Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European Prospective Investigation into Cancer and Nutrition.
Western style diets and lifestyles are associated with increasing rates of obesity, diabetes and insulin resistance. Higher circulating insulin levels may modulate cell proliferation and apoptosis either directly or indirectly by increasing the bioactivity of IGF-I and decreasing the bioactivity of some of its binding proteins. The objective of this study was to determine the association of increasing levels of serum C-peptide, a biomarker of pancreatic insulin secretion, and IGF binding proteins (IGFBP) -1 and -2 with colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 Western European countries. A total of 1,078 colorectal cancer cases were matched (age, date of blood donation, fasting status, gender, study center) to an equal number of control subjects. Relative cancer risks were estimated using conditional logistic regression models. Serum C-peptide concentration was positively associated with an increased colorectal cancer risk for the highest versus the lowest quintile (OR=1.56, 95% CI=1.16-2.09, p(trend)<0.01), which was slightly attenuated after adjustment for BMI and physical activity (OR=1.37, 95% CI=1.00-1.88, p(trend)=0.10). When stratified by anatomical site, the cancer risk was stronger in the colon (OR=1.67, 95% CI=1.14-2.46, p(trend)<0.01) than in the rectum (OR=1.42, 95% CI=0.90-2.25, p(trend)=0.35). The cancer risk estimates were not heterogeneous by gender or fasting status. No clear colorectal cancer risk associations were observed for IGFBP-1 or -2. This large prospective study confirms that hyperinsulinemia, as determined by C-peptide levels, is associated with an increased colorectal cancer risk.
Jenab
Mazda
M
Nutrition and Hormones Group, IARC-WHO, Lyon, France.
Riboli
Elio
E
Cleveland
Rebecca J
RJ
Norat
Teresa
T
Rinaldi
Sabina
S
Nieters
Alexandra
A
Biessy
Carine
C
Tjønneland
Ann
A
Olsen
Anja
A
Overvad
Kim
K
Grønbaek
Henning
H
Clavel-Chapelon
Françoise
F
Boutron-Ruault
Marie-Christine
MC
Linseisen
Jakob
J
Boeing
Heiner
H
Pischon
Tobias
T
Trichopoulos
Dimitrios
D
Oikonomou
Eleni
E
Trichopoulou
Antonia
A
Panico
Salvatore
S
Vineis
Paolo
P
Berrino
Franco
F
Tumino
Rosario
R
Masala
Giovanna
G
Peters
Petra H
PH
van Gils
Carla H
CH
Bueno-de-Mesquita
H Bas
HB
Ocké
Marga C
MC
Lund
Eiliv
E
Mendez
Michelle A
MA
Tormo
María José
MJ
Barricarte
Aurelio
A
Martínez-García
Carmen
C
Dorronsoro
Miren
M
Quirós
José Ramón
JR
Hallmans
Göran
G
Palmqvist
Richard
R
Berglund
Göran
G
Manjer
Jonas
J
Key
Timothy
T
Allen
Naomi E
NE
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Cust
Anne
A
Kaaks
Rudolf
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood*; D016022:Case-Control Studies; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000097:blood* / Q000175:diagnosis; D012307:Risk Factors
D002096:C-Peptide; D018970:Insulin-Like Growth Factor Binding Protein 1; D018971:Insulin-Like Growth Factor Binding Protein 2