Influence of dietary insulin scores on survival in colorectal cancer patients

Background: Although hyperinsulinemia is hypothesised to be involved in colorectal carcinogenesis, it remains unclear whether a diet inducing an elevated insulin response influences colorectal cancer (CRC) survival. Methods: We examined the association of post-diagnosis dietary insulin scores with s...

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Published in:British journal of cancer 2017-09, Vol.117 (7), p.1079-1087
Main Authors: Yuan, Chen, Bao, Ying, Sato, Kaori, Nimptsch, Katharina, Song, Mingyang, Brand-Miller, Jennie C, Morales-Oyarvide, Vicente, Zoltick, Emilie S, Keum, NaNa, Wolpin, Brian M, Meyerhardt, Jeffrey A, Chan, Andrew T, Willett, Walter C, Stampfer, Meir J, Wu, Kana, Giovannucci, Edward L, Fuchs, Charles S, Ng, Kimmie
Format: Article
Language:English
Subjects:
692/4028/67/1504/1885
692/4028/67/2324
Adenocarcinoma - mortality
Adult
Aged
Biomedical and Life Sciences
Biomedicine
Body mass
Body Mass Index
Cancer Research
Carcinogenesis
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - mortality
Drug Resistance
Energy Intake
Epidemiology
Female
Food
Health risks
Health Surveys
Humans
Hyperinsulinemia
Insulin
Insulin - blood
Male
Middle Aged
Molecular Medicine
Mortality
Oncology
Postprandial Period
Proportional Hazards Models
Risk factors
Statistical analysis
Survival
Survival Rate
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cited_by cdi_FETCH-LOGICAL-c450t-bc70e182b5cede7fc615b27c1636fabeddd51b67df61436189b714aff554f8293
cites cdi_FETCH-LOGICAL-c450t-bc70e182b5cede7fc615b27c1636fabeddd51b67df61436189b714aff554f8293
container_end_page 1087
container_issue 7
container_start_page 1079
container_title British journal of cancer
container_volume 117
creator Yuan, Chen
Bao, Ying
Sato, Kaori
Nimptsch, Katharina
Song, Mingyang
Brand-Miller, Jennie C
Morales-Oyarvide, Vicente
Zoltick, Emilie S
Keum, NaNa
Wolpin, Brian M
Meyerhardt, Jeffrey A
Chan, Andrew T
Willett, Walter C
Stampfer, Meir J
Wu, Kana
Giovannucci, Edward L
Fuchs, Charles S
Ng, Kimmie
description Background: Although hyperinsulinemia is hypothesised to be involved in colorectal carcinogenesis, it remains unclear whether a diet inducing an elevated insulin response influences colorectal cancer (CRC) survival. Methods: We examined the association of post-diagnosis dietary insulin scores with survival among 2006 patients from two large prospective cohorts who were diagnosed with CRC from 1976 to 2010. Dietary insulin load was calculated as a function of the food insulin index. Dietary insulin index was calculated by dividing insulin load by total energy intake. Cox proportional hazards models were used to calculate hazard ratios (HRs) for CRC-specific mortality and overall mortality, adjusted for other risk factors for cancer survival. Results: The adjusted HRs for CRC-specific mortality comparing the highest to the lowest quintiles were 1.82 (95% CI: 1.20–2.75, P trend =0.006) for dietary insulin load and 1.66 (95% CI: 1.10–2.50, P trend =0.004) for dietary insulin index. We also observed an increased risk for overall mortality, with adjusted HRs of 1.33 (95% CI: 1.03–1.72, P trend =0.03) for dietary insulin load and 1.32 (95% CI: 1.02–1.71, P trend =0.02) for dietary insulin index, comparing extreme quintiles. The increase in CRC-specific mortality associated with higher dietary insulin scores was more apparent among patients with body mass index (BMI)⩾25 kg m −2 than BMI
doi_str_mv 10.1038/bjc.2017.272
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Methods: We examined the association of post-diagnosis dietary insulin scores with survival among 2006 patients from two large prospective cohorts who were diagnosed with CRC from 1976 to 2010. Dietary insulin load was calculated as a function of the food insulin index. Dietary insulin index was calculated by dividing insulin load by total energy intake. Cox proportional hazards models were used to calculate hazard ratios (HRs) for CRC-specific mortality and overall mortality, adjusted for other risk factors for cancer survival. Results: The adjusted HRs for CRC-specific mortality comparing the highest to the lowest quintiles were 1.82 (95% CI: 1.20–2.75, P trend =0.006) for dietary insulin load and 1.66 (95% CI: 1.10–2.50, P trend =0.004) for dietary insulin index. We also observed an increased risk for overall mortality, with adjusted HRs of 1.33 (95% CI: 1.03–1.72, P trend =0.03) for dietary insulin load and 1.32 (95% CI: 1.02–1.71, P trend =0.02) for dietary insulin index, comparing extreme quintiles. The increase in CRC-specific mortality associated with higher dietary insulin scores was more apparent among patients with body mass index (BMI)⩾25 kg m −2 than BMI&lt;25 kg m −2 ( P interaction =0.01). Conclusions: Higher dietary insulin scores after CRC diagnosis were associated with a statistically significant increase in CRC-specific and overall mortality.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2017.272</identifier><identifier>PMID: 28817837</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/4028/67/1504/1885 ; 692/4028/67/2324 ; Adenocarcinoma - mortality ; Adult ; Aged ; Biomedical and Life Sciences ; Biomedicine ; Body mass ; Body Mass Index ; Cancer Research ; Carcinogenesis ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - mortality ; Drug Resistance ; Energy Intake ; Epidemiology ; Female ; Food ; Health risks ; Health Surveys ; Humans ; Hyperinsulinemia ; Insulin ; Insulin - blood ; Male ; Middle Aged ; Molecular Medicine ; Mortality ; Oncology ; Postprandial Period ; Proportional Hazards Models ; Risk factors ; Statistical analysis ; Survival ; Survival Rate</subject><ispartof>British journal of cancer, 2017-09, Vol.117 (7), p.1079-1087</ispartof><rights>The Author(s) 2017</rights><rights>Copyright Nature Publishing Group Sep 26, 2017</rights><rights>Copyright © 2017 Cancer Research UK 2017 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-bc70e182b5cede7fc615b27c1636fabeddd51b67df61436189b714aff554f8293</citedby><cites>FETCH-LOGICAL-c450t-bc70e182b5cede7fc615b27c1636fabeddd51b67df61436189b714aff554f8293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625675/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625675/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28817837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yuan, Chen</creatorcontrib><creatorcontrib>Bao, Ying</creatorcontrib><creatorcontrib>Sato, Kaori</creatorcontrib><creatorcontrib>Nimptsch, Katharina</creatorcontrib><creatorcontrib>Song, Mingyang</creatorcontrib><creatorcontrib>Brand-Miller, Jennie C</creatorcontrib><creatorcontrib>Morales-Oyarvide, Vicente</creatorcontrib><creatorcontrib>Zoltick, Emilie S</creatorcontrib><creatorcontrib>Keum, NaNa</creatorcontrib><creatorcontrib>Wolpin, Brian M</creatorcontrib><creatorcontrib>Meyerhardt, Jeffrey A</creatorcontrib><creatorcontrib>Chan, Andrew T</creatorcontrib><creatorcontrib>Willett, Walter C</creatorcontrib><creatorcontrib>Stampfer, Meir J</creatorcontrib><creatorcontrib>Wu, Kana</creatorcontrib><creatorcontrib>Giovannucci, Edward L</creatorcontrib><creatorcontrib>Fuchs, Charles S</creatorcontrib><creatorcontrib>Ng, Kimmie</creatorcontrib><title>Influence of dietary insulin scores on survival in colorectal cancer patients</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background: Although hyperinsulinemia is hypothesised to be involved in colorectal carcinogenesis, it remains unclear whether a diet inducing an elevated insulin response influences colorectal cancer (CRC) survival. Methods: We examined the association of post-diagnosis dietary insulin scores with survival among 2006 patients from two large prospective cohorts who were diagnosed with CRC from 1976 to 2010. Dietary insulin load was calculated as a function of the food insulin index. Dietary insulin index was calculated by dividing insulin load by total energy intake. Cox proportional hazards models were used to calculate hazard ratios (HRs) for CRC-specific mortality and overall mortality, adjusted for other risk factors for cancer survival. Results: The adjusted HRs for CRC-specific mortality comparing the highest to the lowest quintiles were 1.82 (95% CI: 1.20–2.75, P trend =0.006) for dietary insulin load and 1.66 (95% CI: 1.10–2.50, P trend =0.004) for dietary insulin index. We also observed an increased risk for overall mortality, with adjusted HRs of 1.33 (95% CI: 1.03–1.72, P trend =0.03) for dietary insulin load and 1.32 (95% CI: 1.02–1.71, P trend =0.02) for dietary insulin index, comparing extreme quintiles. The increase in CRC-specific mortality associated with higher dietary insulin scores was more apparent among patients with body mass index (BMI)⩾25 kg m −2 than BMI&lt;25 kg m −2 ( P interaction =0.01). Conclusions: Higher dietary insulin scores after CRC diagnosis were associated with a statistically significant increase in CRC-specific and overall mortality.</description><subject>692/4028/67/1504/1885</subject><subject>692/4028/67/2324</subject><subject>Adenocarcinoma - mortality</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Cancer Research</subject><subject>Carcinogenesis</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Drug Resistance</subject><subject>Energy Intake</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Food</subject><subject>Health risks</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Hyperinsulinemia</subject><subject>Insulin</subject><subject>Insulin - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Molecular Medicine</subject><subject>Mortality</subject><subject>Oncology</subject><subject>Postprandial Period</subject><subject>Proportional Hazards Models</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNptkUtLxDAUhYMoOj52rqXgxoUdk7R5dCOI-ALFja5DmiaaoZOMSTvgv_cOo6LiKrm5X849l4PQIcFTgit51s7MlGIiplTQDTQhrKIlkVRsognGWJS4oXgH7eY8g7LBUmyjHSolEbISE_RwF1w_2mBsEV3ReTvo9F74kMfehyKbmGwuItzGtPRL3UOrMLGHZzNAZTT8TMVCD96GIe-jLaf7bA8-zz30fH31dHlb3j_e3F1e3JemZngoWyOwBY8tM7azwhlOWEuFIbziTre26zpGWi46x0ldcSKbVpBaO8dY7SRtqj10vtZdjO3cdgZmJ92rRfJzsK-i9up3J_hX9RKXinHKuGAgcPIpkOLbaPOg5j4b2_c62DhmRZoK10JIxgE9_oPO4pgCrAdUXWFJGrISPF1TJsWck3XfZghWq5wU5KRWOSnICfCjnwt8w1_BAFCugQyt8GLTj6n_CX4Asm2ekg</recordid><startdate>20170926</startdate><enddate>20170926</enddate><creator>Yuan, Chen</creator><creator>Bao, Ying</creator><creator>Sato, Kaori</creator><creator>Nimptsch, Katharina</creator><creator>Song, Mingyang</creator><creator>Brand-Miller, Jennie C</creator><creator>Morales-Oyarvide, Vicente</creator><creator>Zoltick, Emilie S</creator><creator>Keum, NaNa</creator><creator>Wolpin, Brian M</creator><creator>Meyerhardt, Jeffrey A</creator><creator>Chan, Andrew T</creator><creator>Willett, Walter C</creator><creator>Stampfer, Meir J</creator><creator>Wu, Kana</creator><creator>Giovannucci, Edward L</creator><creator>Fuchs, Charles S</creator><creator>Ng, Kimmie</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170926</creationdate><title>Influence of dietary insulin scores on survival in colorectal cancer patients</title><author>Yuan, Chen ; 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Methods: We examined the association of post-diagnosis dietary insulin scores with survival among 2006 patients from two large prospective cohorts who were diagnosed with CRC from 1976 to 2010. Dietary insulin load was calculated as a function of the food insulin index. Dietary insulin index was calculated by dividing insulin load by total energy intake. Cox proportional hazards models were used to calculate hazard ratios (HRs) for CRC-specific mortality and overall mortality, adjusted for other risk factors for cancer survival. Results: The adjusted HRs for CRC-specific mortality comparing the highest to the lowest quintiles were 1.82 (95% CI: 1.20–2.75, P trend =0.006) for dietary insulin load and 1.66 (95% CI: 1.10–2.50, P trend =0.004) for dietary insulin index. We also observed an increased risk for overall mortality, with adjusted HRs of 1.33 (95% CI: 1.03–1.72, P trend =0.03) for dietary insulin load and 1.32 (95% CI: 1.02–1.71, P trend =0.02) for dietary insulin index, comparing extreme quintiles. The increase in CRC-specific mortality associated with higher dietary insulin scores was more apparent among patients with body mass index (BMI)⩾25 kg m −2 than BMI&lt;25 kg m −2 ( P interaction =0.01). Conclusions: Higher dietary insulin scores after CRC diagnosis were associated with a statistically significant increase in CRC-specific and overall mortality.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>28817837</pmid><doi>10.1038/bjc.2017.272</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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692/4028/67/2324
Adenocarcinoma - mortality
Adult
Aged
Biomedical and Life Sciences
Biomedicine
Body mass
Body Mass Index
Cancer Research
Carcinogenesis
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - mortality
Drug Resistance
Energy Intake
Epidemiology
Female
Food
Health risks
Health Surveys
Humans
Hyperinsulinemia
Insulin
Insulin - blood
Male
Middle Aged
Molecular Medicine
Mortality
Oncology
Postprandial Period
Proportional Hazards Models
Risk factors
Statistical analysis
Survival
Survival Rate
title Influence of dietary insulin scores on survival in colorectal cancer patients
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