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Asociación entre síndrome metabólico y cáncer de mama / Association between metabolic syndrome and breast cancer
Resumen
Resumen
El síndrome metabólico es un conjunto de factores de riesgo para enfermedad cardiovascular y diabetes mellitus. En México, su prevalencia se ha reportado en un 49.8%, siendo notablemente mayor que en otros países del mundo. En los últimos 30 años se ha observado un incremento en la incidencia de cáncer de mama en México, alcanzando a ser la neoplasia con mayor frecuencia y mortalidad en el año 2018. A finales de la década de los noventa, múltiples estudios observacionales identificaron una asociación entre síndrome metabólico y un incremento en el riesgo de cáncer de mama. Actualmente se postulan, por lo menos, tres mecanismos interrelacionados que explican el incremento en el riesgo de cáncer asociado a síndrome metabólico: el primero de ellos es el aumento en los niveles de estrógenos derivados del tejido adiposo, en segundo lugar la hiperinsulinemia y su efecto anabólico sobre las células epiteliales y, finalmente, el efecto endócrino de la grasa abdominal. Los componentes del síndrome metabólico asociados a un incremento en el riesgo de cáncer de mama son: diabetes mellitus tipo 2 con un riesgo relativo de 1.27 (IC95%: 1.16-1.39), la obesidad en mujeres posmenopáusicas con un riesgo relativo de 1.39 (IC95%: 1.14-1.70) y, finalmente, los niveles bajos de HDL que han mostrado un incremento en el riesgo.
Abstract
Metabolic syndrome is a set of risk factors associated with cardiovascular disease and diabetes. In Mexico, its prevalence has been reported up to 49.8%, significantly higher than in other countries. In the last 30 years there has been an increase in breast cancer incidence in Mexico, becoming the most frequent and deadly neoplasm in 2018. Since the late 1990s, several observational studies have identified an association between metabolic syndrome and an increased risk of breast cancer. At least 3 interrelated mechanisms that explain the risk increase of cancer associated with metabolic syndrome are postulated: the increase in estrogen levels derived from adipose tissue, hyperinsulinemia and its anabolic effect on epithelial cells and the endocrine effect of abdominal fat. The components of metabolic syndrome associated with an increased risk of breast cancer are: type 2 diabetes with a relative risk of 1.27 (95%CI: 1.16-1.39), obesity in postmenopausal women with a relative risk of 1.39 (95%CI: 1.14- 1.70) and low HDL cholesterol levels have demonstrated an increased risk.
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DOI: https://doi.org/10.24875/RMIMSS.M20000120
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