Hormonal factors and insulin-like growth factor-1 in North American postmenopausal women

Background: Mechanisms underlying the effect of estrogen exposure on breast cancer risk remain unclear. Insulin-like growth factor-1 (IGF-1) levels have been positively associated with breast cancer and are a potential mechanism. Objectives: The objectives of this thesis are: 1) to explore whether the reproductive risk factors and the lifetime cumulative number of menstrual cycles (LCMC), as measures for long-term estrogen exposure, are associated with IGF-1 levels, and 2) to examine the effect of an aromatase inhibitor (AI) on IGF-1 levels, and the potential interaction with BMI. Methods: A cross sectional study and a randomized controlled trial nested with the MAP.3 chemoprevention trial were used to address objective 1 and 2, respectively. 567 postmenopausal women were selected. Anthropometric measurements, lifestyle factors, reproductive characteristics and serum IGF-1 concentrations were collected at baseline and one year. Objective 1. The LCMC was computed as a composite measure of the reproductive characteristics. Multivariable linear regression models were used to assess the association between IGF-1 levels and LCMC and the hormonal risk factors, while adjusting for potential covariates. Objective 2. Changes in IGF-1 were compared between the exemestane and placebo, and effect modification by BMI was tested with an interaction term. Results: Objective 1. Women aged 55 years or older at menopause had 16.26 ng/mL (95% CI: 1.76, 30.75) higher IGF-1 compared to women aged less than 50 years at menopause. Women in the highest category of menstrual cycles (≥500 cycles) had an average 19.00 ng/mL (95%CI: 5.86, 32.14) higher concentration of IGF-1 compared to women in the lowest category (<350). Exogenous hormones had no effect on postmenopausal IGF-1 levels. Objective 2. Exemestane significantly increased IGF-1 levels by 18% (95% CI: 14%-22%); while, placebo had no effect on IGF-1. The changes in IGF-1 were significantly different between the treatment arms (P<0.0001) and no significant interaction was observed between treatment and BMI on IGF-1 changes (P=0.1327). Conclusion: Objective 1. Larger number of menstrual cycles and a later age at menopause are positively associated with IGF-1. IGF-1 may be one mechanism by which prolonged estrogen exposure increases cancer risk. Objective 2. We conclude that the reduced cancer risk observed with AI therapy likely occurs in an IGF-1 independent mechanism. Further studies exploring the clinical consequences of increased IGF-1 on AI therapy are needed.

Impaired GABA Plasticity at ovBNST Synapses Predicts Compulsive Drinking in Schedule-Induced Polydipsia

Schedule-Induced Polydipsia (SIP) is an animal model of adjunctive drinking induced when a hungry rat receives food on a fixed interval of time. This model has been implemented as a model of compulsive behaviour and may represent a powerful tool to understand the neural mechanisms of compulsion. The bed nucleus of the stria terminalis (BNST) is thought to translate challenges to energy homeostasis into consummatory behaviours, and is therefore likely to contribute to drinking behaviours displayed by food restricted rats in the SIP paradigm. Furthermore, the BNST seems implicated in various compulsive behaviors, including compulsive water drinking in rats. Therefore, the goal of this project was to determine whether compulsive drinking in the SIP paradigm was associated with alterations in transmission at oval BNST (ovBNST) synapses. Rats undergoing the SIP procedure had restricted food access (1-hours/day) for a total of 29 days. After 7 days of food restriction and for the next 21 consecutive days, the rats had daily 2-hour access to operant conditioning chambers where they were presented with a 45-mg food pellet every minute. Water consumed during these 2-hour sessions was measured and the rats that drank 15 ml or more water for a minimum of 3 consecutive days were considered High Drinkers (HD; n=17) or otherwise, Low Drinkers (LD; n=13). Brain slices whole-cell patch clamp recordings conducted 18-hours after the last SIP training showed that chronic food restriction changed low frequency stimulation (LFS) - induced long-term potentiation of ovBNST inhibitory synaptic transmission (iLTP) into LFS - induced long-term depression (iLTD) in a majority of neurons, regardless of drinking behaviours. However, ad libitum access to food between the last day of SIP training and brain slice recordings (18-hour refeed) rescued LFS-induced iLTP in LD but not in HD, suggesting that impaired bi-directional plasticity of ovBNST synapses may contribute to compulsive drinking in the SIP paradigm.