Metabolic Profile and Negatively Association Between Insulin Resistance and Metastatic Incidence in Indonesian Primary Invasive Breast Cancer: A Cross-Sectional Study

Abstract

Andhika Rachman,1,2 Zaenal Hakiki Fiantoro,3 Noorwati Sutandyo,4 Dimas Priantono,1 Pradana Zaky Romadhon,5 Reganedgary Jonlean6 1Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 2Siloam MRCCC Semanggi Hospital, Jakarta, Indonesia; 3Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 4Dharmais National Cancer Referral Hospital, Jakarta, Indonesia; 5Division of Hematology and Medical Oncology, Department of Internal Medicine, Airlangga University, Surabaya, Indonesia; 6Tzu Chi Hospital, Jakarta, IndonesiaCorrespondence: Andhika Rachman, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Pangeran Diponegoro No. 71, Jakarta, 10430, Indonesia, Tel +62 813 9862 0570, Email [email protected]; [email protected]: Metastatic breast cancer was associated with high morbidity and mortality. Insulin resistance was hypothesized to be related to the incidence of advanced breast cancer. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Triglyceride/Glucose Index (TyG Index) are two metrics used to measure the degree of insulin resistance. This study aims to assess the relationship between the incidence of metastatic breast cancer and insulin resistance as reflected by both metrics.Material and Methods: This study is a cross-sectional study involving 150 primary invasive breast cancer patients recruited from two hospitals of different sectors from August 2019 to April 2020. Patients with double cancer and autoimmune disorder were excluded from this study. Data obtained from the patients include age, body mass index (BMI), type 2 diabetes mellitus (T2DM) status and treatment, and low-density lipoprotein (LDL) cholesterol. The electronic medical records (EMR) was consulted to find histopathology examination result, cancer staging, and any missing data. The association between HOMA-IR and TyG with metastatic incidence was analyzed using either the Mann–Whitney test (for non-normally distributed data) or the independent-sample t-test (for normally distributed data).Results: The mean of the TyG index is 8.60, and the median of HOMA-IR is 1.22. We found no significant correlation between both variables and the incidence of metastases.Conclusion: Insulin resistance was not associated with metastatic breast cancer.Keywords: HOMA-IR, TyG index, breast cancer, metastase