Colorectal cancer mortality and factors related to the insulin resistance syndrome.
Colorectal cancer mortality and factors related to the insulin resistance syndrome.
复制标题
DOI：
--
复制
发表时间：
2002-04
期刊：
影响因子：
--
通讯作者：
L. Colangelo;S. Gapstur;P. Gann;A. Dyer;Kiang Liu
中科院分区：
文献类型：
--
作者：
L. Colangelo;S. Gapstur;P. Gann;A. Dyer;Kiang Liu
已经提出高胰岛素血症参与结肠癌的发生。负荷后血糖（PLG）水平与结直肠癌死亡率风险之间的相关性与这一假设一致。我们使用来自芝加哥心脏协会工业检测项目的数据来检查非空腹PLG和其他与胰岛素抵抗综合征相关的变量（即，收缩压、体重指数、尿酸和静息心率）与结直肠癌死亡率的关系。在排除了报告糖尿病史的参与者后，20，433名男性和15，149名女性分别发生了191和126例结直肠癌死亡。在多变量考克斯回归分析中，PLG水平与女性结直肠癌死亡率呈正相关（趋势P = 0.08），但与男性无关。当将男性和女性合并时，PLG的趋势（P = 0.05）仍然存在。对胰岛素抵抗综合征相关危险因素的聚类检查显示，具有4种危险因素中至少3种的男性（即，在PLG的性别特异性分布的最高四分位数中，收缩压、体重指数或静息心率）与这些因素中任何一个都不在上四分位数中的男性相比，相对危险度（RR）为1.67 [95%置信区间（CI），1.04-2.70]。对于女性，RR为1.29（95% CI，0.70-2.37）。对于男性和女性，RR为1.50（95% CI，1.03-2.19）。这些发现为PLG和胰岛素抵抗综合征与结直肠癌死亡率的适度关联提供了证据，并支持胰岛素假说。
It has been proposed that hyperinsulinemia is involved in colon carcinogenesis. An association between post-load plasma glucose (PLG) levels and risk of colorectal cancer mortality would be consistent with this hypothesis. We used data from the Chicago Heart Association Detection Project in Industry to examine the associations of nonfasting PLG and other variables related to the insulin resistance syndrome (i.e., systolic blood pressure, body mass index, uric acid, and resting heart rate) with colorectal cancer mortality. After excluding participants reporting a history of diabetes, 191 and 126 colorectal cancer deaths occurred among 20,433 men and 15,149 women, respectively. In multivariate Cox regression analysis, there was a positive relationship between PLG levels and colorectal cancer mortality for women (P for trend = 0.08) but not for men. When men and women were combined, a trend (P = 0.05) for PLG remained. Examination of clustering of insulin resistance syndrome-related risk factors revealed that men with at least 3 of 4 risk factors (i.e., in the highest quartile of the sex-specific distribution for PLG, systolic blood pressure, body mass index, or resting heart rate) had a relative risk (RR) of 1.67 [95% confidence interval (CI), 1.04-2.70] as compared with men who were not in the upper quartile for any of these factors. For women, the RR was 1.29 (95% CI, 0.70-2.37). For men and women combined, the RR was 1.50 (95% CI, 1.03-2.19). These findings provide evidence for a modest association of PLG and insulin resistance syndrome with colorectal cancer mortality and support the insulin hypothesis.