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Insulin resistance and the development of breast cancer in premenopausal women: the Kangbuk Samsung Health Study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Data availability statement

The data that support the findings of this study are available from the Kangbuk Samsung Health Study group, but restrictions apply to the availability of these data, which were used under the permission from the Institutional Review Board to distribute the data, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the Kangbuk Samsung Health Study group.

Abbreviations

aHR:

Adjusted hazard ratio

BMI:

Body mass index

BP:

Blood pressure

CI:

Confidence interval

CVD:

Cardiovascular disease

HDL-C:

High-density lipoprotein cholesterol

HEPA:

Health-enhancing physical activity

HOMA-IR:

Homeostasis model assessment of insulin resistance

HPEA:

Health-enhancing physical activity

hsCRP:

High-sensitivity C-reactive protein

IR:

Insulin resistance

LDL-C:

Low-density lipoprotein cholesterol

TNBC:

Triple-negative breast cancer

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Acknowledgements

We thank our staff members at the Kangbuk Samsung Health Study for their hard work, dedication, and continuing support. This study was supported by SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020.

Funding

None to declare.

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Authors and Affiliations

  1. Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea

    Jeesun Lee, Yoosoo Chang & Seungho Ryu

  2. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yoosoo Chang, Yejin Kim & Seungho Ryu

  3. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea

    Yoosoo Chang & Seungho Ryu

  4. Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea

    Boyoung Park

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  1. Jeesun Lee
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Contributions

Jeesun Lee and Yoosoo Chang contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jeesun Lee, Yoosoo Chang, and Seungho Ryu. The first draft of the manuscript was written by Jeesun lee and Yejin Kim and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yoosoo Chang or Seungho Ryu.

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The authors have no conflicts of interest to disclose and nothing to declare.

Ethical approval

This study used only available data that are available from the Kangbuk Samsung Health Study; therefore, it was waived the requirement for informed consent as we used only de-identified data obtained during regular health screening exams of the Kangbuk Samsung Health Study. This study was approved by the Institutional Review Board of the Kangbuk Samsung Hospital (KBSMC 2021-05-036).

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Lee, J., Chang, Y., Kim, Y. et al. Insulin resistance and the development of breast cancer in premenopausal women: the Kangbuk Samsung Health Study. Breast Cancer Res Treat 192, 401–409 (2022). https://doi.org/10.1007/s10549-022-06513-7

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  • DOI: https://doi.org/10.1007/s10549-022-06513-7

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