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The USA trial (Reach for Health) included postmenopausal BC survivors (n\u2009=\u2009333) randomly assigned to 6-month metformin vs placebo and lifestyle intervention (LSI) vs control (2\u2009\u00d7\u20092 factorial design). The Italian trial (MetBreCS) included BC survivors (n\u2009=\u200940) randomized to 12-month metformin vs placebo. Insulin resistance (HOMA-IR), adipokines, cytokines, and steroids were measured.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Metformin compared to placebo showed a favorable decrease in leptin (\u2212 8.8 vs \u2212 3.5\u00a0ng\/mL; p\u2009&lt;\u20090.01) and HOMA-IR (\u2212 0.48 vs \u2212 0.25; p\u2009=\u20090.03), and an increase in SHBG (2.80 vs 1.45\u00a0nmol\/L; p\u2009&lt;\u20090.01). Excluding women taking aromatase inhibitors, metformin (n\u2009=\u200984) compared to placebo (n\u2009=\u200999) decreased estradiol (\u2212 4 vs 0\u00a0pmol\/L; p\u2009&lt;\u20090.01), estrone (\u2212 8 vs 2\u00a0pmol\/L; p\u2009&lt;\u20090.01) and testosterone (\u2212 0.1 vs 0\u00a0nmol\/L-; p\u2009=\u20090.02). LSI favorably affected adiponectin (0.45 vs \u2212 0.06 ug\/mL; p\u2009&lt;\u20090.01), leptin (\u2212 10.5 vs \u2212 4.4\u00a0ng\/mL; p\u2009&lt;\u20090.01), HOMA-IR (\u2212 0.6 vs 0.2; p\u2009=\u20090.03), and SHBG (2.7 vs 1.1 nMol\/L; p\u2009=\u20090.04) compared to controls. The strongest impact was observed combining metformin with LSI on adipokines, CRP, SHBG, and estrogens.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Supportive healthy lifestyle programs combined with metformin to achieve maximal risk reduction among BC cancer survivors are recommended, especially for those with obesity in menopause.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-023-07241-2","type":"journal-article","created":{"date-parts":[[2024,1,26]],"date-time":"2024-01-26T19:02:37Z","timestamp":1706295757000},"page":"49-59","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of metformin and lifestyle intervention on adipokines and hormones in breast cancer survivors: a pooled analysis from two randomized controlled trials"],"prefix":"10.1007","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4131-2030","authenticated-orcid":false,"given":"Harriet","family":"Johansson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bellerba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Macis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn-Erik","family":"Bertelsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliana","family":"Guerrieri-Gonzaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Aristarco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Viste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Mellgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Di Cola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemos","family":"Costantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Scalbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy D.","family":"Sears","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gandini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"DeCensi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Bonanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,26]]},"reference":[{"key":"7241_CR1","doi-asserted-by":"publisher","first-page":"230","DOI":"10.3322\/caac.21719","volume":"72","author":"CL Rock","year":"2022","unstructured":"Rock CL, Thomson CA, Sullivan KR et al (2022) American Cancer Society nutrition and physical activity guideline for cancer survivors. 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