title: A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers.
abstract: Type 2 diabetes mellitus shares risk factors for and has shown a positive association with colorectal cancer. Anthropometric measures (height, weight, and body mass index (weight (kg)/height (m)(2)) and metabolic abnormalities associated with insulin resistance syndrome (IRS) (abnormalities in measured blood pressure, high density lipoprotein (HDL) cholesterol, and total cholesterol) were prospectively evaluated for associations with incident colon (n = 227), rectal (n = 183), and colorectal (n = 410) cancers diagnosed between 1985 and 2002 in 28,983 Finnish male smokers from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. In comparison with the lowest quintile, the highest quintile of body mass index was significantly associated with colorectal cancer (hazard ratio (HR) = 1.70, 95% confidence interval (CI): 1.01, 2.85; p-trend = 0.01), particularly colon cancer. Subjects with a cluster of three IRS-related conditions (hypertension, body mass index >/=25 kg/m(2), and HDL cholesterol level <40 mg/dl (<1.55 mmol/liter)), compared with those with fewer conditions, had a significantly increased risk of colorectal cancer (HR = 1.40, 95% CI: 1.12, 1.74), particularly colon cancer (HR = 1.58, 95% CI: 1.18, 2.10), but not rectal cancer. These results support the hypothesis that the significant association observed between IRS-defining metabolic abnormalities and colorectal cancer is determined primarily by adiposity.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bowers
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Paul
authors.initials: P
authors.lastname: Limburg
authors.forename: Pirjo
authors.initials: P
authors.lastname: Pietinen
authors.forename: Phil R
authors.initials: PR
authors.lastname: Taylor
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Rachael
authors.initials: R
authors.lastname: Stolzenberg-Solomon
mesh_terms: D050154:Adiposity; D000367:Age Factors; D000886:Anthropometry; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D015986:Confounding Factors, Epidemiologic; D004311:Double-Blind Method; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*