Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis

BackgroundGestational diabetes mellitus (GDM), a prevalent metabolic complication during pregnancy, has a global prevalence of approximately 14%. Its onset is closely associated with insulin resistance, insufficient compensatory function of β - cells, and abnormal placental function. Epidemiological...

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Main Authors: Jing Li, Jinzhu Li, Jie Jin, Ruiqin Zhang, Rong Li, Xian Xu, Yu Wang, Xinghe Hu, Lu Wang, Siyuan Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1621932/full
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author Jing Li
Jinzhu Li
Jie Jin
Ruiqin Zhang
Rong Li
Xian Xu
Yu Wang
Xinghe Hu
Lu Wang
Siyuan Yu
author_facet Jing Li
Jinzhu Li
Jie Jin
Ruiqin Zhang
Rong Li
Xian Xu
Yu Wang
Xinghe Hu
Lu Wang
Siyuan Yu
author_sort Jing Li
collection DOAJ
description BackgroundGestational diabetes mellitus (GDM), a prevalent metabolic complication during pregnancy, has a global prevalence of approximately 14%. Its onset is closely associated with insulin resistance, insufficient compensatory function of β - cells, and abnormal placental function. Epidemiological studies have indicated that type 2 diabetes is an independent risk factor for breast cancer. However, the association between GDM and the risk of breast cancer remains controversial.ObjectiveThis systematic review and meta-analysis aim to comprehensively evaluate the association between GDM and the risk of breast cancer and explore its underlying mechanisms.MethodsThis study systematically searched PubMed, Web of Science, Scopus, EMBASE, and the Cochrane Library databases, covering the period from establishing each database until April 14, 2025. Two researchers extracted relevant data and assessed the quality of included studies using the Newcastle-Ottawa Scale. The study evaluated inter-study heterogeneity using the I² statistic. Based on the magnitude of heterogeneity, fixed-effect or random-effect models were employed to calculate the pooled hazard ratio (HR) and its corresponding 95% confidence interval (CI). Additionally, subgroup analyses, sensitivity analyses, funnel plot analyses, and publication bias assessments were performed. All data analyses were conducted using STATA 17 software.ResultsThe overall analysis revealed no significant association between GDM and breast cancer risk (HR=1.03, 95%CI: 0.92-1.15). However, subgroup analysis revealed significant regional heterogeneity: within the regional subgroups, North American results showed an association between GDM and a reduced breast cancer risk (HR=0.89, 95%CI: 0.84-0.95), whereas Asian findings suggested an association with an increased risk (HR=1.23, 95%CI: 1.15-1.31). No significant associations were observed in subgroups based on study design (cohort/case-control) or follow-up duration (short-term/long-term). Sensitivity analysis demonstrated robust results, and there was no publication bias in this study.ConclusionIn summary, there is no significant association between GDM and breast cancer risk overall. However, notable regional heterogeneity exists: in the North American subgroup, GDM is associated with a reduced risk of breast cancer, while in the Asian subgroup, GDM is significantly associated with an increased risk of breast cancer.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251032589.
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spelling doaj-art-7a6c82cbea2f45379073fb5fb1710c0b2025-08-20T03:29:18ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16219321621932Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysisJing Li0Jinzhu Li1Jie Jin2Ruiqin Zhang3Rong Li4Xian Xu5Yu Wang6Xinghe Hu7Lu Wang8Siyuan Yu9Department of Geriatric Radiology, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of the Sixth Health Care, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Emergency, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Emergency, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of the First Health Care, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Radiology, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Radiology, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Radiology, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Cardiovascular, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaDepartment of Geriatric Cardiovascular, The Second Medical Centre & National Clinical Research Centre, Chinese PLA General Hospital, Beijing, ChinaBackgroundGestational diabetes mellitus (GDM), a prevalent metabolic complication during pregnancy, has a global prevalence of approximately 14%. Its onset is closely associated with insulin resistance, insufficient compensatory function of β - cells, and abnormal placental function. Epidemiological studies have indicated that type 2 diabetes is an independent risk factor for breast cancer. However, the association between GDM and the risk of breast cancer remains controversial.ObjectiveThis systematic review and meta-analysis aim to comprehensively evaluate the association between GDM and the risk of breast cancer and explore its underlying mechanisms.MethodsThis study systematically searched PubMed, Web of Science, Scopus, EMBASE, and the Cochrane Library databases, covering the period from establishing each database until April 14, 2025. Two researchers extracted relevant data and assessed the quality of included studies using the Newcastle-Ottawa Scale. The study evaluated inter-study heterogeneity using the I² statistic. Based on the magnitude of heterogeneity, fixed-effect or random-effect models were employed to calculate the pooled hazard ratio (HR) and its corresponding 95% confidence interval (CI). Additionally, subgroup analyses, sensitivity analyses, funnel plot analyses, and publication bias assessments were performed. All data analyses were conducted using STATA 17 software.ResultsThe overall analysis revealed no significant association between GDM and breast cancer risk (HR=1.03, 95%CI: 0.92-1.15). However, subgroup analysis revealed significant regional heterogeneity: within the regional subgroups, North American results showed an association between GDM and a reduced breast cancer risk (HR=0.89, 95%CI: 0.84-0.95), whereas Asian findings suggested an association with an increased risk (HR=1.23, 95%CI: 1.15-1.31). No significant associations were observed in subgroups based on study design (cohort/case-control) or follow-up duration (short-term/long-term). Sensitivity analysis demonstrated robust results, and there was no publication bias in this study.ConclusionIn summary, there is no significant association between GDM and breast cancer risk overall. However, notable regional heterogeneity exists: in the North American subgroup, GDM is associated with a reduced risk of breast cancer, while in the Asian subgroup, GDM is significantly associated with an increased risk of breast cancer.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251032589.https://www.frontiersin.org/articles/10.3389/fendo.2025.1621932/fullmeta-analysisgestational diabetes mellitusbreast cancersystematic reviewPRISMA
spellingShingle Jing Li
Jinzhu Li
Jie Jin
Ruiqin Zhang
Rong Li
Xian Xu
Yu Wang
Xinghe Hu
Lu Wang
Siyuan Yu
Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
Frontiers in Endocrinology
meta-analysis
gestational diabetes mellitus
breast cancer
systematic review
PRISMA
title Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
title_full Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
title_fullStr Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
title_full_unstemmed Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
title_short Association between gestational diabetes mellitus and risk of breast cancer: a systematic review and meta-analysis
title_sort association between gestational diabetes mellitus and risk of breast cancer a systematic review and meta analysis
topic meta-analysis
gestational diabetes mellitus
breast cancer
systematic review
PRISMA
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1621932/full
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