Serum glucose and fructosamine in relation to risk of cancer.
BACKGROUND
Impaired glucose metabolism has been linked with increased cancer risk, but the association between serum glucose and cancer risk remains unclear. We used repeated measurements of glucose and fructosamine to get more insight into the association between the glucose metabolism and risk of cancer.


METHODS
We selected 11,998 persons (>20 years old) with four prospectively collected serum glucose and fructosamine measurements from the Apolipoprotein Mortality Risk (AMORIS) study. Multivariate Cox proportional hazards regression was used to assess standardized log of overall mean glucose and fructosamine in relation to cancer risk. Similar analyses were performed for tertiles of glucose and fructosamine and for different types of cancer.


RESULTS
A positive trend was observed between standardized log overall mean glucose and overall cancer risk (HR= 1.08; 95% CI: 1.02-1.14). Including standardized log fructosamine in the model resulted in a stronger association between glucose and cancer risk and aninverse association between fructosamine and cancer risk (HR = 1.17; 95% CI: 1.08-1.26 and HR: 0.89; 95% CI: 0.82-0.96, respectively). Cancer risks were highest among those in the highest tertile of glucose and lowest tertile of fructosamine. Similar findings were observed for prostate, lung, and colorectal cancer while none observed for breast cancer.


CONCLUSIONS
The contrasting effect between glucose, fructosamine, and cancer risk suggests the existence of distinct groups among those with impaired glucose metabolism, resulting in different cancer risks based on individual metabolic profiles. Further studies are needed to clarify whether glucose is a proxy of other lifestyle-related or metabolic factors.
King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, London, United Kingdom.
Wahyu
W
Wulaningsih
Lars
L
Holmberg
Hans
H
Garmo
Björn
B
Zethelius
Annette
A
Wigertz
Paul
P
Carroll
Mats
M
Lambe
Niklas
N
Hammar
Göran
G
Walldius
Ingmar
I
Jungner
Mieke
M
Van Hemelrijck
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D001786:Blood Glucose; D019270:Fructosamine