Diabetes, insulin resistance, and metabolic syndrome in women at high risk for breast cancer.

Abstract

e12522 Background: Despite the growing body of research on diabetes (Db), insulin resistance (IR) and metabolic syndrome (MetS) in association with breast cancer, the prevalence of these metabolic conditions has yet to be explored in the high risk population. Delineating the numerous factors that contribute to these women’s risk is key in the management of this vulnerable population, especially when outlining potentially modifiable risk factors. The overall objective of this prospective study was to quantify the prevalence of Db, IR and MetS in women at high risk for breast cancer. Methods: Participants consisted of 100 Caucasian women above the age of 35 with an estimated 5yr risk of ≥1.7%. This criteria was met by (a) BRCA mutation carriers, (b) history of LCIS, (c) history of ADH, (d) history of mantle radiation, or (e) calculated 5yr risk of ≥1.7% using the Gail model. A comprehensive metabolic profile was obtained for each participant based on a questionnaire, fasting blood sample and biophysical measurements. The diagnostic criteria used for Db were those established by the Candian Practice Guidelines. The threshold for IR was a HOMA-IR value of 2.29. The MetS diagnostic criteria were those set by the IDF where 3 of 5 criteria from ↑waist circumference, ↑triglycerides, ↓HDL, HTN and hyperglycemia must be met. Results: The frequency (%) of Db (n=97), IR (n=96) and MetS (n=88) was 5(5), 17(18) and 29(33) respectively. Among the components of MetS, ↑waist circumference had the highest prevalence 60(68.2), followed by HTN 33(37.5), hyperglycemia 27(30.7), ↑triglycerides 23(26.1) and ↓HDL 22(29.7). There was a significant correlation observed between the Gail score and HDL (0.37, p<0.01), as well as systolic Bp (0.28, p<0.01). Conclusions: The prevalence of IR and MetS in this sample of women at high risk for breast cancer is considerably higher than the prevalence of these metabolic conditions in a similar population of average risk women, based on population data. This supports the significance and feasibility of an experimental study comparing the prevalence of IR and MetS in women at high risk and average risk for breast cancer. The prevalence of Db in this sample was comparable to the prevalence described in the general population.