Insulin-like growth factor-I, soy protein intake, and breast cancer risk

Diabetes as a Risk Factor for Breast Cancer

Diabetes is one of the most important chronic conditions worldwide, and breast cancer is the most prevalent cancer in women worldwide. Several types of research have been conducted to ascertain the link between diabetes and its potential for increasing the risk of breast cancer. This research aims to determine the relationship between diabetes and breast cancer; patients with diabetes have a higher risk than the general population of developing cancer, and diabetes patients have a higher incidence and mortality of breast cancer. This research also reviewed the relationship between cytokines, the mitogenic effect of insulin-like growth factors, and breast cells. The review includes searching the PubMed database using the keywords "diabetes," "breast cancer," "risk factor," and "premenopausal." The search returned 53 articles used for review of this article.

Genetic polymorphisms of insulin-like growth factor 1 and insulin-like growth factor binding protein 3, xenoestrogen, phytoestrogen, and premenopausal breast cancer

BACKGROUND

Previous studies suggest a combined effect of insulin-like growth factor 1 (igf-1) and igf binding protein 3 (igfbp-3) gene polymorphisms, xenoestrogen, and phytoestrogen on the igf-1 signalling pathway and serum concentrations in the igf system, which are associated with premenopausal breast cancer (bca) risk.

METHODS

Between 2010 and 2012, our study recruited 140 premenopausal bca patients and 160 community-based premenopausal control subjects. Participants were surveyed about oral contraceptive (oc) use, dietary habits, and other bca risk factors. TaqMan assays were used to determine igf-1 rs1520220 and igfbp-3 rs2854744 genotypes. Daily intakes of energy-adjusted soy isoflavones (easis) were calculated by the residual method. Multivariate logistic regression was applied to estimate the adjusted odds ratios (ors) and 95% confidence intervals (cis) of the igf-1 rs1520220 and igfbp-3 rs2854744 genotypes, oc use, and intake of easis. Stratified analyses were performed to detect the gene-environment combined effect, and multivariate logistic regression was used to estimate interaction coefficients (iors) by the multiplicative model, with 95% cis. The delta method was used to calculate interaction coefficients by the additive model [relative excess risk of interaction (reri), attributable proportions of interaction (apis)] and 95% cis.

RESULTS

The igf-1 and igfbp-3 genotypes, oc use, and easis were not found to be associated with bca risk (p > 0.05). Stratified analysis showed that the risk of bca was markedly increased in women carrying the igfbp-3C allele and using ocs compared with women either carrying the igfbp-3C allele or using ocs (or: 3.02; 95% ci: 1.04 to 8.79). The interaction coefficients ior, reri, and api were 4.89 (95% ci: 1.09 to 21.90), 2.42 (95% ci: -0.76 to 5.61), and 0.80 (95% ci: 0.46 to 1.67) respectively.

CONCLUSIONS

The igfbp-3 rs2854744 polymorphism and oc use might synergistically increase premenopausal bca risk.

Soy, red clover, and isoflavones and breast cancer: a systematic review

BACKGROUND

Soy and red clover isoflavones are controversial due to purported estrogenic activity and possible effects on breast cancer. We conducted a systematic review of soy and red clover for efficacy in improving menopausal symptoms in women with breast cancer, and for potential impact on risk of breast cancer incidence or recurrence.

METHODS

We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to March 2013 for human interventional or observational data pertaining to the safety and efficacy of soy and red clover isoflavones in patients with or at risk of breast cancer.

RESULTS

Of 4179 records, we included a total of 131 articles: 40 RCTs, 11 uncontrolled trials, and 80 observational studies. Five RCTs reported on the efficacy of soy for hot flashes, showing no significant reductions in hot flashes compared to placebo. There is lack of evidence showing harm from use of soy with respect to risk of breast cancer or recurrence, based on long term observational data. Soy intake consistent with that of a traditional Japanese diet (2-3 servings daily, containing 25-50mg isoflavones) may be protective against breast cancer and recurrence. Human trials show that soy does not increase circulating estradiol or affect estrogen-responsive target tissues. Prospective data of soy use in women taking tamoxifen does not indicate increased risk of recurrence. Evidence on red clover is limited, however existing studies suggest that it may not possess breast cancer-promoting effects.

CONCLUSION

Soy consumption may be associated with reduced risk of breast cancer incidence, recurrence, and mortality. Soy does not have estrogenic effects in humans. Soy intake consistent with a traditional Japanese diet appears safe for breast cancer survivors. While there is no clear evidence of harm, better evidence confirming safety is required before use of high dose (≥ 100 mg) isoflavones can be recommended for breast cancer patients.

Serum IGF-1 concentrations change with soy and seaweed supplements in healthy postmenopausal American women

Insulin-like growth factor 1 (IGF-1) is an anabolic hormone important for growth and development. However, high-circulating serum concentrations in adults are associated with increased risk of postmenopausal breast cancer. Nutritional status and specific foods influence serum IGF-1 concentrations. Breast cancer incidence is typically low in Asian countries where soy is commonly consumed. Paradoxically, soy supplement trials in American women have reported significant increases in IGF-1. Seaweed also is consumed regularly in Asian countries where breast cancer risk is low. We investigated the possibility that seaweed could modify soy-associated increases in IGF-1 in American women. Thirty healthy postmenopausal women (mean age 58 yr) participated in this 14-wk double-blinded, randomized, placebo-controlled crossover clinical trial. Participants consumed 5 g/day placebo or seaweed (Alaria esculenta) in capsules for 7 wk. During the 7th wk, a high-soy protein isolate powder was added (2 mg/kg body weight aglycone equivalent isoflavones). Overnight fasting blood samples were collected after each intervention period. Soy significantly increased serum IGF-1 concentrations compared to the placebo (21.2 nmol/L for soy vs. 16.9 nmol/L for placebo; P = 0.0001). The combination of seaweed and soy significantly reduced this increase by about 40% (21.2 nmol/L for soy alone vs. 19.4 nmol/L; P = 0.01). Concurrent seaweed and soy consumption may be important in modifying the effect of soy on IGF-1 serum concentrations.

Effects of high-isoflavone soy diet vs. casein protein diet and obesity on DMBA-induced mammary tumor development

Obesity and elevated serum insulin growth factor-1 (IGF-1) level are major risk factors in the development of breast cancer. We investigated the long-term effects of high-isoflavone soy intake and obesity on 7,12-dimethylbenz(a)anthracene (DMBA)-induced mammary tumor development and on serum IGF-1 and binding protein (IGFBP-3) levels. Lean and obese female Zucker rats fed casein or high-isoflavone soy protein were orally gavaged at age 50 days with DMBA and sacrificed after 147 days. The majority of lean casein-fed rats (69%) developed mammary tumors compared to 50% in lean soy-fed rats (P=0.176). In the obese groups, 76% of soy-fed rats developed mammary tumors compared to 15% of obese casein-fed rats (P<0.001). At age 43 days, IGFBP-3 was increased in the lean soy-fed rats compared to the lean casein-fed rats (P<0.05). At age 99 days, soy- and obese casein-fed rats exhibited increased serum IGF-1 compared to the lean rats and this increase was maintained for the rest of the experiment (P<0.05). Obese rats fed casein exhibited increased IGFBP-3 levels (P<0.001). However, obese rats fed soy exhibited a significant decrease in IGFBP-3 levels compared to the lean soy-fed rats (P<0.001) and a significant decrease in IGFBP-3 levels compared to the obese casein-fed rats (P<0.001). At age 197 days, IGFBP-3 levels were increased in obese casein-and soy-fed rats (P<0.001). The results suggest that female Zucker rats fed casein diets are protected against DMBA-induced mammary tumors, which is not the case for those on high-isoflavone soy diet, and changes in the concentration of serum IGFBP-3 may contribute to the incidence of DMBA-induced mammary tumors.

Dietary soy and tea combinations for prevention of breast and prostate cancers by targeting metabolic syndrome elements in mice

BACKGROUND

The prevalence of metabolic syndrome is high and is increasing in parallel with increasing incidences of breast and prostate cancers. The combination of soy with tea was shown to have synergistic effects on preventing breast and prostate tumors, but the effects of soy and tea combinations on metabolic syndrome-related elements have not been investigated.

OBJECTIVE

We aimed to determine the effects of soy and tea components, alone and in combination, on abdominal adipose mass and serum concentrations of adipokines, growth factors, and sex hormones in male and female mice.

DESIGN

Male and female FVB/N mice were treated with soy, tea components, or both. Food intake and body weight were monitored weekly. At the end of the experiment, abdominal white adipose tissue was weighed, and serum concentrations of biomarkers were measured.

RESULTS

Whole teas, but not the tea polyphenol extracts, significantly reduced abdominal white adipose tissue by 43-60% in female mice and by 65-70% in male mice. The combination of soy phytochemical concentrate and green tea reduced serum insulin-like growth factor-I concentrations in both male and female mice in a synergistic manner. The soy phytochemical concentrate and tea combinations reduced serum estrogen concentrations in female mice in a synergistic manner. Soy phytochemical concentrate and teas also significantly reduced serum leptin concentrations in both male and female mice and testosterone concentrations in male mice.

CONCLUSION

Further research is warranted to investigate whether soy and tea combinations may prevent breast or prostate cancer in a synergistic manner in part by alleviating metabolic disorders.

Soyfood Intake in the Prevention of Breast Cancer Risk in Women: A Meta-Analysis of Observational Epidemiological Studies

Many studies have suggested that the intake of soy products may protect against the occurrence of breast cancer because of the considerable amount of isoflavones they contain. To review the results of the observational studies, we performed this meta-analysis of the relevant literature. We searched Medline for reports that examined the association between soyfood consumption (or isoflavone intake) and breast cancer risk from January 1966 to April 2006. The random-effects model was used to estimate the pooled relative risk (RR). Twenty-one independent studies (14 case-control studies and 7 cohort studies) were included in the final analysis. The pooled RR of breast cancer for soyfood intake was 0.75 with a 95% CI of 0.59-0.95. As the main types of soyfood in Japan and China, tofu and miso showed clear protective effects. Isoflavone intake resulted in a 20% decrease in risk (RR = 0.81, 95% CI 0.67-0.99). The pooled RR varied little according to study stratification. When the studies published in Japanese and Chinese were added, the inverse associations between soyfood, tofu and breast cancer risk became slightly stronger. The weak association of miso was possibly due to the high concentration of salt in miso soup. In the present analysis, we did not find strong evidence for publication bias in the combination of the studies. This meta-analysis supported the hypotheses that soyfood intake may be associated with a decreased risk of breast cancer due to the isoflavones. Further epidemiological studies need to be conducted with more comprehensive information about the soyfood, and more accurate assessment of the isoflavones.

Genetic, Anthropometric, and Lifestyle Factors Associated with IGF-1 and IGFBP-3 Levels in Hispanic and Non-Hispanic White Women

Circulating concentrations of IGF-I and IGFBP-3 are associated with risk of pre-menopausal breast cancer. Racial differences in levels of these factors have been reported, and determinants of IGF-I and IGFBP-3 levels within racial and ethnic groups are unclear. In this study we examine genetic, anthropometric, diet, and lifestyle factors that may predict serum levels of IGF-I and IGFBP-3 among Hispanic and non-Hispanic white women. A sample of healthy controls participating in the SHINE (Southwest Hormone, Insulin, Nutrition, and Exercise Study) case-control breast cancer in Arizona, Colorado, New Mexico, and Utah were included in these analyses. Subjects included 210 Hispanic and 284 non-Hispanic white women. Hispanic women had significantly lower levels of IGFBP-3 (mean=3764.3 mcg/ml) after adjusting for age, body size, physical activity, menopausal status, and dietary factors than non-Hispanic white women (mean = 4058.0 mcg/ml; p<0.01). The CC genotype of the -202 A>C polymorphism of the IGFBP3 gene was associated with lower IGFBP-3 levels in both ethnic groups. The frequency of the IGFBP3 C allele differed between Hispanic (0.65) and non-Hispanic white women (0.53), but serum levels of IGFBP-3 were lower for Hispanic women than non-Hispanic after accounting for IGFBP3 genotype. Body size indicators, vigorous physical activity, and dietary factors appeared to influence serum levels of IGF-1 and the ratio of IGF-1 to IGFBP-3 in pre-menopausal women more than in post-menopausal women. On the other hand, using aspirin/NSAIDs appeared to increase IGFBP-3 levels significantly among pre-menopausal Hispanic women. Results from this study suggest that differences in IGFBP-3 levels exist in Hispanic and non-Hispanic white women. These differences could be due to the combined effects of genetic and behavioral factors which could account for ethnic differences in the risk of breast cancer and other chronic diseases.