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Ibrahim Karadag,1 Serdar Karakaya,2 Tolga Akkan,3 Bilgin Demir,4 Ertugrul Gazi Alkurt,5 Mutlu Dogan6 1Department of Medical Oncology, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey; 2Department of Medical Oncology, Health Science University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey; 3Department of Endocrinology, Eskisehir City Hospital, Eskisehir, Turkey; 4Department of Medical Oncology, Aydın Atatürk Public Hospital, Aydın, Turkey; 5Department of Surgical Oncology, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey; 6Department of Medical Oncology, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TurkeyCorrespondence: Ibrahim Karadag, Email ikaradag58@gmail.comBackground: We aimed to investigate the prognostic significance of insulin resistance (IR) markers fasting triglyceride-glucose (TyG) index and triglyceride high-density lipoprotein cholesterol (TG/HDL-C) ratio in HER2-positive breast cancer (BC) patients with brain metastasis (BM).Methods: In this single-center study, 120 patients who met the criteria were included. TyG and TG/HDL-C at the time of diagnosis were computed retrospectively. For TyG and TG/HDL-C, the median values of 9.32 and 2.95 were taken as the cut-off, respectively. TyG values < 9.32 and < 2.95 were considered low, and TG/HDL-C values ≥ 9.32 and ≥ 2.95 were considered high.Results: The median overall survival (OS) was 47 months (95% CI: 40.54– 53.45). Time to BM was 22 months (95% CI: 17.22– 26.73). The median time to BM was 35 months (95% CI: 20.90– 49.09) in the low TyG group and 15 months (95% CI: 8.92– 21.07) in the high TyG group (p < 0.001). The time to BM was 27 months (95% CI: 20.49– 33.50) in the low TG/HDL-C group and 20 months (95% CI: 16.76– 23.23) in the high TG/HDL-C group (p=0.084). In the multivariate Cox regression analysis, the TyG index (HR: 20.98, 95% CI: 7.14– 61.59, p < 0.001) was an independent risk factor for time to BM.Conclusion: These findings suggest that the TyG index could be used as a predictive biomarker at the time of diagnosis for risk of time BM in patients with HER2-positive BC. The TyG index can be used as a standard potential marker with prospective studies confirming these data.Keywords: TyG index, TG/HDL-C ratio, brain metastasis, HER2 positive breast cancer, glucose-lipid metabolism |
