Clear link between neurotensin and CVD, type 2 diabetes and breast cancer

[News]

"It was surprising to find such a clear link to the risk of type 2 diabetes and cardiovascular disease as well as to breast cancer. Obesity is a common risk factor for all three conditions, but the connection with neurotensin is not explained by obesity or other known risk factors", says Professor Olle Melander from the Department of Clinical Sciences at Lund University, who is also a consultant at Sk-ne University Hospital.

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[Jackie07]

Thought many of us would be interested in the link between diabetes and breast cancer. It seems to me, from researching and reading the following abstracts, that there are several common risk factors shared by the two. And certain side effect of cancer treatment, such as weight gain and less active life style, could contribute to those diabetes risk factors .
http://www.news-medical.net/news/20121011/Clear-link-between-neurotensin-and-CVD-type-2-diabetes-and-breast-cancer.aspx

According to http://diabetes.webmd.com/guide/type-2-diabetes?page=2Anyone can get type 2 diabetes. However, those at highest risk for the disease are those who
· Are over 45
· Are obese or overweight
· Have had gestational diabetes
· Have family members who have type 2 diabetes
· Have prediabetes
· Are inactive
· Have low HDL cholesterol or high triglycerides levels
· Have high blood pressure
· Are members of certain racial or ethnic groups
Type 2 diabetes is increasingly common. Perhaps up to 4.5 million people will have it in the UK by 2020. It is more common in people who have a family history, people who are overweight, and people who have other related conditions like high blood pressure. It is more common in different ethnic groups like Asians and Afro-Caribbeans. http://www.news-medical.net/news/20121012/Type-2-diabetes-screening-an-interview-with-Dr-Simon-Griffin-MRC-Epidemiology-Unit-at-Addenbrookee28099s-Hospital-Cambridge.aspx
http://www.diabetes.org/diabetes-basics/type-2/


Am J Ther. 2012 Nov;19(6):449-64. doi: 10.1097/MJT.0b013e31826fc5e5.
What have we learned about the treatment of type 2 diabetes? The evolving paradigms.
Freeman JS, Horton ES.
Source
1Division of Endocrinology and Metabolism, Philadelphia College of Osteopathic Medicine, Philadelphia, PA 2Joslin Diabetes Center, Boston, MA.
Abstract
Insulin, the first treatment for diabetes, was discovered >90 years ago. Since then, many new types of insulin have become available, including analogs that more closely mimic the characteristics of endogenous insulin. In addition, oral antidiabetes drugs and other types of injectable therapies have been approved for the treatment of patients with type 2 diabetes. As newer treatments are approved for type 2 diabetes, the choice and-paradoxically-the complexity of treatment increases. The potential benefits of all treatment options must be carefully balanced against potential adverse events to truly analyze the overall efficacy, safety, tolerability, and potential long-term effects. The manner in which outcomes are assessed and the methods employed to make such assessments have changed over time. This review will address these issues as they are related to therapies for type 2 diabetes, including insulin, oral antidiabetes drugs, and incretin-based agents.


Infect Disord Drug Targets. 2012 Oct 15. [Epub ahead of print]
Biology of Circulating Nucleic Acids and Possible Roles in Diagnosis and Treatment in Diabetes and Cancer.
Gahan PB.
Source
Anatomy & Human Sciences, King's College London, London Bridge, London SE1 1UL, UK.
Abstract
The presence of DNA and RNA circulating in human plasma and serum is described. The possible sources of the DNA/RNA in blood, their ability to enter other cells and to express in the recipient cells are discussed and the relationship with metastases considered. The possible role(s) of the DNA/RNA in clinical diagnosis, in monitoring treatment and in prognosis are considered for diabetes and oncology.

Cancer Sci. 2012 Oct 15. doi: 10.1111/cas.12043. [Epub ahead of print]
Diabetes mellitus and cancer risk: Review of the epidemiological evidence.
Shikata K, Ninomiya T, Kiyohara Y.
Source
Department of Environmental Medicine, Kyushu University, Fukuoka.
Abstract
Diabetes mellitus and cancer are diseases of epidemic proportions across the globe. These diseases are influenced by many factors, both genetic and environmental. A possible association between diabetes and cancer risk has long been speculated. Increased incidences of several cancers have been observed in diabetes patients, notably pancreatic, hepatic, colorectal, breast, urinary tract, and endometrial cancers. In contrast, a decreased incidence of prostate cancer is observed in diabetes patients, implying a protective effect. Precise knowledge of the complex associations and interactions between these two conditions is of great importance for their prevention and treatment. Multiple potential mechanisms have been proposed, but they have tended to be site-specific. Possible common mechanisms for a biological link between diabetes and cancer include hyperinsulinemia, hyperglycemia, and inflammation. Today, 366 million people live with diabetes globally, and this figure is expected to increase. Thus, if diabetes is associated with even a small increase in cancer risk, this may have important consequences at the population level. The aim of this review is to summarize recent epidemiological evidence of an association between diabetes and total cancer and specific sites of cancer, and to consider causal associations between these diseases.

Ann N Y Acad Sci.2012 Oct;1271:37-43. doi: 10.1111/j.1749-6632.2012.06750.x.
Obesity and cancer risk: evidence, mechanisms, and recommendations.
Vucenik I, Stains JP.
Source
Department of Medical and Research Technology Department of Pathology Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
Abstract
Obesity, a growing health problem worldwide, has been associated with the metabolic syndrome, diabetes, cardiovascular disease, hypertension, and other chronic diseases. Recently, the obesity-cancer link has received much attention. Epidemiological studies have shown that obesity is also associated with increased risk of several cancer types, including colon, breast, endometrium, liver, kidney, esophagus, gastric, pancreatic, gallbladder, and leukemia, and can also lead to poorer treatment and increased cancer-related mortality. Biological mechanisms underlying the relationship between obesity and cancer are not well understood. They include modulation of energy balance and calorie restriction, growth factors, multiple signaling pathways, and inflammatory processes. Key among the signaling pathways linking obesity and cancer is the PI3K/Akt/mTOR cascade, which is a target of many of the obesity-associated factors and regulates cell proliferation and survival. Understanding the molecular and cellular mechanisms of the obesity-cancer connection is important in developing potential therapeutics. The link between obesity and cancer underscores the recommendation to maintain a healthy body weight throughout life as one of the most important ways to protect against cancer.

Cancer Causes Control. 2012 Nov;23(11):1785-95. doi: 10.1007/s10552-012-0057-0. Epub 2012 Sep 13.
Associations of type 2 diabetes and diabetes treatment with breast cancer risk and mortality: a population-based cohort study among British women.

Redaniel MT, Jeffreys M, May MT, Ben-Shlomo Y, Martin RM.
Source

School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK, theresa.redaniel@bristol.ac.uk.
Abstract

PURPOSE:

There is great interest in whether type 2 diabetes and its treatments alter breast cancer risk and prognosis, but previous studies are inconclusive. We conducted a cohort study within the UK General Practice Research Database to investigate associations of type 2 diabetes and patterns of diabetes treatment with breast cancer risk and all-cause mortality.
METHODS:

We identified 52,657 women with type 2 diabetes, diagnosed between 1987 and 2007, and 30,210 randomly selected women without diabetes. We performed a time-dependent analysis using Cox proportional hazards models.
RESULTS:

Diabetes was associated with a 29 % increased overall breast cancer risk (95 % CI: 1.16-1.44), but the association markedly attenuated when adjusted for age, period of cohort entry, region, and body mass index (BMI) (HR: 1.12; 95 % CI: 0.98-1.29). Women with breast cancer and pre-existing diabetes had a 49 % (95 % CI: 1.17-1.88) increased all-cause mortality risk compared with women with breast cancer but without diabetes, after controlling for age, period, region, BMI, smoking, alcohol, and deprivation. Compared with sulfonylurea, we found weak evidence that metformin monotherapy (HR: 1.04; 95 % CI: 0.79-1.37) and insulin (HR: 1.33; 95 % CI: 0.63-2.83) modified breast cancer risk among women with diabetes.
CONCLUSIONS:

We found weak evidence that diabetes is associated with a small increased risk of breast cancer. Among treated women, there is no evidence that anti-diabetes treatments modify the risk of developing breast cancer, with wide confidence intervals indicating imprecise effect estimates. Women with breast cancer and diabetes, however, had an increased all-cause mortality risk highlighting the potential importance of maintaining adequate glycemic control alongside anti-cancer treatments and subsequent follow-up.