Evaluation of prediabetes as a potential risk factor for breast cancer: A systematic review and meta-analysis.

Abstract

e13168 Background: Recent research has shown conflicting results regarding the relationship between prediabetes and breast cancer. Factors such as insulin resistance, metabolic dysfunction, and chronic inflammation possibly have a role in tumor development. Understanding this relationship could offer valuable insight into prevention strategies. This study aims to assess the relationship between prediabetes and breast cancer. Methods: On December 28, 2024, an electronic search was performed using PubMed, Scopus, and Cochrane, focusing mainly on cohort studies that assessed the relationship between prediabetes patients and the development of breast cancer. We evaluated the incidence of breast cancer in prediabetes compared to normoglycemic cohorts. A sub-group analysis based on menopausal status was conducted. Those with longer follow-up durations beyond 8 years were analyzed as well. The effect size was estimated using the odds ratio with a 95% confidence interval. Results: Out of the 3559 articles we screened, only nine papers met our criteria, comprising a total of 1,064,191 patients. Both impaired fasting glycemia and prediabetic HbA1c levels (defined as HbA1c 5.7–6.4%) were not significantly associated with breast cancer, with odds ratios of 1.07 (95% CI: 0.96–1.19; p = 0.24) and 0.96 (95% CI: 0.88–1.03; p = 0.26), respectively. In our evaluation of menopausal status, premenopausal women in both arms had similar rates of breast cancer (OR: 0.87, CI: 0.72–1.05, p = 0.14). Similarly, postmenopausal women showed comparable rates of breast cancer in both groups (OR: 1.06, CI: 0.89–1.25, p = 0.51). Finally, studies with longer follow-ups beyond 8 years did not show a significant association between prediabetes and breast cancer with an odds ratio of 1.04 (Cl: 0.94 to 1.16, p = 0.46). Conclusions: The relationship between prediabetes and breast cancer remains complex and inconclusive. Our study has not shown a significant association between the two. Many factors, such as menopausal status, lifestyle, and genetic predisposition, may play a role in modulating this relationship. Further large-scale, longitudinal studies are needed to clarify these findings.