Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis.
Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis.
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DOI：
10.1054/bjoc.2000.1582
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发表时间：
2001-02-02
影响因子：
8.8
通讯作者：
Vatten LJ
中科院分区：
文献类型：
--
作者：
Nilsen TI;Vatten LJ
久坐不动的生活方式、肥胖和西化的饮食与结直肠癌和非胰岛素依赖型糖尿病的病因有关，从而提出了高胰岛素血症可能促进结直肠癌的假设。我们前瞻性研究了75219名挪威男性和女性的结直肠癌风险与胰岛素抵抗和高胰岛素血症相关因素（包括BMI、体力活动、糖尿病和血糖）之间的关系。 关于结肠直肠癌发病病例的信息可从挪威癌症登记处获得。报告的P值为双侧。在12年的随访中，登记了730例结直肠癌。在男性中，但不是在女性中，我们发现了一个负相关的休闲时间的体力活动（趋势P = 0.002），与年龄调整的RR为0.54的最高与最低类别的活动（95%CI = 0.37-0.79）。有糖尿病史的女性（而非男性）患结直肠癌的风险增加（年龄校正RR = 1.55; 95%CI = 1.04-2.31），非空腹血糖≥8.0 mmol l−1的女性（年龄校正RR = 1.98; 95%CI = 1.31-2.98）与血糖<8.0 mmol l−1的女性相比也是如此。总体而言，我们发现BMI与结直肠癌风险之间没有关联。包括每个主要变量、婚姻状况和教育程度在内的其他调整并没有实质性地改变结果。我们的结论是，男性的休闲时间的体力活动和结直肠癌之间的负相关，和女性的糖尿病，血糖和结直肠癌之间的正相关，至少部分地支持了胰岛素可能作为肿瘤促进剂在结直肠癌发生的假设。© 2001年癌症研究运动http://www.bjcancer.com
A sedentary lifestyle, obesity, and a Westernized diet have been implicated in the aetiology of both colorectal cancer and non-insulin dependent diabetes mellitus, leading to the hypothesis that hyperinsulinaemia may promote colorectal cancer. We prospectively examined the association between colorectal cancer risk and factors related to insulin resistance and hyperinsulinaemia, including BMI, physical activity, diabetes mellitus, and blood glucose, in a cohort of 75 219 Norwegian men and women. Information on incident cases of colorectal cancer was made available from the Norwegian Cancer Registry. Reported P values are two-sided. During 12 years of follow up, 730 cases of colorectal cancer were registered. In men, but not in women, we found a negative association with leisure-time physical activity (P for trend = 0.002), with an age-adjusted RR for the highest versus the lowest category of activity of 0.54 (95% CI = 0.37–0.79). Women, but not men, with a history of diabetes were at increased risk of colorectal cancer (age-adjusted RR = 1.55; 95% CI = 1.04–2.31), as were women with non-fasting blood glucose ≥8.0 mmol l−1(age-adjusted RR = 1.98; 95% CI = 1.31–2.98) compared with glucose <8.0 mmol l−1. Overall, we found no association between BMI and risk of colorectal cancer. Additional adjustment including each of the main variables, marital status, and educational attainment did not materially change the results. We conclude that the inverse association between leisure-time physical activity and colorectal cancer in men, and the positive association between diabetes, blood glucose, and colorectal cancer in women, at least in part, support the hypothesis that insulin may act as a tumour promoter in colorectal carcinogenesis. © 2001 Cancer Research Campaign http://www.bjcancer.com
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