title: Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study.
abstract: BACKGROUND
  Several in vitro studies have suggested the effects of adipokines and insulin resistance on breast cancer cell proliferation and survival. However, little is known about the clinical significance of these findings.
  
  
  METHODS
  We examined associations between breast cancer recurrence and adiponectin, leptin, insulin resistance, and metabolic syndrome (MetS) in a cohort of 747 patients from 2001 to 2004.
  
  
  RESULTS
  Adjusted hazard ratios showed an inverse trend across the quartiles for serum adiponectin concentration in estrogen receptor (ER)/progesterone receptor (PR) -negative patients (P for trend = 0.027) but not in ER/PR-positive patients. Compared to the highest quartile for adiponectin level, the lowest quartile showed a hazard ratio of 2.82 (1.03 to 7.68). Homeostasis model assessment for insulin resistance (HOMA-IR) showed a positive trend for recurrence in the ER/PR-negative group (P for trend = 0.087) and a negative trend in the ER/PR-positive group (P for trend = 0.081). Leptin did not show any associations (P for trend >0.05). A linear trend was observed with the number of components of MetS in ER/PR-negative patients (P for trend = 0.044). This association disappeared when adjusted for adiponectin and HOMA-IR.
  
  
  CONCLUSIONS
  Adiponectin and HOMA-IR have prognostic significance in breast cancer recurrence and interventions related to these factors may protect against recurrence in ER/PR-negative patients. These findings were not observed in the case of ER/PR-positive patients. Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.
authors: Center for Obesity, Nutrition, and Metabolism, Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 814 Siksa-Dong, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, 410-773, Korea. osw6021@yahoo.co.kr
authors: Sang Woo
authors: SW
authors: Oh
authors: Cheol-Young
authors: CY
authors: Park
authors: Eun Sook
authors: ES
authors: Lee
authors: Yeong Sook
authors: YS
authors: Yoon
authors: Eon Sook
authors: ES
authors: Lee
authors: Sang Shin
authors: SS
authors: Park
authors: Yuil
authors: Y
authors: Kim
authors: Nak Jin
authors: NJ
authors: Sung
authors: Young Ho
authors: YH
authors: Yun
authors: Keun Seok
authors: KS
authors: Lee
authors: Han Sung
authors: HS
authors: Kang
authors: Youngmee
authors: Y
authors: Kwon
authors: Jungsil
authors: J
authors: Ro
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000150:complications / Q000378:metabolism*; D049109:Cell Proliferation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood*; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
chemical_list: D052242:Adiponectin; D014408:Biomarkers, Tumor; D020738:Leptin; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone