Abstract
BackgroundMetabolic syndrome (MetS) has been suggested to be a risk factor for many cancers, including breast cancer. However, it remains unclear whether MetS predicts poor prognosis in women with breast cancer. A meta-analysis was performed to summarize the association between MetS and clinical outcome in women with breast cancer.MethodsCohort studies were identified by search of PubMed and Embase databases. A random-effect model incorporating the potential heterogeneity was applied to pool the results. Subgroup analyses according to the ethnicity and study design were performed.ResultsNine cohort studies with 17,892 women with breast cancer were included. Pooled results showed that MetS was significantly associated with an increased risk of breast cancer recurrence (adjusted risk ratio [RR] = 1.52, 95%, p = 0.02). Subgroup analyses showed that MetS was independently associated with increased recurrence of breast cancer in Caucasians (adjusted RR = 1.75, p = 0.02), but not in Asians (adjusted RR = 1.07, p = 0.81), and MetS was associated with a trend of increased risk of breast cancer recurrence in both the prospective and retrospective studies. Although we failed to show a significant association between MetS and breast cancer related deaths (adjusted RR = 1.24, p = 0.41), MetS was associated with increased risk of all-cause deaths in these patients (adjusted RR = 1.80, p < 0.001).ConclusionsMetS may predict the risk of cancer recurrence and mortality in women with breast cancer, particularly in Caucasians.
Highlights
Metabolic syndrome (MetS) has been suggested to be a risk factor for many cancers, including breast cancer
472 studies were obtained from database search, and 443 of them were excluded primarily due to the irrelevance to the objective of the study
Since three studies provided data based on the status of hormone receptors (HR) of the cancer [16, 19, 20] and one study based on age stratification [22], these datasets were included separately
Summary
Metabolic syndrome (MetS) has been suggested to be a risk factor for many cancers, including breast cancer. Despite of the improvements in the prevention and management of cancer, breast cancer remains a common malignancy in women, and about 1.4 million women are diagnosed with breast cancer annually [1,2,3] Metabolic disorders, such as obesity and insulin resistance, have been suggested to be involved in the pathogenesis and. Li et al Diabetol Metab Syndr (2020) 12:10 association between MetS and poor clinical outcomes in women with breast cancer [19,20,21,22,23] Whether factors such as ethnicity and study design affects the association between MetS and prognosis in women with breast cancer remains to be determined [24]. In this study, we performed a meta-analysis to evaluate the potential association between MetS and risks of recurrence or death in women with breast cancer
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