Association of Adipose Tissue Distribution With Type 2 Diabetes in Breast Cancer Patients

Purpose: We examined the association of adipose tissue distribution with type 2 diabetes (T2D) in breast cancer patients. Methods: Participants (N = 238) diagnosed with breast cancer at 20-75 years old who received breast cancer treatment at a major hospital from January 1, 2012, to December 31, 2017, with at least one completed and identifiable abdominal or pelvic computed tomography (CT) scan and data regarding race and ethnicity were included. Thirty-two breast cancer patients were identified as T2D patients after their breast cancer diagnoses. The adipose tissue distribution (visceral fat area [VFA], subcutaneous fat area [SFA], and the ratio of VFA to SFA [VFA/SFA]) was quantified on CT images of the third lumbar vertebra. T2D status was retrieved from patients’ electronic medical records. The association of adipose tissue distribution with T2D in women with breast cancer was examined using multivariable logistic regression. Results: Participants with T2D had significantly smaller SFA compared to those without T2D (odds ratio [OR] = 0.88, 95% confidence interval [95% CI] = 0.81-0.96, per 10 cm2 SFA). A positive association of VFA/SFA ratio with T2D was observed (OR = 19.57, 95% CI = 3.26-117.42, per unit VFA/SFA), although the estimate was imprecise. Conclusions: The amount of subcutaneous adipose tissue was inversely associated with T2D, and the ratio of the amount of visceral adipose tissue to the amount of subcutaneous adipose tissue was positively associated with T2D in breast cancer patients.

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Metformin improves the outcomes in Chinese invasive breast cancer patients with type 2 diabetes mellitus

Scientific Reports ◽

10.1038/s41598-021-89475-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tianli Hui ◽

Chao Shang ◽

Liu Yang ◽

Meiqi Wang ◽

Ruoyang Li ◽

...

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cancer Patients ◽

Invasive Breast Cancer ◽

Breast Cancer Patients ◽

Diabetes Group ◽

Metformin Group

AbstractEarly reports indicate that metformin, a clinical drug administered to treat type 2 diabetes mellitus (T2DM), was found to be associated with a better prognosis of cancer. The objective of this study was retrospectively analyzed the effect of metformin on the outcomes of Chinese breast cancer patients with T2DM. A total of 3757 primary invasive breast cancer patients who underwent surgery from January 2010 to December 2013 were enrolled. According to the medication treatment, all the patients were divided as non-diabetes group, metformin group and insulin group. The follow-up data for disease-free survival (DFS) and overall survival (OS) were obtained from 3553 patients (median follow up of 85 months) and estimated with the Kaplan–Meier method followed by a log-rank test. Multivariate Cox proportional hazards regression model was applied. The results showed that there was a significant survival difference among non-diabetes group, metformin group and insulin group, 5-year DFS was 85.8%, 96.1%, 73.0%, and 5-year OS was 87.3%, 97.1%, 73.3% respectively (P < 0.05). Prognostic analysis showed metformin was significantly associated with better DFS and OS. Our results suggested that metformin may have a good effect on the survival of invasive breast cancer patients with T2DM.

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Adipose tissue distribution is different in type 2 diabetes

American Journal of Clinical Nutrition ◽

10.3945/ajcn.2008.26955 ◽

2009 ◽

Vol 89 (3) ◽

pp. 807-814 ◽

Cited By ~ 125

Author(s):

◽

Dympna Gallagher ◽

David E Kelley ◽

Jung-Eun Yim ◽

Natasha Spence ◽

...

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Tissue Distribution ◽

Adipose Tissue Distribution

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The Mineralocorticoid Receptor Antagonist Eplerenone Suppress Interstitial Fibrosis in Subcutaneous Adipose Tissue in Type 2 Diabetes Patients

10.2337/figshare.13050743.v1 ◽

2020 ◽

Author(s):

Ada Admin ◽

Marie Louise Johansen ◽

Jaime Ibarrola ◽

Amaya Fernández-Celis ◽

Morten Schou ◽

...

Keyword(s):

Type 2 Diabetes ◽

Adipose Tissue ◽

Receptor Antagonist ◽

Subcutaneous Adipose Tissue ◽

Mineralocorticoid Receptor ◽

Prostaglandin D2 ◽

Type I ◽

Mineralocorticoid Receptor Antagonist ◽

Subcutaneous Adipose

Activation of the mineralocorticoid receptor (MR) may promote dysfunctional adipose tissue in patients with type 2 diabetes, where increased pericellular fibrosis has emerged as a major contributor. The knowledge of the association between the MR, fibrosis and the effects of an MR antagonist (MRA) in human adipocytes remains very limited. The present sub-study including 30 participants was prespecified as part of the Mineralocorticoid Receptor Antagonist in type 2 Diabetes (MIRAD) trial, randomizing patients to either high dose eplerenone or placebo for 26 weeks. In adipose tissue biopsies, changes in fibrosis were evaluated by immunohistological examinations and by the expression of mRNA and protein markers of fibrosis. Treatment with an MRA reduced pericellular fibrosis, synthesis of the major subunits of collagen type I and VI, and the profibrotic factor α-smooth muscle actin, as compared to placebo in subcutaneous adipose tissue. Furthermore, we found decreased expression of the MR and downstream molecules neutrophil gelatinase–associated lipocalin, galectin-3, and lipocalin-like prostaglandin D2 synthase with an MRA. In conclusions, we present original data demonstrating reduced fibrosis in adipose tissue with inhibition of the MR, which could be a potential therapeutic approach to prevent the extracellular matrix remodeling of adipose tissue in type 2 diabetes.

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Abstract MP045: The Ratio of Visceral and Subcutaneous Adipose Tissue Area was Positively Associated with Subclinical Atherosclerosis for Smoking Men

Circulation ◽

10.1161/circ.135.suppl_1.mp045 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Jung H Lee ◽

Hyeon C Kim ◽

Jee-Seon Shim ◽

Myung H Lee ◽

Bo M Song ◽

...

Keyword(s):

Adipose Tissue ◽

Tissue Distribution ◽

Subcutaneous Adipose Tissue ◽

Smoking Status ◽

Positive Association ◽

Adipose Tissue Distribution ◽

Tissue Area ◽

Never Smokers ◽

Study Participants ◽

Subcutaneous Adipose

Introduction: Several studies have examined the association between adipose tissue distribution and atherosclerosis. However, the effect of smoking on this association has not been evaluated yet. Hypothesis: We assessed the hypothesis that there is positive association between the ratio of visceral and subcutaneous adipose tissue areas and carotid intima media thickness (CIMT), and the association can be modified according to gender and smoking status in South Korea. Methods: A total of 1,606 middle-aged participants without cardiovascular disease were enrolled in this cross-sectional study from 2013 to 2015 in South Korea (568 men; 1,038 women). The CIMT of study participants was measured using B-mode ultrasonography at distal right common carotid artery, based on a predetermined protocol. We measured the abdominal adipose tissue distribution of study participants using computerized tomography. The area of adipose tissue at L4 vertebrae level was calculated, and the area of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were separated by abdominal wall. Then, we calculated the ratio of VAT and SAT (VAT/SAT) area. Other major cardiovascular risk factors were measured by standardized questionnaire, physical exam and fasting blood analysis. Smoking status of study participants was classified into three groups: current, former and never smokers. For evaluating the association between adipose tissue area and CIMT, we used multiple linear regressions. Separated analyses based on gender and smoking status were also performed. Results: Mean CIMT of study participants was 0.62 mm (SD, 0.12 mm), and mean VAF/SAF ratio of study participants was 0.62 (SD, 0.29). The prevalence of current smoker was 36.8% (209 of 568) for men, and 4.1% (42 of 1038) for women. In our multiple linear regression models, the VAT/SAT ratio showed statistically significant positive β-coefficient for total participants (β =8.62, p=0.008): showing significant for men (β =15.95, p=0.001) and not for women (β =3.15, p=0.377). When considering men only with respect to smoking status, the association between VAT/SAT ratio and CIMT was significant for current smokers (β=30.37, p<0.001), while it was not for never smokers (β=0.62, p=0.958) and former smokers (β=12.84, p=0.119). There was no significant interaction for gender and also for smoking status for men (p for interaction>0.05). Conclusions: In conclusion, the VAT/SAT ratio was positively associated with CIMT, and more preeminent positive association was observed for current men smokers than for never and former men smokers. The results of this study supported the need of smoking cessation to prevent atherosclerosis by adipose tissue distribution, especially for men.

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