Title | Increased blood glucose and insulin, body size, and incident colorectal cancer. |
Publication Type | Journal Article |
Year of Publication | 1999 |
Authors | Schoen, RE, Tangen, CM, Kuller, LH, Burke, GL, Cushman, M, Tracy, RP, Dobs, A, Savage, PJ |
Journal | J Natl Cancer Inst |
Volume | 91 |
Issue | 13 |
Pagination | 1147-54 |
Date Published | 1999 Jul 07 |
ISSN | 0027-8874 |
Keywords | Adipose Tissue, Aged, Blood Glucose, Body Constitution, Cholesterol, HDL, Colorectal Neoplasms, Female, Humans, Incidence, Insulin, Male, Prospective Studies, Risk, Triglycerides, Viscera |
Abstract | <p><b>BACKGROUND: </b>Abdominal obesity--an elevated level of visceral adipose tissue--has been linked to colorectal cancer. Furthermore, elevated levels of visceral adipose tissue have been associated with hyperinsulinemia, and insulin is a growth factor in the colon. We assessed whether waist circumference, a surrogate measure of visceral adipose tissue, and metabolic parameters associated with visceral adipose tissue were related to colorectal cancer.</p><p><b>METHODS: </b>In the Cardiovascular Health Study cohort, we examined the relationship of baseline measurements of body size, glucose, insulin, and lipoproteins to incident colorectal cancer. All P values are two-sided.</p><p><b>RESULTS: </b>Among 5849 participants, 102 incident cases of colorectal cancer were identified. Individuals in the highest quartile of fasting glucose had a nearly twofold increased risk of colorectal cancer (relative risk [RR] = 1.8; 95% confidence interval [CI] = 1.0-3.1), and the linear trend RR (LT RR = 1.2; 95% CI = 1.0-1.5) for fasting glucose level was statistically significant (P =. 02). Glucose and insulin levels 2 hours after oral glucose challenge also exhibited statistically significant associations with colorectal cancer (2-hour glucose levels: RR = 2.4 [95% CI = 1.2-4. 7]/LT RR = 1.3 [95% CI = 1.0-1.6; P =.02]; 2-hour insulin levels: RR = 2.0 [95% CI = 1.0-3.8]/LT RR = 1.2 [95% CI = 1.0-1.5; P =.04]). Analysis of fasting insulin levels suggested a threshold effect, with values above the median associated with colorectal cancer (RR = 1.6; 95% CI = 1.1-2.4; P =.02). Higher levels of waist circumference were also statistically significantly associated with colorectal cancer (RR = 1.9; 95% CI = 1.1-3.3; P =.02).</p><p><b>CONCLUSIONS: </b>These data provide, to our knowledge, the first direct evidence of an association between elevated visceral adipose tissue level, its associated metabolic effects, and colorectal cancer.</p> |
DOI | 10.1093/jnci/91.13.1147 |
Alternate Journal | J Natl Cancer Inst |
PubMed ID | 10393723 |
Grant List | K07CA72561 / CA / NCI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States |