Effect Of Different Glucose Metabolic States On The Occurrence And Severity Of Breast Cancer

BackgroundSome studies find diabetes is closely related to breast cancer. The incidence of breast cancer in diabetic patients is higher than those of the same age with normal blood glucose. Type2diabetes is an independent risk factor of recurrence and metastasis in breast cancer patients. However, between the state of normal glucose tolerance(NGT) and diabetes mellitus(DM), there is an intermediate state named impaired glucose regulation (IGR, also known as pre-diabetes mellitus). It is still lack of relevant data about the effect of IGR on the occurrence of breast cancer. And few studies were done to compare the impact of different glucose metabolic states on breast cancer. Based on this, we compared incidence, metabolic items, pathological features etc. of breast cancer in different glucose metabolic states, and discuss the effect of different glucose metabolic states on the occurrence and severity of breast cancer, so as to provide theoretical basis for prevention and treatment.MethodAccording to inclusion criteria and exclusion criteria, we included131female patients with breast cancer in breast surgery ward of Beijing Hospital to breast cancer group, and72healthy women from physical examination center of Beijing Hospital as control group. In all of the enrolled women, we performed OGTT for those who were not diagnosed previous as diabetes and judged their glucose metabolic state based on the OGTT result, then divided them into NGT group, IGR group, and DM group. Women with previous diagnose of diabetes were automatically included in DM group. IGR and DM were collectively referred to as abnormal glucose metabolism (AGM). We created a database which included information of age, menopausal status, BMI, blood pressure, glucose metabolic, liver and renal function, and blood lipids of all the enrolled individuals. For breast cancer group we also recorded pathology results. All the statistical analysis was processed with SPSS17.0. We compared effect of different glucose metabolic statuses on the occurrence of breast cancer and its parameters such as demography, metabolism and pathology.Results1. AGM, IGR, DM were respectively independently associated with occurrence of breast cancer. Among them, IGR had the greatest impact. Under IGR state, risk of breast cancer was4.357times higher than that of NGT state(P=0.004).2. Compared with control group, breast cancer group had significantly increased age, BMI, and SBP, decreased glucose tolerance, elevated glucose metabolic parameter values, and increased partial liver enzyme parameters, increased prevalence of metabolic syndrome, and all the differences are significant.3. Among patients with breast cancer, with the glucose tolerance gradually decreasing, mean age, menopause age and prevalence of metabolic syndrome gradually increased, and SBP, BMI and partial liver enzyme parameters increased, and all the differences are significant.4. All the pathological parameters of breast cancer patients between different glucose metabolic statuses had no significant difference.5. IGR and DM both can increase prevalence of breast cancer, affect related demographic, metabolic parameters of breast cancer. In terms of increasing breast cancer prevalence, blood pressure and so on, the role of IGT was more significant than DM.Conclusion 1. AGM, IGR, DM were respectively independently associated with occurrence of breast cancer.2. Compared with control group, patients with breast cancer had significantly increased age and liver enzyme parameters, and had significantly increased prevalence of metabolic syndrome and related parameters.3. Among patients with breast cancer, with the glucose tolerance gradually decreasing, mean age, menopause age and prevalence of metabolic syndrome gradually increased, and liver enzyme parameters increased.4. In terms of monitoring the occurrence of breast cancer and related parameters, IGR should be given equal importance as DM.