影响。所有这些因素都通过源自脂肪组织的细胞因子介导的炎症状态起作用，似乎与更高的 BC 发展风险和更差的预后相关。
