The association between METS-IR, an indirect index for insulin resistance, and lung cancer risk

• Published in: European journal of public health 2024-08, Vol.34 (4), p.800-805
• Main Authors: Wang, Guoqing, Zhu, Zhaopeng, Wang, Yi, Zhang, Qiang, Sun, Yungang, Pang, Guanlian, Ge, Wenjing, Ma, Zhimin, Ma, Huimin, Gong, Linnan, Ma, Hongxia, Shao, Feng, Zhu, Meng
• Format: Article
• Language: English
• Subjects: Adult; Aged; Breast cancer; Cancer; Care and treatment; Colorectal carcinoma; Complications and side effects; Epidemiology; Evaluation; Female; Genetic aspects; Genetic susceptibility; Health risks; Humans; Incidence; Insulin; Insulin Resistance; Low level; Lung cancer; Lung Neoplasms - epidemiology; Male; Mendelian Randomization Analysis; Metabolic Syndrome - epidemiology; Middle Aged; Prevention; Proportional Hazards Models; Prostate cancer; Randomization; Regression models; Resistance; Risk; Risk Factors
• ISSN: 1101-1262; 1464-360X; 1464-360X
• DOI: 10.1093/eurpub/ckad234

Abstract Background Insulin resistance has been reported to increase the risk of breast, prostate and colorectal cancer. However, the role of insulin resistance and its interaction with genetic risk in the development of lung cancer remains controversial. Therefore, we aimed to explore the association between a novel metabolic score for insulin resistance (METS-IR) and lung cancer risk. Methods A total of 395 304 participants without previous cancer at baseline were included. The Cox proportional hazards regression model was performed to investigate the association between METS-IR and lung cancer risk. In addition, a Mendelian randomization analysis was also performed to explore the causal relationship. The joint effects and additive interactions between METS-IR and polygenetic risk score (PRS) of lung cancer were also investigated. Results During a median follow-up of 11.03 years (Inter-quartile range (IQR): 10.30–11.73), a total of 3161 incident lung cancer cases were diagnosed in 395 304 participants. There was a significant association between METS-IR and lung cancer risk, with an HR of 1.28 (95% CI: 1.17–1.41). Based on the Mendelian randomization analysis, however, no causal associations were observed. We observed a joint effect but no interaction between METS-IR and genetic risk. The lung cancer incidence was estimated to be 100.42 (95% CI: 91.45–109.38) per 100 000 person-year for participants with a high METS-IR and PRS, while only 42.76 (95% CI: 36.94–48.59) with low METS-IR and PRS. Conclusions High METS-IR was significantly associated with an increased risk of lung cancer. Keeping a low level of METS-IR might help reduce the long-term incident risk of lung cancer.