Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer

Geoffrey C. Kabat, Mimi Kim, Bette J. Caan, Rowan T. Chlebowski, Marc J. Gunter, Gloria Y F Ho, Beatriz L. Rodriguez, James M. Shikany, Howard Strickler, Mara Z. Vitolins, Thomas E. Rohan

Research output: Contribution to journalArticle

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Abstract

Experimental and epidemiological evidence suggests that circulating glucose and insulin may play a role in breast carcinogenesis. However, few cohort studies have examined breast cancer risk in association with glucose and insulin levels, and studies to date have had only baseline measurements of exposure. We conducted a longitudinal study of postmenopausal breast cancer risk using the 6% random sample of women in the Women's Health Initiative clinical trials whose fasting blood samples, provided at baseline and at years 1, 3 and 6, were analyzed for glucose and insulin. In addition, a 1% sample of women in the observational study, who had glucose and insulin measured in fasting blood samples drawn at baseline and in year 3, were included in the analysis. We used Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals for the association of baseline and follow-up measurements of serum glucose and insulin with breast cancer risk. All statistical tests were 2-sided. Among 5,450 women with baseline serum glucose and insulin values, 190 incident cases of breast cancer were ascertained over a median of 8.0 years of follow-up. The highest tertile of baseline insulin, relative to the lowest, was associated with a 2-fold increase in risk in the total population (multivariable hazard ratio 2.22, 95% confidence interval 1.39-3.53) and with a 3-fold increase in risk in women who were not enrolled in the intervention arm of any clinical trial (multivariable hazard ratio 3.15, 95% confidence interval 1.61-6.17). Glucose levels showed no association with risk. Analysis of the repeated measurements supported the results of the baseline analysis. These data suggest that elevated serum insulin levels may be a risk factor for postmenopausal breast cancer.

Original languageEnglish (US)
Pages (from-to)2704-2710
Number of pages7
JournalInternational Journal of Cancer
Volume125
Issue number11
DOIs
StatePublished - Dec 1 2009

Fingerprint

Insulin
Breast Neoplasms
Glucose
Serum
Confidence Intervals
Fasting
Clinical Trials
Women's Health
Proportional Hazards Models
Observational Studies
Longitudinal Studies
Carcinogenesis
Breast
Arm
Cohort Studies
Population

Keywords

  • Breast neoplasms
  • Postmenopausal women
  • Serum glucose
  • Serum insulin

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. / Kabat, Geoffrey C.; Kim, Mimi; Caan, Bette J.; Chlebowski, Rowan T.; Gunter, Marc J.; Ho, Gloria Y F; Rodriguez, Beatriz L.; Shikany, James M.; Strickler, Howard; Vitolins, Mara Z.; Rohan, Thomas E.

In: International Journal of Cancer, Vol. 125, No. 11, 01.12.2009, p. 2704-2710.

Research output: Contribution to journalArticle

Kabat, GC, Kim, M, Caan, BJ, Chlebowski, RT, Gunter, MJ, Ho, GYF, Rodriguez, BL, Shikany, JM, Strickler, H, Vitolins, MZ & Rohan, TE 2009, 'Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer', International Journal of Cancer, vol. 125, no. 11, pp. 2704-2710. https://doi.org/10.1002/ijc.24609
Kabat, Geoffrey C. ; Kim, Mimi ; Caan, Bette J. ; Chlebowski, Rowan T. ; Gunter, Marc J. ; Ho, Gloria Y F ; Rodriguez, Beatriz L. ; Shikany, James M. ; Strickler, Howard ; Vitolins, Mara Z. ; Rohan, Thomas E. / Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. In: International Journal of Cancer. 2009 ; Vol. 125, No. 11. pp. 2704-2710.
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