Increased blood glucose and insulin, body size, and incident colorectal cancer
Increased blood glucose and insulin, body size, and incident colorectal cancer
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DOI：
10.1093/jnci/91.13.1147
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发表时间：
1999-07-07
影响因子：
10.3
通讯作者：
Savage, PJ
中科院分区：
文献类型：
--
作者：
Schoen, RE;Tangen, CM;Savage, PJ
背景：腹部肥胖（内脏脂肪组织水平升高）与结直肠癌有关。此外，内脏脂肪组织水平升高与高胰岛素血症有关，胰岛素是结肠中的生长因子。我们评估了腰围（内脏脂肪组织的替代指标）和与内脏脂肪组织相关的代谢参数是否与结直肠癌相关。方法：在心血管健康研究队列中，我们检查了基线测量的体型、葡萄糖、胰岛素和脂蛋白与结直肠癌的关系。所有P值均为双侧。结果：在5849名参与者中，确定了102例大肠癌的发病病例。空腹血糖最高四分位数的个体患结直肠癌的风险增加近两倍（相对风险[RR] = 1.8; 95%置信区间[CI] = 1.0-3.1），线性趋势RR（LT RR = 1.2; 95%CI = 1.0-1.5）对空腹血糖水平有统计学意义口服葡萄糖后2小时的葡萄糖和胰岛素水平也显示出与结直肠癌的统计学显著相关性（P =.02）。（2小时血糖水平：RR = 2.4 [95% CI = 1.2-4.7]/LT RR = 1.3 [95% CI = 1.0-1.6; P = 0.02]; 2小时胰岛素水平：RR = 2.0 [95% CI = 1.0-3.8]/LT RR = 1.2 [95% CI = 1.0-1.5;空腹胰岛素水平的分析表明存在阈值效应，高于中位数的值与结直肠癌相关（RR = 1.6; 95%CI = 1.1-2.4; P = 0.02）。较高的腰围水平也与结直肠癌有统计学显著相关（RR = 1.9; 95% CI = 1.1-3.3; P = 0.02）。结论：据我们所知，这些数据提供了内脏脂肪组织水平升高及其相关代谢效应与结直肠癌之间相关性的第一个直接证据。
Background: 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, Methods: 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. Results: 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). Conclusions: 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.