ArticleInternational journal of surgery (London, England)2025
Association between insulin resistance and breast cancer risk in perimenopausal and postmenopausal women: mediating effects of oxidative stress and inflammatory biomarkers.
Article in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Spatiotemporal dynamics of the host-tumor metabolic interface: Implications for precision nutritional oncology.Genes & diseases · 2026Review
- Correlation between TyG index and its modified index with breast cancer risk in women a study based on NHANES database and real-world data.Frontiers in oncology · 2026Article
- Toward reliable preoperative prediction of urinary stone composition: critical considerations for imaging and clinical data integration.Urolithiasis · 2025Article
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6 authors.
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Abstract
backgroundInsulin resistance is implicated in breast carcinogenesis, but the comparative performance of different surrogate indices in associating with breast cancer risk among perimenopausal and postmenopausal women remains unclear.
methodsWe analyzed data from 7,713 peri-/postmenopausal women from the National Health and Nutrition Examination Survey (1999-2020). Four insulin resistance indices, namely, the triglyceride-glucose index (TyG), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), homeostasis model assessment of insulin resistance (HOMA-IR), and metabolic score for insulin resistance (METS-IR), were assessed. Boruta algorithm-based feature selection preceded weighted multivariate logistic regression, estimating associations with prevalent self‑reported breast cancer. Restricted cubic spline method was used to test for nonlinearity. Mediation analysis explored mechanisms, whereas Cox regression was used to evaluate mortality.
resultsThe TyG index was associated with higher odds of prevalent breast cancer, both as a continuous variable (OR = 1.52; 95% CI: 1.14-2.04; P = 0.005) and in its highest quartile (OR = 2.45; 95% CI: 1.18-5.07; P = 0.017, P for trend = 0.009),with a roughly linear pattern. HOMA-IR showed a weaker, nonlinear association concentrated only in the highest quartile (OR = 2.46, 95% CI: 1.29-4.69; P = 0.007; P for trend = 0.013). TG/HDL-C and METS-IR were not consistently related. Uric acid to high-density lipoprotein cholesterol (UHR, 33.84%) and the neutrophil-to-platelet ratio (NPR, 7.11%) partially mediated the effect of TyG (P < 0.05). Cox regression showed that the TyG index increased all-cause (HR = 1.67; 95% CI: 1.49-1.86; P < 0.001) and cancer mortality (HR = 1.57; 95% CI: 1.27-1.93; P < 0.001), but not among the subgroup of women with prevalent breast cancer.
conclusionsIn a nationally representative sample of peri-/postmenopausal women, TyG was associated with higher odds of prevalent breast cancer. Oxidative stress (UHR) and inflammation (NPR) may partially explain this relationship. GRAPHICAL ABSTRACT:
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