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Erschienen in: Breast Cancer Research and Treatment 3/2023

23.04.2023 | Clinical trial

Subjective social status, race, and metabolic syndrome in women with breast cancer

verfasst von: Giampaolo Greco, Nina A. Bickell, Sylvia Lin, Radhi Yagnik, Derek LeRoith, Emily J. Gallagher

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2023

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Abstract

Purpose

To evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer.

Methods

Multicenter cross-sectional study (10 US hospitals) in women (n = 1206) with primary diagnosis of invasive breast cancer received during Mar/2013–Feb/2020. Participants, self-identified as non-Hispanic White or Black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history, and behavioral risks. SSS was measured with the 10-rung MacArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation.

Results

Average age was 58 years. On average, the SSS of Black women, given equivalent level of income and education, was lower than the SSS of White women: 6.6 (6.1–7.0) vs 7.7 (7.54–7.79) among college graduates and 6.8 (6.4–7.2) vs 7.6 (7.5–7.8) among women in the high-income category (> $75,000). In multivariable analysis, after controlling for age, income, education, diet, and physical activity, increasing SSS was associated with a decrease in MetS-Z score, − 0.10 (− 0.16 to − 0.04) per every 2 rung increase in the MacArthur scale.

Conclusion

Black women with breast cancer rank their SSS lower than White women with breast cancer do at each level of income and education. As SSS is strongly associated with MetS severity these results identify potentially modifiable factors that contribute to racial disparities.
Literatur
1.
Zurück zum Zitat Blanquet M, Legrand A, Pelissier A, Mourgues C (2019) Socio-economics status and metabolic syndrome: a meta-analysis. Diabetes Metab Syndr 13(3):1805–1812CrossRefPubMed Blanquet M, Legrand A, Pelissier A, Mourgues C (2019) Socio-economics status and metabolic syndrome: a meta-analysis. Diabetes Metab Syndr 13(3):1805–1812CrossRefPubMed
2.
Zurück zum Zitat Stringhini S, Carmeli C, Jokela M, Avendano M, Muennig P, Guida F, Ricceri F, d’Errico A, Barros H, Bochud M et al (2017) Socioeconomic status and the 25 x 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1.7 million men and women. Lancet 389(10075):1229–1237CrossRefPubMedPubMedCentral Stringhini S, Carmeli C, Jokela M, Avendano M, Muennig P, Guida F, Ricceri F, d’Errico A, Barros H, Bochud M et al (2017) Socioeconomic status and the 25 x 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1.7 million men and women. Lancet 389(10075):1229–1237CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Berger E, Castagne R, Chadeau-Hyam M, Bochud M, d’Errico A, Gandini M, Karimi M, Kivimaki M, Krogh V, Marmot M et al (2019) Multi-cohort study identifies social determinants of systemic inflammation over the life course. Nat Commun 10(1):773CrossRefPubMedPubMedCentral Berger E, Castagne R, Chadeau-Hyam M, Bochud M, d’Errico A, Gandini M, Karimi M, Kivimaki M, Krogh V, Marmot M et al (2019) Multi-cohort study identifies social determinants of systemic inflammation over the life course. Nat Commun 10(1):773CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Singh GK, Jemal A (2017) Socioeconomic and racial/ethnic disparities in cancer mortality, incidence, and survival in the United States, 1950–2014: over six decades of changing patterns and widening inequalities. J Environ Public Health 2017:2819372CrossRefPubMedPubMedCentral Singh GK, Jemal A (2017) Socioeconomic and racial/ethnic disparities in cancer mortality, incidence, and survival in the United States, 1950–2014: over six decades of changing patterns and widening inequalities. J Environ Public Health 2017:2819372CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat O’Connor DB, Thayer JF, Vedhara K (2021) Stress and health: a review of psychobiological processes. Ann Rev Psychol 72:663–688CrossRef O’Connor DB, Thayer JF, Vedhara K (2021) Stress and health: a review of psychobiological processes. Ann Rev Psychol 72:663–688CrossRef
6.
Zurück zum Zitat Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed Singh-Manoux A, Adler NE, Marmot MG (2003) Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med 56(6):1321–1333CrossRefPubMed
8.
Zurück zum Zitat Ko NY, Hong S, Winn RA, Calip GS (2020) Association of insurance status and racial disparities with the detection of early-stage breast cancer. JAMA Oncol 6(3):385–392CrossRefPubMedPubMedCentral Ko NY, Hong S, Winn RA, Calip GS (2020) Association of insurance status and racial disparities with the detection of early-stage breast cancer. JAMA Oncol 6(3):385–392CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Ellis L, Canchola AJ, Spiegel D, Ladabaum U, Haile R, Gomez SL (2018) Racial and ethnic disparities in cancer survival: the contribution of tumor, sociodemographic, institutional, and neighborhood characteristics. J Clin Oncol 36(1):25–33CrossRefPubMed Ellis L, Canchola AJ, Spiegel D, Ladabaum U, Haile R, Gomez SL (2018) Racial and ethnic disparities in cancer survival: the contribution of tumor, sociodemographic, institutional, and neighborhood characteristics. J Clin Oncol 36(1):25–33CrossRefPubMed
10.
Zurück zum Zitat Jemal A, Robbins AS, Lin CC, Flanders WD, DeSantis CE, Ward EM, Freedman RA (2018) Factors that contributed to black-white disparities in survival among nonelderly women with breast cancer between 2004 and 2013. J Clin Oncol 36(1):14–24CrossRefPubMed Jemal A, Robbins AS, Lin CC, Flanders WD, DeSantis CE, Ward EM, Freedman RA (2018) Factors that contributed to black-white disparities in survival among nonelderly women with breast cancer between 2004 and 2013. J Clin Oncol 36(1):14–24CrossRefPubMed
11.
Zurück zum Zitat Seeman T, Epel E, Gruenewald T, Karlamangla A, McEwen BS (2010) Socio-economic differentials in peripheral biology: cumulative allostatic load. Ann N Y Acad Sci 1186:223–239CrossRefPubMed Seeman T, Epel E, Gruenewald T, Karlamangla A, McEwen BS (2010) Socio-economic differentials in peripheral biology: cumulative allostatic load. Ann N Y Acad Sci 1186:223–239CrossRefPubMed
12.
13.
Zurück zum Zitat Healy LA, Ryan AM, Carroll P, Ennis D, Crowley V, Boyle T, Kennedy MJ, Connolly E, Reynolds JV (2010) Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Clin Oncol (R Coll Radiol) 22(4):281–288CrossRefPubMed Healy LA, Ryan AM, Carroll P, Ennis D, Crowley V, Boyle T, Kennedy MJ, Connolly E, Reynolds JV (2010) Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Clin Oncol (R Coll Radiol) 22(4):281–288CrossRefPubMed
14.
Zurück zum Zitat Gallagher EJ, Fei K, Feldman SM, Port E, Friedman NB, Boolbol SK, Killelea B, Pilewskie M, Choi L, King T et al (2020) Insulin resistance contributes to racial disparities in breast cancer prognosis in US women. Breast Cancer Res 22(1):40CrossRefPubMedPubMedCentral Gallagher EJ, Fei K, Feldman SM, Port E, Friedman NB, Boolbol SK, Killelea B, Pilewskie M, Choi L, King T et al (2020) Insulin resistance contributes to racial disparities in breast cancer prognosis in US women. Breast Cancer Res 22(1):40CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287(3):356–359CrossRefPubMed Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287(3):356–359CrossRefPubMed
16.
Zurück zum Zitat Gurka MJ, Lilly CL, Oliver MN, DeBoer MD (2014) An examination of sex and racial/ethnic differences in the metabolic syndrome among adults: a confirmatory factor analysis and a resulting continuous severity score. Metabolism 63(2):218–225CrossRefPubMed Gurka MJ, Lilly CL, Oliver MN, DeBoer MD (2014) An examination of sex and racial/ethnic differences in the metabolic syndrome among adults: a confirmatory factor analysis and a resulting continuous severity score. Metabolism 63(2):218–225CrossRefPubMed
17.
Zurück zum Zitat Gallagher EJ, Greco G, Lin S, Yagnik R, Feldman SM, Port E, Friedman NB, Boolbol SK, Killelea B, Pilewskie M et al (2022) Insulin resistance and racial disparities in breast cancer prognosis: a multi-center cohort study. Endocr Relat Cancer 29(12):693–701CrossRefPubMed Gallagher EJ, Greco G, Lin S, Yagnik R, Feldman SM, Port E, Friedman NB, Boolbol SK, Killelea B, Pilewskie M et al (2022) Insulin resistance and racial disparities in breast cancer prognosis: a multi-center cohort study. Endocr Relat Cancer 29(12):693–701CrossRefPubMed
18.
Zurück zum Zitat van Buuren S (2007) Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res 16(3):219–242CrossRefPubMed van Buuren S (2007) Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res 16(3):219–242CrossRefPubMed
19.
Zurück zum Zitat Li P, Wang T, Zeng C, Yang M, Li G, Han J, Wu W (2020) Association between metabolic syndrome and prognosis of breast cancer: a meta-analysis of follow-up studies. Diabetol Metab Syndr 12:10CrossRefPubMedPubMedCentral Li P, Wang T, Zeng C, Yang M, Li G, Han J, Wu W (2020) Association between metabolic syndrome and prognosis of breast cancer: a meta-analysis of follow-up studies. Diabetol Metab Syndr 12:10CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Dhooge L, Achterberg P, Reeskens T (2018) Mind over matter. The impact of subjective social status on health outcomes and health behaviors. PloS one 13(9):e0202489CrossRefPubMed Dhooge L, Achterberg P, Reeskens T (2018) Mind over matter. The impact of subjective social status on health outcomes and health behaviors. PloS one 13(9):e0202489CrossRefPubMed
21.
Zurück zum Zitat Bonaccio M, Di Castelnuovo A, Pounis G, De Curtis A, Costanzo S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L et al (2017) Relative contribution of health-related behaviours and chronic diseases to the socioeconomic patterning of low-grade inflammation. Int J Public Health 62(5):551–562CrossRefPubMed Bonaccio M, Di Castelnuovo A, Pounis G, De Curtis A, Costanzo S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L et al (2017) Relative contribution of health-related behaviours and chronic diseases to the socioeconomic patterning of low-grade inflammation. Int J Public Health 62(5):551–562CrossRefPubMed
22.
Zurück zum Zitat Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674CrossRefPubMed Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674CrossRefPubMed
23.
Zurück zum Zitat Derry HM, Fagundes CP, Andridge R, Glaser R, Malarkey WB, Kiecolt-Glaser JK (2013) Lower subjective social status exaggerates interleukin-6 responses to a laboratory stressor. Psychoneuroendocrinology 38(11):2676–2685CrossRefPubMed Derry HM, Fagundes CP, Andridge R, Glaser R, Malarkey WB, Kiecolt-Glaser JK (2013) Lower subjective social status exaggerates interleukin-6 responses to a laboratory stressor. Psychoneuroendocrinology 38(11):2676–2685CrossRefPubMed
24.
Zurück zum Zitat Cardel MI, Guo Y, Sims M, Dulin A, Miller D, Chi X, Pavela G, DeBoer MD, Gurka MJ (2020) Objective and subjective socioeconomic status associated with metabolic syndrome severity among African American adults in Jackson Heart Study. Psychoneuroendocrinology 117:104686CrossRefPubMedPubMedCentral Cardel MI, Guo Y, Sims M, Dulin A, Miller D, Chi X, Pavela G, DeBoer MD, Gurka MJ (2020) Objective and subjective socioeconomic status associated with metabolic syndrome severity among African American adults in Jackson Heart Study. Psychoneuroendocrinology 117:104686CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Rohleder N (2014) Stimulation of systemic low-grade inflammation by psychosocial stress. Psychosom Med 76(3):181–189CrossRefPubMed Rohleder N (2014) Stimulation of systemic low-grade inflammation by psychosocial stress. Psychosom Med 76(3):181–189CrossRefPubMed
26.
27.
28.
Zurück zum Zitat Singh GK, Williams SD, Siahpush M, Mulhollen A (2011) Socioeconomic, rural-urban, and racial inequalities in US cancer mortality: part I-all cancers and lung cancer and part II-colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol 2011:107497CrossRefPubMed Singh GK, Williams SD, Siahpush M, Mulhollen A (2011) Socioeconomic, rural-urban, and racial inequalities in US cancer mortality: part I-all cancers and lung cancer and part II-colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol 2011:107497CrossRefPubMed
29.
Zurück zum Zitat Quinlan C, Rattray B, Pryor D, Northey JM, Anstey KJ, Butterworth P, Cherbuin N (2021) The accuracy of self-reported physical activity questionnaires varies with sex and body mass index. PLoS One 16(8):e0256008CrossRefPubMedPubMedCentral Quinlan C, Rattray B, Pryor D, Northey JM, Anstey KJ, Butterworth P, Cherbuin N (2021) The accuracy of self-reported physical activity questionnaires varies with sex and body mass index. PLoS One 16(8):e0256008CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Ravelli MN, Schoeller DA (2020) Traditional self-reported dietary instruments are prone to inaccuracies and new approaches are needed. Front Nutr 7:90CrossRefPubMedPubMedCentral Ravelli MN, Schoeller DA (2020) Traditional self-reported dietary instruments are prone to inaccuracies and new approaches are needed. Front Nutr 7:90CrossRefPubMedPubMedCentral
Metadaten
Titel
Subjective social status, race, and metabolic syndrome in women with breast cancer
verfasst von
Giampaolo Greco
Nina A. Bickell
Sylvia Lin
Radhi Yagnik
Derek LeRoith
Emily J. Gallagher
Publikationsdatum
23.04.2023
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 3/2023
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-023-06949-5

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