Role of Serum Lipids, Blood Glucose and Blood Pressure in Breast Cancer Risk for Women with Type 2 Diabetes Mellitus

Figures & data

Table 1 Baseline Characteristics by Breast Cancer Diagnosis in Women with Type 2 Diabetes Mellitus

Characteristics	Patients with Breast Cancer (n = 183)		Patients without Breast Cancer (n = 10,000)		P values ^a
	N (%)	Mean (SD)	N (%)	Mean (SD)
Follow-up period (months)		47.50 (26.64)		59.46 (28.52)	<0.001
Duration of diabetes (years)					0.928
<2	176 (96.17)		9576 (95.76)
≥2	7 (3.83)		424 (4.24)
Age, groups (years)					0.011
<55	31 (16.94)		2682 (26.82)
≥55, <65	64 (34.97)		3090 (30.90)
≥65	88 (48.09)		4228 (42.28)
Age continuous (years)		63.57 (9.13)		61.79 (10.96)	0.010
BMI groups (kg/m^2)					0.152
<25	25 (13.66)		1115 (11.15)
≥25, <30	65 (35.52)		2908 (29.08)
≥30	77 (42.08)		4661 (46.61)
Missing	16 (8.74)		1316 (13.16)
BMI, continuous(kg/m^2)		30.26 (5.21)		31.37 (6.12)	0.007
Smoking status					0.139
Non-smoker	132 (72.13)		6470 (64.70)
Smoker	25 (13.66)		1730 (17.30)
Missing	26 (14.21)		1800 (18.00)
A history of cancers					0.637
No	170 (92.90)		9401 (94.01)
Yes	13 (7.10)		599 (5.99)
A history of cardiovascular diseases					0.238
No	150 (81.97)		8536 (85.36)
Yes	33 (18.03)		1464 (14.64)
A history of diabetes comorbidities					0.083
No	167 (91.26)		9450 (94.50)
Yes	16 (8.74)		550 (5.50)
A history of hypertension					0.181
No	97 (53.01)		5821 (58.21)
Yes	86 (46.99)		4179 (41.79)
Metformin					0.067
No	91 (49.73)		4268 (42.68)
Yes	92 (50.27)		5732 (57.32)
Non-Metformin					0.647
No	135 (73.77)		7552 (75.52)
Yes	48 (26.23)		2448 (24.48)
ACE-i or ARB					0.558
No	91 (49.73)		5219 (52.19)
Yes	92 (50.27)		4781 (47.81)
Non-ACE-i or non-ARB					0.352
No	57 (31.15)		3473 (34.73)
Yes	126 (68.85)		6527 (65.27)
Statins					0.884
No	71 (38.80)		3799 (37.99)
Yes	112 (61.20)		6201 (62.01)
HDL-C, groups (mmol/L)					0.001
<1.1	38 (20.77)		2071 (20.71)
≥1.1, <1.6	58 (31.69)		4663 (46.63)
≥1.6	45 (24.59)		1755 (17.55)
Missing	42 (22.95)		1511 (15.11)
HDL-C, continuous (mmol/L)		1.38 (0.44)		1.30 (0.35)	0.029
LDL-C, groups (mmol/L)					0.069
<2.6	51 (27.87)		2671 (26.71)
≥2.6, <4.1	54 (29.51)		4098 (40.98)
≥4.1	34 (18.58)		1661 (16.61)
Missing	44 (24.04)		1570 (15.70)
LDL-C, continuous (mmol/L)		3.06 (1.11)		3.14 (1.07)	0.396
Total cholesterol, groups (mmol/L)					0.003
<4.7	52 (28.42)		2717 (27.17)
≥4.7, <6.1	43 (23.50)		3679 (36.79)
≥6.1	49 (26.78)		2084 (20.84)
Missing	39 (21.31)		1520 (15.20)
Total cholesterol, continuous (mmol/L)		5.33 (1.37)		5.27 (1.21)	0.589
Triglycerides, groups (mmol/L)					0.056
<1.3	24 (13.11)		1993 (19.93)
≥1.3, <2.4	85 (46.45)		4234 (42.34)
≥2.4	34 (18.58)		2277 (22.77)
Missing	40 (21.86)		1496 (14.96)
Triglycerides, continuous (mmol/L)		2.02 (1.02)		2.00 (1.11)	0.807
HbA1c, groups (%)					0.616
<7.0	109 (59.56)		6119 (61.19)
≥7.0, <8.0	36 (19.67)		1920 (19.20)
≥8.0	21 (11.48)		1454 (14.54)
Missing	17 (9.29)		507 (5.07)
HbA1c, continuous (%)		6.98 (1.43)		7.05 (1.43)	0.525
SBP, groups (mmHg)					0.151
<140	63 (34.43)		3344 (33.44)
≥140, <164	78 (42.62)		4634 (46.34)
≥164	36 (19.67)		1442 (14.42)
Missing	6 (3.28)		580 (5.80)
SBP, continuous (mmHg)		145.44 (20.23)		145.10 (19.84)	0.827

Notes: ^aP values were estimated by chi-square tests for categorical variables and t-tests for continuous variables. Chi-square tests did not consider missing values. P-values <0.05 are shown in bold and italic. P-values 0.05–0.1 are shown in italic.

Abbreviations: ACE-i/ARB, angiotensin converting enzyme inhibitors/angiotensin-receptor blockers; BMI, body mass index; FPG, fasting plasma glucose; HbA1c, glycated hemoglobin A; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure; SD, standard deviation.

Figure 1 Flow chart of patient selection.

Abbreviations: BC, breast cancer; FPG, fasting plasma glucose; HbA1c, glycated hemoglobin A; n, sample size.

Figure 2 Forest plots of the multivariate analyses examining the associations of lipids, glycated hemoglobin A and systolic blood pressure with breast cancer risk. Associations of (A) total cholesterol, (B) HDL-C, (C) LDL-C, (D) triglycerides, (E) HbA1c and (F) SBP with breast cancer were indicated in HR and 95% CI. Model 1: adjusted for age and BMI; Model 2: adjusted for lipids, HbA1c and SBP (plus Model 1); Model 3: adjusted for metformin, non-metformin glucose-lowering medications, ACE-i or ARB, non-ACE-i or non-ARB antihypertensives, and statins (plus Model 1); Model 4: adjusted for any covariate with a P-value <0.2 in the univariate models.

Abbreviations: ACE-i/ARB, angiotensin converting enzyme inhibitors/angiotensin-receptor blockers; BMI, body mass index; CI, confidence interval; HbA1c, glycated hemoglobin A; HDL-C, high-density lipoprotein cholesterol; HR, hazard ratio; LDL-C, low-density lipoprotein cholesterol; Ref., reference; SBP, systolic blood pressure.