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Association between Insulin Resistance and Breast Carcinoma: A Systematic Review and Meta-Analysis

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. / Objective: This study was undertaken to evaluate the association between components defining insulin resistance and
breast cancer in women.
Study Design: We conducted a systematic review of four databases (PubMed-Medline, EMBASE, Web of Science, and
Scopus) for observational studies evaluating components defining insulin resistance in women with and without breast
cancer. A meta-analysis of the association between insulin resistance components and breast cancer was performed using
random effects models.
Results: Twenty-two studies (n = 33,405) were selected. Fasting insulin levels were not different between women with and
without breast cancer (standardized mean difference, SMD 20.03, 95%CI 20.32 to 0.27; p = 0.9). Similarly, non-fasting/
fasting C-peptide levels were not different between the two groups (mean difference, MD 0.07, 20.21 to 0.34; p = 0.6). Using
individual odds ratios (ORs) adjusted at least for age, there was no higher risk of breast cancer when upper quartiles were
compared with the lowest quartile (Q1) of fasting insulin levels (OR Q2 vs. Q1 0.96, 0.71 to 1.28; OR Q3 vs. Q1 1.22, 0.91 to 1.64;
OR Q4 vs. Q1 0.98, 0.70 to 1.38). Likewise, there were no differences for quartiles of non-fasting/fasting C-peptide levels (OR Q2
vs. Q1 1.12, 0.91 to 1.37; OR Q3 vs. Q1 1.20, 0.91 to 1.59; OR Q4 vs. Q1 1.40, 1.03 to 1.92). Homeostatic model assessment (HOMAIR)
levels in breast cancer patients were significantly higher than in people without breast cancer (MD 0.22, 0.13 to 0.31, p,
0.00001).
Conclusions: Higher levels of fasting insulin or non-fasting/fasting C-peptide are not associated with breast cancer in
women. HOMA-IR levels are slightly higher in women with breast cancer.

Identiferoai:union.ndltd.org:PERUUPC/oai:repositorioacademico.upc.edu.pe:10757/320267
Date09 June 2014
CreatorsHernández, Adrian V., Guarnizo, Mirella, Miranda, Yony, Pasupuleti, Vinay, Deshpande, Abhishek, Paico, Socorro, Lenti, Hosten, Ganoza, Silvia, Montalvo, Laritza, Thota, Priyaleela, Lazaro, Herbert
PublisherPublic Library of Science (PLoS)
Source SetsUniversidad Peruana de Ciencias Aplicadas (UPC)
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/article
SourceUniversidad Peruana de Ciencias Aplicadas (UPC), Repositorio Académico - UPC
Rightsinfo:eu-repo/semantics/openAccess
Relationhttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0099317

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