Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Breast Cancer Res Treat. 2022 Apr;192(2):401-409. doi: 10.1007/s10549-022-06513-7. Epub 2022 Jan 8.
Research on the role of insulin resistance (IR) in breast cancer risk in premenopausal women is scarce. We aimed to investigate the relationship between IR and the development of breast cancer in premenopausal women.
We analyzed the prospective association of IR and incident breast cancer in premenopausal women without breast cancer at baseline using a subsample of the Kangbuk Samsung Health Study.
Among 134,488 Korean premenopausal women, 696 women developed incident breast cancers during a median follow-up of 4.34 years. After adjustment for dense breast and other potential confounders, HR (95% CI) for incident breast cancer comparing HOMA-IR quintiles 2, 3, 4, and 5 to the first quintile was 0.91 (0.71-1.17), 0.89 (0.69-1.15), 0.75 (0.57-0.98), and 0.87 (0.65-1.16), respectively (P for trend = 0.117), while HR (95% CI) comparing insulin quintiles 2, 3, 4, and 5 to the first quintile was 1.02 (0.80-1.30), 0.90 (0.69-1.16), 0.72 (0.54-0.96), and 0.96 (0.72-1.28), respectively (P for trend = 0.151). This pattern did not significantly differ by obesity. These results were attenuated and no longer significant in time-dependent analyses where updated status of insulin and other covariates over time were treated as time-varying covariates.
Our findings do not support the positive relationship of IR with the development of breast cancer in premenopausal women, unlike in postmenopausal women. Thus, the role of IR as a risk factor for breast cancer may differ by menopausal status.
针对绝经前女性中胰岛素抵抗（IR）在乳腺癌风险中的作用的研究较少。我们旨在研究 IR 与绝经前女性乳腺癌发展之间的关系。
我们使用 Kangbuk Samsung Health 研究的一个亚组，分析了无基线乳腺癌的绝经前女性中 IR 与乳腺癌发病之间的前瞻性关联。
在 134488 名韩国绝经前女性中，有 696 名女性在中位随访 4.34 年后发生了乳腺癌事件。在调整致密乳房和其他潜在混杂因素后，与 HOMA-IR 五分位数 2、3、4 和 5 相比，五分位数 1 的乳腺癌事件的 HR（95%CI）分别为 0.91（0.71-1.17）、0.89（0.69-1.15）、0.75（0.57-0.98）和 0.87（0.65-1.16）（趋势 P=0.117），而与胰岛素五分位数 2、3、4 和 5 相比，五分位数 1 的乳腺癌事件的 HR（95%CI）分别为 1.02（0.80-1.30）、0.90（0.69-1.16）、0.72（0.54-0.96）和 0.96（0.72-1.28）（趋势 P=0.151）。这种模式在肥胖亚组中没有显著差异。在时间依赖性分析中，这些结果减弱且不再显著，其中胰岛素和其他协变量的最新状态被视为随时间变化的协变量。
与绝经后女性不同，我们的研究结果不支持 IR 与绝经前女性乳腺癌发展之间的正相关关系。因此，IR 作为乳腺癌风险因素的作用可能因绝经状态而异。
