Fructosamine and diabetes as predictors of mortality among Hispanic and non-Hispanic white breast cancer survivors
| Autor: | Richard N. Baumgartner, Nader Rifai, Avonne E. Connor, Kala Visvanathan, Kathy B. Baumgartner, Stephanie D. Boone |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Blood sugar lcsh:RC254-282 Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Breast cancer Internal medicine Diabetes mellitus medicine Pharmacology (medical) Radiology Nuclear Medicine and imaging 030212 general & internal medicine business.industry Hazard ratio medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Confidence interval 3. Good health Glucose management Fructosamine Oncology chemistry 030220 oncology & carcinogenesis Biomarker (medicine) business |
| Zdroj: | npj Breast Cancer, Vol 5, Iss 1, Pp 1-6 (2019) NPJ Breast Cancer |
| ISSN: | 2374-4677 |
| Popis: | Epidemiologic studies have found that elevated insulin levels and chronic hyperglycemia among breast cancer (BC) survivors are associated with poor prognosis; few of these studies have included Hispanic women in whom diabetes is highly prevalent. We examined the associations between circulating fructosamine-a biomarker of hyperglycemia and blood glucose control, self-reported diabetes, and risk of BC-specific and all-cause mortality among Hispanic and non-Hispanic white (NHW) women diagnosed with invasive BC. A total of 399 BC survivors (96 Hispanic, 303 NHW) contributed baseline data and plasma samples. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable Cox proportional hazards regression models. After a median follow-up time of 13 years, a total of 134 deaths occurred, of which 56 deaths were from BC. Diabetes was associated with BC-specific (HR, 2.89; 95% CI 1.27–6.60) and all-cause (HR, 2.10; 95% CI 1.24–3.55) mortality. Associations were stronger among women with clinically high fructosamine levels (>285 µmol/L) (BC-specific: HR, 4.25; 95% CI 1.67–10.80; all-cause: HR, 2.32; 95% CI 1.30–4.14) compared to women with normal levels (≤285 µmol/L). In mediation analysis, fructosamine explained 47% of the association between diabetes and all-cause mortality and 41% of BC-specific mortality; the largest attenuation was among Hispanics for all-cause mortality (56%). Our results demonstrate that poor glycemic control explains a large extent of the relationship between diabetes and mortality among women with invasive BC, particularly among Hispanic women. The associations we observed for BC mortality should be confirmed in larger studies of ethnically diverse BC patients. Epidemiology: Poor glycemic control increases risk of cancer-linked death Diabetes and poor blood sugar control significantly increase a woman’s odds of dying from invasive breast cancer. A team led by Avonne Connor from Johns Hopkins University in Baltimore, Maryland, USA, tracked the fate of 399 survivors of breast cancer, 96 of whom were Hispanic, an underrepresented ethnicity in many biomedical studies. After a median follow-up of 13 years, the researchers found that women with diabetes had a nearly 3-fold higher risk of dying from their breast cancer and more than a two-fold greater risk for all-cause mortality. Poor glycemic control, as measured by elevated levels of a common blood biomarker called fructosamine, explained a large extent of the relationship between diabetes and cancer-linked mortality, especially among Hispanic women. The findings suggest that better glucose management could improve outcomes for breast cancer survivors with diabetes. |
| Databáze: | OpenAIRE |
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