Fasting C-Peptide Levels and Death Resulting From All Causes and Breast Cancer: The Health, Eating, Activity, and Lifestyle Study
Fasting C-Peptide Levels and Death Resulting From All Causes and Breast Cancer: The Health, Eating, Activity, and Lifestyle Study
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DOI：
10.1200/jco.2010.28.4752
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发表时间：
2011-01-01
影响因子：
45.3
通讯作者：
Ballard-Barbash, Rachel
中科院分区：
文献类型：
--
作者：
Irwin, Melinda L.;Duggan, Catherine;Ballard-Barbash, Rachel
PurposeTo检查血清C-肽，胰岛素分泌的标志物，乳腺癌诊断后3年测量，和所有原因和乳腺癌导致的死亡之间的关联。患者和方法这是一项前瞻性的观察性研究，604名妇女参加了健康，饮食，活动，在1995年至1998年期间被诊断患有局部或区域性乳腺癌并观察至死亡或2006年12月31日（以先发生者为准）的患者。使用多变量分层考克斯回归分析估计的风险比（HR）的所有死亡和死亡，由于乳腺癌和95% CI的HR。ResultsAmong妇女没有2型糖尿病，空腹C-肽水平与死亡的风险增加，导致所有原因和乳腺癌。C肽增加1 ng/mL与任何死亡风险增加31%（HR = 1.31; 95% CI，1.06至1.63; P = 0.013）和乳腺癌死亡风险增加35%（HR = 1.35; 95% CI，1.02至1.87，P = 0.048）相关。在某些亚组中，C肽水平与乳腺癌导致的死亡之间的相关性更强，包括2型糖尿病女性、体重指数低于25 kg/m2的女性、诊断为疾病较高阶段的女性以及肿瘤为雌激素受体阳性的女性。结论降低乳腺癌患者C肽水平的治疗策略，包括饮食诱导的减肥，应探索体力活动和/或使用降低胰岛素的药物。
PurposeTo examine the association between serum C-peptide, a marker of insulin secretion, measured 3 years after a breast cancer diagnosis, and death resulting from all causes and breast cancer.Patients and MethodsThis was a prospective, observational study of 604 women enrolled onto the Health, Eating, Activity, and Lifestyle (HEAL) Study who were diagnosed with local or regional breast cancer between 1995 and 1998 and observed until death or December 31, 2006, whichever came first. The hazard ratio (HR) for all deaths and deaths owing to breast cancer and 95% CIs for the HR were estimated using multivariable stratified Cox regression analyses.ResultsAmong women without type 2 diabetes, fasting C-peptide levels were associated with an increased risk of death resulting from all causes and from breast cancer. A 1-ng/mL increase in C-peptide was associated with a 31% increased risk of any death (HR = 1.31; 95% CI, 1.06 to 1.63; P = .013) and a 35% increased risk of death as a result of breast cancer (HR = 1.35; 95% CI, 1.02 to 1.87, P = .048). Associations between C-peptide levels and death as a result of breast cancer were stronger in certain subgroups, including women with type 2 diabetes, women with a body mass index less than 25 kg/m(2), women diagnosed with a higher stage of disease, and women whose tumors were estrogen receptor positive.ConclusionTreatment strategies to reduce C-peptide levels in patients with breast cancer, including dietary-induced weight loss, physical activity, and/or use of insulin-lowering medications, should be explored.