ArticleBMC cancer2026
Genetic evidence for potential molecular mediators underlying the causal relationship between obesity and breast cancer: a two-step, two-sample Mendelian randomization study.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRelationships between BMI and breast cancer risk have been widely reported in previous Mendelian randomization (MR) studies, but the underlying molecular mechanisms remain unclear. We conducted this comprehensive two-sample MR to investigate the mediating role of 8 circulating biomarkers linking genetically predicted BMI to breast cancer risk both individually and simultaneously.
methodsA total of 281 BMI-associated single-nucleotide polymorphisms (SNPs) were used to estimate the associations of BMI with biomarker levels and breast cancer susceptibility. Instruments involving 8 ~ 364 SNPs were used to proxy 8 circulating biomarkers related to adipocytokine imbalance, chronic low-grade inflammation and insulin/insulin-like growth factor (IGF) axis dysregulation. Two-step MR mediation analyses were conducted to evaluate the indirect effects of a single biomarker in the relationship between genetically predicted BMI and breast cancer risk, and stepwise MR mediation analyses were employed to identify potential pathways involving multiple mediators.
resultsGenetically predicted BMI was positively correlated with genetically predicted circulating leptin (LEP), insulin (INS), and C-reactive protein (CRP) levels, with β values ranging from 0.166 to 0.453, and negatively correlated with IGF-1 levels (β=-0.118), whereas no statistically significant associations were found for adiponectin, resistin, soluble leptin receptor or insulin-like growth factor binding protein-3 levels. Two-step MR mediation analyses showed that in the association between genetically predicted BMI and breast cancer susceptibility (OR: 0.894; 95%CI: 0.832, 0.960; P = 2.06 × 10
conclusionsChronic low-grade inflammation is a vital pathway linking genetically predicted BMI to breast cancer risk. Genetically predicted BMI is associated with higher genetically predicted CRP levels, potentially through a pathway involving reduced IGF-1 levels, which may attenuate the inverse association between genetically predicted BMI and breast cancer risk.
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