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Cancer Epidemiol Biomarkers Prev. 2014 Oct;23(10):2057-65. doi: 10.1158/1055-9965.EPI-14-0240. Epub 2014 Jul 10.

Metabolic health reduces risk of obesity-related cancer in framingham study adults.

Author information

1
Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts. Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts. llmoore@bu.edu.
2
Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
3
Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts. General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
4
Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts. Cancer Research Center, Boston University School of Medicine, Boston, Massachusetts.

Abstract

BACKGROUND:

It is unknown whether the risk for obesity-related cancers differs between metabolically unhealthy and healthy overweight/obese adults.

METHODS:

Data on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and random blood glucose in Framingham Heart Study adults (n = 3,763) ages 55 to 69 years were used to estimate risks of obesity-related cancers (n = 385), including postmenopausal breast, female reproductive, colon, liver, gallbladder, pancreas, and kidney cancers, as well as esophageal adenocarcinomas. Multivariable-adjusted Cox proportional hazards models were used to estimate risk for obesity-related cancers associated with body fat and metabolic health (as defined by glucose levels) among subjects in three risk groups (vs. referent group with normal weight/normal glucose): normal weight/elevated glucose, overweight/normal glucose, and overweight/elevated glucose.

RESULTS:

Overweight adults [BMI ≥ 25 or WHtR ≥ 0.51 (men) and ≥0.57 (women)] with elevated glucose (≥125 mg/dL) had a statistically significant 2-fold increased risk of developing obesity-related cancer, whereas overweight adults with normal glucose had a 50% increased risk. Normal-weight adults with elevated glucose had no excess cancer risk. The effects of BMI and WHtR were independent of one another. Finally, overweight women with elevated blood glucose had a 2.6-fold increased risk [95% confidence interval (CI), 1.4-4.9] of female reproductive (cervical, endometrial, uterine cancers) and postmenopausal breast cancers, whereas overweight women with normal glucose levels had only a 70% increased risk (95% CI, 1.1-2.5).

CONCLUSION:

These results suggest that cancer risk may be lower among metabolically healthy overweight/obese older adults than among overweight/obese adults with metabolic dysfunction.

IMPACT:

Metabolic dysfunction and obesity act synergistically to increase cancer risk.

PMID:
25012997
PMCID:
PMC4184957
DOI:
10.1158/1055-9965.EPI-14-0240
[Indexed for MEDLINE]
Free PMC Article

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