Metabolic health reduces risk of obesity-related cancer in framingham study adults

• Published in: Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2014-10, Vol.23 (10), p.2057-2065
• Main Authors: Moore, Lynn L, Chadid, Susan, Singer, Martha R, Kreger, Bernard E, Denis, Gerald V
• Format: Article
• Language: English
• Subjects: Aged; Blood Glucose - analysis; Blood Glucose - metabolism; Body Mass Index; Female; Humans; Male; Middle Aged; Neoplasms - blood; Neoplasms - epidemiology; Obesity - blood; Obesity - complications; Proportional Hazards Models; Waist-Height Ratio
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1055-9965.EPI-14-0240

It is unknown whether the risk for obesity-related cancers differs between metabolically unhealthy and healthy overweight/obese adults. Data on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and random blood glucose in Framingham Heart Study adults (n = 3,763) ages 55 to 69 years were used to estimate risks of obesity-related cancers (n = 385), including postmenopausal breast, female reproductive, colon, liver, gallbladder, pancreas, and kidney cancers, as well as esophageal adenocarcinomas. Multivariable-adjusted Cox proportional hazards models were used to estimate risk for obesity-related cancers associated with body fat and metabolic health (as defined by glucose levels) among subjects in three risk groups (vs. referent group with normal weight/normal glucose): normal weight/elevated glucose, overweight/normal glucose, and overweight/elevated glucose. Overweight adults [BMI ≥ 25 or WHtR ≥ 0.51 (men) and ≥0.57 (women)] with elevated glucose (≥125 mg/dL) had a statistically significant 2-fold increased risk of developing obesity-related cancer, whereas overweight adults with normal glucose had a 50% increased risk. Normal-weight adults with elevated glucose had no excess cancer risk. The effects of BMI and WHtR were independent of one another. Finally, overweight women with elevated blood glucose had a 2.6-fold increased risk [95% confidence interval (CI), 1.4-4.9] of female reproductive (cervical, endometrial, uterine cancers) and postmenopausal breast cancers, whereas overweight women with normal glucose levels had only a 70% increased risk (95% CI, 1.1-2.5). These results suggest that cancer risk may be lower among metabolically healthy overweight/obese older adults than among overweight/obese adults with metabolic dysfunction. Metabolic dysfunction and obesity act synergistically to increase cancer risk.