Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac

Abstract Breast cancer (BC) is the most common tumor worldwide and it has been recognized that up to one third of BC patients have co-existing diabetes mellitus (DM) (BC-DM). Although many observational studies have indicated an association between DM and BC, the causal relationship of DM and BC pro...

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Main Authors: Binbin Tan, Yang Liu, Qianqian Chen, Weijie Yang, Wenhan Yang, Kaiping Gao, Li Fu, Tiantian Zhang, Penglong Chen, Yongyi Huang, Yuting Wang, Guoqiang Zhang, Juan Xiong, Rihong Zhai
Format: Article
Language:English
Published: Nature Publishing Group 2025-07-01
Series:Cell Death and Disease
Online Access:https://doi.org/10.1038/s41419-025-07849-w
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author Binbin Tan
Yang Liu
Qianqian Chen
Weijie Yang
Wenhan Yang
Kaiping Gao
Li Fu
Tiantian Zhang
Penglong Chen
Yongyi Huang
Yuting Wang
Guoqiang Zhang
Juan Xiong
Rihong Zhai
author_facet Binbin Tan
Yang Liu
Qianqian Chen
Weijie Yang
Wenhan Yang
Kaiping Gao
Li Fu
Tiantian Zhang
Penglong Chen
Yongyi Huang
Yuting Wang
Guoqiang Zhang
Juan Xiong
Rihong Zhai
author_sort Binbin Tan
collection DOAJ
description Abstract Breast cancer (BC) is the most common tumor worldwide and it has been recognized that up to one third of BC patients have co-existing diabetes mellitus (DM) (BC-DM). Although many observational studies have indicated an association between DM and BC, the causal relationship of DM and BC prognosis remained uncertain and the molecular mechanisms underlying BC-DM are largely unclear. In this study, we used causal inference methods, including g-computation (GC), inverse probability of treatment weighting (IPTW), targeted maximum likelihood estimation (TMLE), and TMLE-super learner (TMLE-SL), to comprehensively analyze the association of DM with BC mortality in a cohort of 3386 BC patients. We found that the adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for 5-year mortality in BC-DM patients were 1.926 (1.082, 2.943), 2.268 (1.063, 3.974), 1.917 (1.091, 2.953), and 2.113 (1.365, 3.270), respectively. Further transcriptomic and qPCR analyses identified that FIBCD1 was highly expressed in BC-DM tumor tissues and in BC cells under hyperglycemia conditions. Functionally, upregulation of FIBCD1 promoted proliferation, migration, and invasion capacities of BC cells in a glucose level-dependent manner. While knockdown of FIBCD1 suppressed BC tumor growth in diabetic mice. Integrated RNA-seq and Ribo-seq analysis revealed that MCM5 was a target of FIBCD1. Mechanistically, hyperglycemia-activated FIBCD1 promoted MCM5 expression to induce S-phase cell cycle arrest by upregulating histone H3K27ac levels in MCM5 promoter via the PDH-acetyl-CoA axis. Our findings provide new evidence that co-existing DM has a causal effect on overall mortality in BC-DM patients. Targeting FIBCD1 may be a promising therapy for BC-DM.
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spelling doaj-art-ca7ec2a0ee7544d697367c8ea167b0b02025-08-20T03:42:10ZengNature Publishing GroupCell Death and Disease2041-48892025-07-0116111610.1038/s41419-025-07849-wDiabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27acBinbin Tan0Yang Liu1Qianqian Chen2Weijie Yang3Wenhan Yang4Kaiping Gao5Li Fu6Tiantian Zhang7Penglong Chen8Yongyi Huang9Yuting Wang10Guoqiang Zhang11Juan Xiong12Rihong Zhai13Department of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolDepartment of Surgery, Harbin Medical University Cancer HospitalCancer Centre, Faculty of Health Sciences, University of MacauDepartment of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolNational Clinical Research Center for Infectious Disease, Shenzhen Third People’s Hospital, Southern University of Science and TechnologySchool of Public Health, Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Medical SchoolDepartment of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolDepartment of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolDepartment of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolSchool of Public Health, Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Medical SchoolSchool of Public Health, Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Medical SchoolDepartment of Surgery, Harbin Medical University Cancer HospitalSchool of Public Health, Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Medical SchoolDepartment of Pharmacology and International Cancer Center, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Shenzhen University Medical SchoolAbstract Breast cancer (BC) is the most common tumor worldwide and it has been recognized that up to one third of BC patients have co-existing diabetes mellitus (DM) (BC-DM). Although many observational studies have indicated an association between DM and BC, the causal relationship of DM and BC prognosis remained uncertain and the molecular mechanisms underlying BC-DM are largely unclear. In this study, we used causal inference methods, including g-computation (GC), inverse probability of treatment weighting (IPTW), targeted maximum likelihood estimation (TMLE), and TMLE-super learner (TMLE-SL), to comprehensively analyze the association of DM with BC mortality in a cohort of 3386 BC patients. We found that the adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for 5-year mortality in BC-DM patients were 1.926 (1.082, 2.943), 2.268 (1.063, 3.974), 1.917 (1.091, 2.953), and 2.113 (1.365, 3.270), respectively. Further transcriptomic and qPCR analyses identified that FIBCD1 was highly expressed in BC-DM tumor tissues and in BC cells under hyperglycemia conditions. Functionally, upregulation of FIBCD1 promoted proliferation, migration, and invasion capacities of BC cells in a glucose level-dependent manner. While knockdown of FIBCD1 suppressed BC tumor growth in diabetic mice. Integrated RNA-seq and Ribo-seq analysis revealed that MCM5 was a target of FIBCD1. Mechanistically, hyperglycemia-activated FIBCD1 promoted MCM5 expression to induce S-phase cell cycle arrest by upregulating histone H3K27ac levels in MCM5 promoter via the PDH-acetyl-CoA axis. Our findings provide new evidence that co-existing DM has a causal effect on overall mortality in BC-DM patients. Targeting FIBCD1 may be a promising therapy for BC-DM.https://doi.org/10.1038/s41419-025-07849-w
spellingShingle Binbin Tan
Yang Liu
Qianqian Chen
Weijie Yang
Wenhan Yang
Kaiping Gao
Li Fu
Tiantian Zhang
Penglong Chen
Yongyi Huang
Yuting Wang
Guoqiang Zhang
Juan Xiong
Rihong Zhai
Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
Cell Death and Disease
title Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
title_full Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
title_fullStr Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
title_full_unstemmed Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
title_short Diabetes is causally associated with increased breast cancer mortality by inducing FIBCD1 to activate MCM5-mediated cell cycle arrest via modulating H3K27ac
title_sort diabetes is causally associated with increased breast cancer mortality by inducing fibcd1 to activate mcm5 mediated cell cycle arrest via modulating h3k27ac
url https://doi.org/10.1038/s41419-025-07849-w
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