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- Title
Effects of Behavioral Weight Loss and Metformin on IGFs in Cancer Survivors: A Randomized Trial.
- Authors
Hsin-Chieh Yeh; Maruthur, Nisa M.; Nae-Yuh Wang; Jerome, Gerald J.; Dalcin, Arlene T.; Tseng, Eva; White, Karen; Miller III, Edgar R.; Juraschek, Stephen P.; Mueller, Noel T.; Charleston, Jeanne; Durkin, Nowella; Hassoon, Ahmed; Lansey, Dina G.; Kanarek, Norma F.; Carducci, Michael A.; Appel, Lawrence J.
- Abstract
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.
- Subjects
WEIGHT loss; SOMATOMEDIN C; CANCER survivors
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 10, pe4179
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/clinem/dgab266