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Metabolic syndrome biomarkers and early breast cancer in Saudi women
– Reported, May 29, 2013
Obesity has a major impact on the risk and prognosis of some of the more common forms of cancer, but also provides us with one of the few preventive interventions capable of making a significant impact on the cancer problem. Weight increase and obesity in menopausal females have been identified as the most important prognostic risk factors for breast cancer in postmenopausal women . Several studies have reported that at diagnosis of breast cancer, obese women exhibit an increase in lymph-node involvement and a higher propensity to develop distant metastases.
Breast cancer is the most commonly occurring female cancer in the industrialized world. Although early diagnosis has contributed to therapeutic success, breast cancer remains a major female health issue and its incidence is increasing in developing countries. Genetic predisposition and environmental factors, such as a high fat diet and alcohol consumption, accompanied with a sedentary life style had been reported to cause an increase in breast cancer risk. Metabolic Syndrome, including obesity and T2DM, are positively associated with an increased breast cancer risk . These conditions are associated with changes in several hormonal systems, including insulin, estrogen, cytokines and growth factors . Recent studies have linked breast cancer with insulin resistance; metabolic syndrome (MetS), and altered adipokine levels .
Alteration in adipocytokine production in obese subjects has been reported in several studies. Studies have shown that increased leptin and decreased adiponectin levels promote carcinogenesis of the breast. It was also shown that adiponectin has prognostic significance in breast cancer recurrence . In addition, obesity is being increasingly recognized as a form of systemic subclinical inflammation and, accordingly, an increased adipose tissue infiltration by immune cells producing inflammatory substances, including C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-a), which have a positive impact on the breast cancer development.
Obesity is an established risk factor for most hormone-dependent cancers, including breast cancer. The pathology underlying this phenomenon may be related to the endocrine and metabolic profile of this state. In the present casecontrol study, our results indicate that metabolic changes among newly diagnosed breast cancer patients are consistent with a systemic stress response, possibly because of the presence and/or diagnosis of cancer activating the stress-system that, in turn, alters further the existing metabolic state to an environment conducive to tumor growth. It has been well established that stress, both acute and chronic induces a powerful cascade of immune, metabolic and inflammatory reactions. On the other hand, we cannot exclude preexisting metabolic syndrome manifestations as a risk factor for the development of breast cancer and the two explanations are not mutually exclusive.
In conclusion, inflammatory and metabolic changes are apparent among patients with early breast cancer as evidenced by the strong positive link between CRP and BMI, the positive association between ANG II and triglycerides, the negative association between HDL and adiponectin, and the strong negative association between PAI-1 and HDL. These associations, independent of age and BMI, are consistent with stress-induced changes secondary to the early breast cancer and/or the psychologic impact of the diagnosis, might enhance tumorigenic activity and lead to a poorer prognosis if left ignored.
CREDITS.
http://www.ncbi.nlm.nih.gov/
Majed S Alokail, Nasser Al-Daghri, Amal Abdulkareem, Hossam M Draz, Sobhy M Yakout, Abdullah M Alnaami, Shaun Sabico, Amal M Alenad, and George P Chrousos
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