Increased blood glucose and insulin, body size, and incident colorectal cancer

Robert E. Schoen, Catherine M. Tangen, Lewis H. Kuller, Gregory L. Burke, Mary Cushman, Russell P. Tracy, Adrian S Dobs, Peter J. Savage

Research output: Contribution to journalArticle

Abstract

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 = 1.12.4; 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.

Original languageEnglish (US)
Pages (from-to)1147-1154
Number of pages8
JournalJournal of the National Cancer Institute
Volume91
Issue number13
StatePublished - Jul 7 1999

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Body Size
Blood Glucose
Colorectal Neoplasms
Insulin
Intra-Abdominal Fat
Confidence Intervals
Glucose
Fasting
Waist Circumference
Abdominal Obesity
Hyperinsulinism
Lipoproteins
Intercellular Signaling Peptides and Proteins
Colon
Cohort Studies
Health

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Schoen, R. E., Tangen, C. M., Kuller, L. H., Burke, G. L., Cushman, M., Tracy, R. P., ... Savage, P. J. (1999). Increased blood glucose and insulin, body size, and incident colorectal cancer. Journal of the National Cancer Institute, 91(13), 1147-1154.

Increased blood glucose and insulin, body size, and incident colorectal cancer. / Schoen, Robert E.; Tangen, Catherine M.; Kuller, Lewis H.; Burke, Gregory L.; Cushman, Mary; Tracy, Russell P.; Dobs, Adrian S; Savage, Peter J.

In: Journal of the National Cancer Institute, Vol. 91, No. 13, 07.07.1999, p. 1147-1154.

Research output: Contribution to journalArticle

Schoen, RE, Tangen, CM, Kuller, LH, Burke, GL, Cushman, M, Tracy, RP, Dobs, AS & Savage, PJ 1999, 'Increased blood glucose and insulin, body size, and incident colorectal cancer', Journal of the National Cancer Institute, vol. 91, no. 13, pp. 1147-1154.
Schoen RE, Tangen CM, Kuller LH, Burke GL, Cushman M, Tracy RP et al. Increased blood glucose and insulin, body size, and incident colorectal cancer. Journal of the National Cancer Institute. 1999 Jul 7;91(13):1147-1154.
Schoen, Robert E. ; Tangen, Catherine M. ; Kuller, Lewis H. ; Burke, Gregory L. ; Cushman, Mary ; Tracy, Russell P. ; Dobs, Adrian S ; Savage, Peter J. / Increased blood glucose and insulin, body size, and incident colorectal cancer. In: Journal of the National Cancer Institute. 1999 ; Vol. 91, No. 13. pp. 1147-1154.
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abstract = "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 = 1.12.4; 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.",
author = "Schoen, {Robert E.} and Tangen, {Catherine M.} and Kuller, {Lewis H.} and Burke, {Gregory L.} and Mary Cushman and Tracy, {Russell P.} and Dobs, {Adrian S} and Savage, {Peter J.}",
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T1 - Increased blood glucose and insulin, body size, and incident colorectal cancer

AU - Schoen, Robert E.

AU - Tangen, Catherine M.

AU - Kuller, Lewis H.

AU - Burke, Gregory L.

AU - Cushman, Mary

AU - Tracy, Russell P.

AU - Dobs, Adrian S

AU - Savage, Peter J.

PY - 1999/7/7

Y1 - 1999/7/7

N2 - 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 = 1.12.4; 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.

AB - 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 = 1.12.4; 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.

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