TY - JOUR
T1 - Effects of behavioral weight loss and metformin on IGFs in cancer survivors
T2 - A randomized trial
AU - Yeh, Hsin Chieh
AU - Maruthur, Nisa M.
AU - Wang, Nae Yuh
AU - Jerome, Gerald J.
AU - Dalcin, Arlene T.
AU - Tseng, Eva
AU - White, Karen
AU - Miller, Edgar R.
AU - Juraschek, Stephen P.
AU - Mueller, Noel T.
AU - Charleston, Jeanne
AU - Durkin, Nowella
AU - Hassoon, Ahmed
AU - Lansey, Dina G.
AU - Kanarek, Norma F.
AU - Carducci, Michael A.
AU - Appel, Lawrence J.
N1 - Funding Information:
This project was supported by the Maryland Cigarette Restitution Fund and Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. H.-C.Y. and N.K. were also supported in part by the National Cancer Institute’s Cancer Centers Support Grant (5P30CA006973).
Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Context: Higher levels of insulin-like growth factor-1 (IGF-1) are associated with increased risk of cancers and higher mortality. Therapies that reduce IGF-1 have considerable appeal as means to prevent recurrence. Design: Randomized, 3-parallel-arm controlled clinical trial. Interventions and Outcomes: Cancer survivors with overweight or obesity were randomized to (1) self-directed weight loss (comparison), (2) coach-directed weight loss, or (3) metformin treatment. Main outcomes were changes in IGF-1 and IGF-1:IGFBP3 molar ratio at 6 months.The trial duration was 12 months. Results: Of the 121 randomized participants, 79% were women, 46% were African Americans, and the mean age was 60 years. At baseline, the average body mass index was 35 kg/m2; mean IGF-1 was 72.9 (SD, 21.7) ng/mL; and mean IGF1:IGFBP3 molar ratio was 0.17 (SD, 0.05). At 6 months, weight changes were -1.0% (P = 0.07), -4.2% (P < 0.0001), and -2.8% (P < 0.0001) in self-directed, coach-directed, and metformin groups, respectively. Compared with the self-directed group, participants in metformin had significant decreases on IGF-1 (mean difference in change: -5.50 ng/mL, P = 0.02) and IGF1:IGFBP3 molar ratio (mean difference in change: -0.0119, P = 0.011) at 3 months. The significant decrease of IGF-1 remained in participants with obesity at 6 months (mean difference in change: -7.2 ng/mL; 95% CI: -13.3 to -1.1), but not in participants with overweight (P for interaction = 0.045). There were no significant differences in changes between the coach-directed and self-directed groups. There were no differences in outcomes at 12 months. Conclusions: In cancer survivors with obesity, metformin may have a short-term effect on IGF-1 reduction that wanes over time.
AB - Context: Higher levels of insulin-like growth factor-1 (IGF-1) are associated with increased risk of cancers and higher mortality. Therapies that reduce IGF-1 have considerable appeal as means to prevent recurrence. Design: Randomized, 3-parallel-arm controlled clinical trial. Interventions and Outcomes: Cancer survivors with overweight or obesity were randomized to (1) self-directed weight loss (comparison), (2) coach-directed weight loss, or (3) metformin treatment. Main outcomes were changes in IGF-1 and IGF-1:IGFBP3 molar ratio at 6 months.The trial duration was 12 months. Results: Of the 121 randomized participants, 79% were women, 46% were African Americans, and the mean age was 60 years. At baseline, the average body mass index was 35 kg/m2; mean IGF-1 was 72.9 (SD, 21.7) ng/mL; and mean IGF1:IGFBP3 molar ratio was 0.17 (SD, 0.05). At 6 months, weight changes were -1.0% (P = 0.07), -4.2% (P < 0.0001), and -2.8% (P < 0.0001) in self-directed, coach-directed, and metformin groups, respectively. Compared with the self-directed group, participants in metformin had significant decreases on IGF-1 (mean difference in change: -5.50 ng/mL, P = 0.02) and IGF1:IGFBP3 molar ratio (mean difference in change: -0.0119, P = 0.011) at 3 months. The significant decrease of IGF-1 remained in participants with obesity at 6 months (mean difference in change: -7.2 ng/mL; 95% CI: -13.3 to -1.1), but not in participants with overweight (P for interaction = 0.045). There were no significant differences in changes between the coach-directed and self-directed groups. There were no differences in outcomes at 12 months. Conclusions: In cancer survivors with obesity, metformin may have a short-term effect on IGF-1 reduction that wanes over time.
KW - Behavioral weight loss
KW - IGF-1
KW - IGFBP3
KW - Insulin-like growth factors
KW - Metformin
KW - Weight
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U2 - 10.1210/clinem/dgab266
DO - 10.1210/clinem/dgab266
M3 - Article
C2 - 33884414
AN - SCOPUS:85111585165
SN - 0021-972X
VL - 106
SP - E4179-E4191
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -