Resistência insulínica em pacientes com câncer de mama. Estudo preliminar da ocorrência e associação com fatores de risco e prognóstico
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Data
2015-09-23
Autores
Ferrugini, Carolina Loyola Prest
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Universidade Federal do Espírito Santo
Resumo
The co-occurrence of insulin resistance (IR) and breast cancer and the possible ethiologic and prognostic link between them has gained increasing importance, although the mechanisms involved are not fully understood. Clinically, the search for understanding of this association has stimulated studies on occurrence and empirical association between RI and risk factors (RF), prognostic factors (PF) and breast cancer subtypes, aiming to improve the treatment of these diseases. Objective. To determine the prevalence of RI and its association with RF and PF in patients with breast cancer. Patients and Methods. Study cases were selected from breast câncer in publicly assisted women at the Mastology Clinic of HUCAM/UFES, in Vitória city, Brazil, between november 2011 and november 2013 in which it was possible to obtain before treatment glucose and insulin blood level. IR was diagnosed by HOMA-IR index. Its occurrence and association with RF and PR was determined in all cases and in groups defined as reproductive and postmenopausal periods. Frequency between groups were contrasted by direct increment, simple rate, chi square test, and odds ratio, intrepreted by the recommended criteria for stochastic and quantitative magnitude significance. Results. In the 80 studied patients, the IR occurrence was 38.7%, higher in reproductive than postmenstrual periods (43.6% versus 28.0%), without significant variation according to RF. Breast cancer with Ki67 expression and HER2 hiperexpression were more frequent in IR patients of postmenopausal period and luminal A breast cancer more frequent in IR patients of reperoductive period. None significant occurrence variation was found in the others PR according IR, either in reproductive or postmenopausal women. Conclusion. These results show that 2 more aggressive PF occur more frequently in postmenopausal IR + patients as the Luminal A tumors, with better prognosis, occurs in reproductive age IR+ patients, adducing empirical evidence, although based on a small number of cases, for routine assessment of insulin resistance in breast câncer patients, especially during the postmenopausal period.
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Breast cancer , Risk factors , Prognostic factors , Insulin resistance , Câncer de mama , Fatores de risco , Fatores prognósticos , Resistência insulínica
Citação
FERRUGINI, Carolina Loyola Prest. Resistência insulínica em pacientes com câncer de mama. Estudo preliminar da ocorrência e associação com fatores de risco e prognóstico. 2015. Dissertação (Mestrado em Medicina) - Programa de Pós-Graduação em Medicina, Universidade Federal do Espírito Santo, Vitória, 2015.