Obesity-related markers and breast cancer in CPS-II Nutrition Cohort

Mia M. Gaudet, Alpa V. Patel, Lauren R. Teras, Juzhong Sun, Peter T. Campbell, Victoria L. Stevens, Eric J. Jacobs, Susan M. Gapstur

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Low circulating levels of adiponectin and high levels of insulin-like growth factor-1 (IGF-1), C-reactive protein (CRP), and C-peptide have been shown to be related to postmenopausal breast cancer risk, and to partially mediate the obesity-postmenopausal breast cancer association; however, data from prospective studies, especially those limited to non-users of postmenopausal hormones, are sparse. To further evaluate these associations, we measured these markers in a case-control study nested in the Cancer Prevention Study-II (CPS-II) Nutrition Cohort. Plasma samples from 302 postmenopausal breast cancer cases and matched controls were analyzed. None of the women were taking postmenopausal hormones at blood draw. Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Low levels of total adiponectin and high levels of total IGF-1 and CRP were associated with increased breast cancer risk, but associations were not statistically significant. The association with C-peptide was statistically significant (T3 vs. T1: OR=1.63, 95% CI 1.08-2.45; p-value for linear trend=0.001), but was slightly attenuated after further adjustment for BMI (T3 vs. T1: OR=1.51, 95% CI 0.99-2.31; p-value for linear trend=0.004). The association between BMI and breast cancer risk was attenuated toward the null after controlling for C-peptide (from OR=1.43 to OR=1.25 for BMI ≥30 kg/m2 compared to <25 kg/m2). The elevated risk of postmenopausal breast cancer associated with higher circulating levels of C-peptide is consistent with a role of hyperinsulinemia in breast carcinogenesis, and might account for some of the higher risk associated with obesity.

Original languageEnglish (US)
Pages (from-to)156-166
Number of pages11
JournalInternational Journal of Molecular Epidemiology and Genetics
Issue number3
StatePublished - 2013
Externally publishedYes


  • Breast cancer
  • C-peptide
  • Obesity
  • Risk

ASJC Scopus subject areas

  • Epidemiology
  • Genetics
  • Genetics(clinical)


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