Content area
Full Text
Cancer Causes Control (2010) 21:631642
DOI 10.1007/s10552-009-9492-y
ORIGINAL PAPER
Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey
Niyati Parekh Yong Lin Richard B. Hayes
Jeanine B. Albu Grace L. Lu-Yao
Received: 2 September 2009 / Accepted: 10 December 2009 / Published online: 23 January 2010 Springer Science+Business Media B.V. 2010
Abstract Insulin and glucose may inuence cancer mortality via their proliferative and anti-apoptotic properties. Using longitudinal data from the nationally representative Third National Health and Nutrition Examination Survey (NHANES III; 19881994), with an average follow-up of 8.5 years to death, we evaluated markers of glucose and insulin metabolism, with cancer mortality, ascertained using death certicates or the National Death Index. Plasma glucose, insulin, C-peptide, and lipid concentrations were measured. Anthropometrics, lifestyle, medical, and demographic information was obtained during in-person interviews. After adjusting for age, race, sex, smoking status, physical activity, and body mass index, for every 50 mg/dl increase in plasma glucose, there was a 22% increased risk of overall cancer mortality. Insulin
resistance was associated with a 41% (95% condence interval (CI) (1.071.87; p = 0.01) increased risk of overall cancer mortality. These associations were stronger after excluding lung cancer deaths for insulin-resistant individuals (HR: 1.67; 95% CI: 1.152.42; p = 0.01), specically among those with lower levels of physical activity (HR: 2.06; 95% CI: 1.43.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically signicant. In conclusion, hyperglycemia and insulin resistance may be high-risk conditions for cancer mortality. Managing these conditions may be effective cancer control tools.
Keywords Cancer mortality Insulin Hyperglycemia
Epidemiology Longitudinal study
N. ParekhDepartment of Nutrition, Food Studies, and Public Health, New York University, 35 W4th Street, Room 1077F, New York, NY 10012, USA
Y. LinThe Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey (UMDNJ), 195 Little Albany Street, Room #5536, New Brunswick, NJ 08901, USA
Y. LinSchool of Public Health, #214, University of Medicine and Dentistry of New Jersey, Piscataway, NJ 08854, USA
R. B. HayesNew York University, Cancer Institute, New York, NY 10016, USA
R. B. HayesDivision of Epidemiology, Department of Environmental Medicine, NYU School of Medicine,New York, NY 10016,...