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

Research output: Contribution to journalArticle

Abstract

Insulin and glucose may influence 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; 1988-1994), 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 certificates 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% confidence interval (CI) (1.07-1.87; 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: 1.15-2.42; p = 0.01), specifically among those with lower levels of physical activity (HR: 2.06; 95% CI: 1.4-3.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically significant. In conclusion, hyperglycemia and insulin resistance may be 'high-risk' conditions for cancer mortality. Managing these conditions may be effective cancer control tools.

Original languageEnglish (US)
Pages (from-to)631-642
Number of pages12
JournalCancer Causes and Control
Volume21
Issue number4
DOIs
StatePublished - Apr 2010

Fingerprint

Nutrition Surveys
Insulin
Glucose
Mortality
Neoplasms
Confidence Intervals
Insulin Resistance
Exercise
Death Certificates
C-Peptide
Hyperglycemia
Blood Glucose
Life Style
Lung Neoplasms
Body Mass Index
Smoking
Demography
Interviews
Lipids

Keywords

  • Cancer mortality
  • Epidemiology
  • Hyperglycemia
  • Insulin
  • Longitudinal study

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey. / Parekh, Niyati; Lin, Yong; Hayes, Richard B.; Albu, Jeanine B.; Lu-Yao, Grace L.

In: Cancer Causes and Control, Vol. 21, No. 4, 04.2010, p. 631-642.

Research output: Contribution to journalArticle

@article{17d108969d3e4f5f8dea481480ed3261,
title = "Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey",
abstract = "Insulin and glucose may influence 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; 1988-1994), 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 certificates 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{\%} confidence interval (CI) (1.07-1.87; 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: 1.15-2.42; p = 0.01), specifically among those with lower levels of physical activity (HR: 2.06; 95{\%} CI: 1.4-3.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically significant. 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, Epidemiology, Hyperglycemia, Insulin, Longitudinal study",
author = "Niyati Parekh and Yong Lin and Hayes, {Richard B.} and Albu, {Jeanine B.} and Lu-Yao, {Grace L.}",
year = "2010",
month = "4",
doi = "10.1007/s10552-009-9492-y",
language = "English (US)",
volume = "21",
pages = "631--642",
journal = "Cancer Causes and Control",
issn = "0957-5243",
publisher = "Springer Netherlands",
number = "4",

}

TY - JOUR

T1 - Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey

AU - Parekh, Niyati

AU - Lin, Yong

AU - Hayes, Richard B.

AU - Albu, Jeanine B.

AU - Lu-Yao, Grace L.

PY - 2010/4

Y1 - 2010/4

N2 - Insulin and glucose may influence 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; 1988-1994), 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 certificates 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% confidence interval (CI) (1.07-1.87; 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: 1.15-2.42; p = 0.01), specifically among those with lower levels of physical activity (HR: 2.06; 95% CI: 1.4-3.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically significant. In conclusion, hyperglycemia and insulin resistance may be 'high-risk' conditions for cancer mortality. Managing these conditions may be effective cancer control tools.

AB - Insulin and glucose may influence 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; 1988-1994), 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 certificates 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% confidence interval (CI) (1.07-1.87; 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: 1.15-2.42; p = 0.01), specifically among those with lower levels of physical activity (HR: 2.06; 95% CI: 1.4-3.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically significant. In conclusion, hyperglycemia and insulin resistance may be 'high-risk' conditions for cancer mortality. Managing these conditions may be effective cancer control tools.

KW - Cancer mortality

KW - Epidemiology

KW - Hyperglycemia

KW - Insulin

KW - Longitudinal study

UR - http://www.scopus.com/inward/record.url?scp=77953286864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953286864&partnerID=8YFLogxK

U2 - 10.1007/s10552-009-9492-y

DO - 10.1007/s10552-009-9492-y

M3 - Article

VL - 21

SP - 631

EP - 642

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

IS - 4

ER -