Abstract
Purpose
Some studies have suggested an increased risk of breast cancer associated with elevated fasting serum glucose in nondiabetic subjects. Given how common both breast cancer and impaired glucose tolerance are in our aging societies, this is an important issue for public health.
Methods
We performed a systematic review of prospective cohort studies that examined the association between elevated serum glucose levels in nondiabetic subjects (levels below 7.0 mml/L) and the subsequent risk of breast cancer. We performed a systematic literature search and extracted relevant data in a standard way. We then computed summary relative risks (SRR) and 95 % confidence intervals using a random effects model applied on the risk of highest versus lowest quantile of serum glucose concentrations.
Results
Ten cohort studies were retrieved. The SRR for all studies was 1.11 (1.00–1.23), with no evidence of heterogeneity or publication bias. The SRR was not affected when the analysis was restricted to the 8 studies that reported results for fasting subjects (SRR = 1.11; 95 % CI 0.98–1.25). Three studies provided BMI-unadjusted and BMI-adjusted SRRs of 1.24 (95 % CI 0.60–2.56) and 1.20 (95 % CI 0.63–2.27), respectively. Similar magnitudes of associations were observed in sensitivity analyses, but statistical significance was lost.
Conclusion
In nondiabetic subjects, the risk of breast cancer associated with fasting serum glucose levels seems to be small. Potential limitations to this meta-analysis include the fact that not all studies reported risks adjusted for adiposity and that serum glucose levels of comparison groups were variable across studies.
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Acknowledgments
This study was part of the research activities of the International Prevention Research Institute (iPRI) Research Group on Diabetes, Metabolic Disorders and Cancer, whose members are P. Autier, A. Koechlin, C. Pizot, M. Boniol, P. Mullie, P. Boyle, F. Valentini, K. Coppens, L-L. Fairley, M. Boniol-Rech, M. Pasterk, M. Smans, M-P. Curado, M. Bota (iPRI, Lyon, France); S. Gandini (European Institute of Oncology, Milan, Italy); Chris Robertson (Department of Mathematics and Statistics, University of Strathclyde, Glasgow, Scotland); Tongzhang Zheng, Yawei Zhang (Yale University School of Public Health, New Haven, Connecticut, United States of America); Geremia Bolli (Department of Internal Medicine and Oncology, S.M. Misericordia Hospital, University of Perugia, Perugia, Italy); J. Rosenstock (Dallas Diabetes and Endocrine Center, Dallas, United States of America).
Conflict of interest
This study was part of works associated with an unrestricted research grant from Sanofi. The authors declare that they have no conflict of interest.
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Boyle, P., Koechlin, A., Pizot, C. et al. Blood glucose concentrations and breast cancer risk in women without diabetes: a meta-analysis. Eur J Nutr 52, 1533–1540 (2013). https://doi.org/10.1007/s00394-012-0460-z
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DOI: https://doi.org/10.1007/s00394-012-0460-z