Influence of Inflammation, Insulin Resistance and Excess Body Size on Breast Cancer Risk: A Nested Case-Control Study

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dc.contributor.advisorBrenner, Darren R.
dc.contributor.advisorFriedenreich, Christine M.
dc.contributor.authorHaig, Tiffany R.
dc.contributor.committeememberLi, Haocheng
dc.contributor.committeememberRobson, Paula
dc.date2020-06
dc.date.accessioned2020-02-07T17:43:39Z
dc.date.available2020-02-07T17:43:39Z
dc.date.issued2020-02-06
dc.description.abstractBackground: Breast cancer is the most common malignancy affecting women in Canada. In 2019, breast cancer represented 25% of all new cancers among Canadian women and 13% of all cancer deaths. Excess body size is associated with postmenopausal breast cancer risk. The mechanisms associating adiposity to breast cancer are unclear. Both inflammation and insulin resistance have been implicated in this association; however, literature to date has been inconsistent. Here, we aim to examine the associations between high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c), common measures of inflammation and insulin resistance, respectively, with breast cancer risk, while adjusting for measures of excess body size. Methods: We conducted a nested case-control study within the Alberta’s Tomorrow Project cohort (Alberta, Canada) including 197 invasive breast cancer cases and 394 matched controls. Serum concentrations of hsCRP and HbA1c were measured from blood samples collected prior to diagnosis, along with anthropometric measurements, general health, and lifestyle data. Conditional logistic regression was used to evaluate the associations between hsCRP, HbA1c, and breast cancer risk adjusted for body fat percentage and other risk factors for breast cancer. Results: Participants included in this study were a mean age of 65.1 years and mostly postmenopausal (147 cases and 293 controls). More than half were categorized as overweight/obese (60.5% for cases; 64.9% for controls), and median values of hsCRP (0.9; interquartile range (IQR) = 1.8) and HbA1c (5.6; IQR = 0.6) were similar between cases and controls. Higher concentrations of hsCRP were associated with elevated breast cancer risk (odds ratio [OR] = 1.27; 95% confidence interval [CI] = 1.03, 1.55). The observed associations were unchanged with adjustment for body fat percentage. Higher HbA1c concentrations were not significantly associated with an increased risk of incident breast cancer relative to controls (OR = 1.22; 95% CI = 0.17, 8.75). Conclusion: These data suggest that hsCRP, a marker of inflammation, may be associated with elevated breast cancer risk, independent of body fat percentage. However, elevated concentrations of HbA1c did not appear to increase breast cancer risk in this group of women in Alberta.en_US
dc.identifier.citationHaig, T. R. (2020). Influence of Inflammation, Insulin Resistance and Excess Body Size on Breast Cancer Risk: A Nested Case-Control Study (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/37573
dc.identifier.urihttp://hdl.handle.net/1880/111637
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectbreast canceren_US
dc.subjecthigh-sensitivity C-reactive proteinen_US
dc.subjecthemoglobin A1cen_US
dc.subjectAlberta’s Tomorrow Project cohorten_US
dc.subjectnested case-control studyen_US
dc.subjectexcess body sizeen_US
dc.subject.classificationEpidemiologyen_US
dc.titleInfluence of Inflammation, Insulin Resistance and Excess Body Size on Breast Cancer Risk: A Nested Case-Control Studyen_US
dc.typemaster thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrueen_US
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