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Insulin- and Obesity-Related Variables in Early-Stage Breast Cancer: Correlations and Time Course of Prognostic Associations.
MedLine Citation:
PMID:  22162568     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSETo investigate patterns of prognostic associations over time of insulin- and obesity-related variables measured at diagnosis of early breast cancer (BC), focusing on whether the prognostic associations with distant recurrence and death changed over time. PATIENTS AND METHODSFive hundred thirty-five nondiabetic women with T1-3, N0-1, M0 invasive BC diagnosed from 1989 to 1996 were included in the study. Insulin-related variables included fasting insulin, Homeostasis Model Assessment, C-peptide, and glucose. Obesity-related variables included weight, body mass index (BMI), waist and hip circumference, and leptin. Correlations were examined using the Pearson correlation coefficient and prognostic associations using the Cox model. RESULTS: hazard ratio [HR], 2.32; 95% CI, 1.39 to 3.86; P < .001 for distant disease-free survival [DDFS]; and HR, 2.85; 95% CI, 1.48 to 5.50; P = .002 for overall survival [OS], with little attenuation of this pattern in multivariable analyses). In contrast, obesity-related variables (BMI, weight, leptin) exerted significant adverse univariable associations that were constant over time (eg, BMI quartile 4 v 2: HR, 1.40; 95% CI, 1.07 to 1.82 for DDFS; P = .014; and HR, 1.50; 95% CI, 1.16 to 1.93; P < .001 for OS); prognostic associations of leptin remained significant in multivariable analyses. CONCLUSIONBaseline insulin- and obesity-related variables exert different patterns of prognostic associations over time in early BC.
Authors:
Pamela J Goodwin; Marguerite Ennis; Kathleen I Pritchard; Maureen E Trudeau; Jarley Koo; Sara K Taylor; Nicky Hood
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-12
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  -     ISSN:  1527-7755     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Pamela J. Goodwin, Mount Sinai Hospital and Princess Margaret Hospital, University of Toronto; Kathleen I. Pritchard and Maureen E. Trudeau, Sunnybrook Odette Cancer Centre, University of Toronto; Jarley Koo, St Michael's Hospital, University of Toronto; Nicky Hood, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto; Marguerite Ennis, Applied Statistician, Markham, Ontario; and Sara K. Taylor, British Columbia Cancer Agency, Kelowna, British Columbia, Canada.
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