Association between metabolic syndrome, insulin resistance, and IGF-1 in breast cancer survivors of DIANA-5 study

• Published in: Journal of cancer research and clinical oncology Vol. 149; no. 11; pp. 8639 - 8648
• Main Authors: De Santi, Mauro, Annibalini, Giosuè, Marano, Giuseppe, Biganzoli, Giacomo, Venturelli, Elisabetta, Pellegrini, Massimo, Lucertini, Francesco, Brandi, Giorgio, Biganzoli, Elia, Barbieri, Elena, Villarini, Anna
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2023; Springer Nature B.V
• Subjects: Aged; Blood glucose; Breast cancer; Breast Neoplasms - complications; Cancer Research; Cancer Survivors; Cholesterol; Cholesterol, HDL; Diagnosis; Female; Hematology; High density lipoprotein; Humans; Insulin Resistance; Insulin-like growth factor I; Insulin-Like Growth Factor I - metabolism; Insulin-like growth factors; Internal Medicine; Medicine; Medicine & Public Health; Metabolic syndrome; Metabolic Syndrome - complications; Oncology; Physical activity; Survivors; Tertiary cancer prevention; IGF-1; Breast cancer survivors; Metabolic syndrome
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-023-04755-6

Purpose
Circulating insulin-like growth factor-1 (IGF-1) is positively associated with the risk of BC recurrence, and is more frequently dysregulated in older people, especially in those with metabolic syndrome (MetS) and obesity. This study aimed to analyze the association between IGF-1 levels and indices of MetS and insulin resistance in BC survivors.
Methods
Baseline data of 563 BC survivors enrolled in the DIet and ANdrogen-5 (DIANA-5; NCT05019989) study were analyzed.
Results
Lower circulating IGF-1 levels in subjects with MetS than in those without MetS were found. After stratification of the patients according to the diagnosis of MetS, we highlighted that the insulin was the main predictor of elevated IGF-1 levels only in subjects without MetS. Moreover, we found an interaction between high-density lipoprotein cholesterol (HDL-C), glycemia, and IGF-1 levels, showing a positive correlation between HDL-C and IGF-1, especially in subjects with higher values of glycemia and without a diagnosis of MetS.
Conclusions
While IGF-1 levels appear to be much more impaired in subjects diagnosed with MetS, in non-MetS subjects, IGF-1 levels may respond better to metabolic parameters and lifestyle changes. Further studies are needed to analyze the role of physical activity and/or dietary intervention in modulating IGF-1 concentrations in BC survivors.
Implications for cancer survivors
These results could have important clinical implications for planning customized strategies aimed at modulating IGF-1 levels in BC survivors. In fact, while the IGF-1 system seems to be much more compromised in subjects with a diagnosis of MetS, in noMetS subjects, IGF-1 levels could better respond to lifestyle changes.