title: Predictors of fasting serum insulin and glucose and the risk of pancreatic cancer in smokers.
abstract: OBJECTIVE
  A history of type 2 diabetes is one of few consistent risk factors for pancreatic cancer. Potentially modifiable factors related to fasting insulin and glucose concentrations may influence pancreatic cancer risk.
  
  
  METHODS
  Multiple linear regression models were used to identify anthropometric, clinical, behavioral, and dietary factors associated with fasting insulin and glucose in a subcohort of non-diabetics in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (n = 366). Hazards ratios (HRs) and 95% confidence intervals (CIs) were calculated among the larger cohort (n = 27,035).
  
  
  RESULTS
  During follow-up (median 16.1 years), 305 participants developed pancreatic cancer. Fasting insulin and/or glucose were positively associated with body mass index (BMI), height, and dietary total and saturated fat and inversely associated with serum high-density lipoprotein cholesterol (HDL) and dietary available carbohydrates, sucrose, and alcohol. Comparing highest to lowest quintiles, total fat (HR = 1.54, 95% CI 1.05-2.25, p-trend = 0.01) and saturated fat (HR = 1.38, 95% CI 0.97-1.98, p-trend = 0.06) were positively associated and available carbohydrates (HR = 0.63, 95% CI 0.44-0.90, p-trend = 0.01), particularly sucrose (HR = 0.62, 95% CI 0.43-0.89, p-trend = 0.09), were inversely associated with risk of pancreatic cancer. BMI, HDL, height, and alcohol were not associated with pancreatic cancer risk.
  
  
  CONCLUSIONS
  Dietary fat is associated with higher fasting insulin concentrations and may increase pancreatic cancer risk in smokers.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, 6120 Executive Blvd, Rockville, MD 20852, USA. meinholdc@mail.nih.gov
authors.forename: Cari L
authors.initials: CL
authors.lastname: Meinhold
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de Gonzalez
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Weinstein
authors.forename: Philip R
authors.initials: PR
authors.lastname: Taylor
authors.forename: Jarmo
authors.initials: J
authors.lastname: Virtamo
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D004311:Double-Blind Method; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D016014:Linear Models; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D007328:Insulin