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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Insulin, glucose, insulin resistance, and incident colorectal cancer in male smokers.

Background & Aims: Hyperinsulinemia is a putative colorectal cancer (CRC) risk factor. Insulin resistance ( IR) commonly precedes hyperinsulinemia and can be quantitatively measured by using the homeostasis model assessment-insulin resistance (HOMA- IR) index. To date, few studies have directly examined serum insulin as an indicator of CRC risk, and none have reported associations on the basis of HOMA- IR. Methods: We performed a case-cohort study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study (n = 29,133). Baseline exposure and fasting serum biomarker data were available for 134 incident CRC case and 399 non-case subjects. HOMA- IR was derived as fasting insulin x fasting glucose/22. 5. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by using age-adjusted and multivariable-adjusted Cox proportional hazards regression models. Results: Median (interquartile range) values for serum insulin, glucose, and HOMA- IR were 4.1 (2.9-7.2) mIU/L, 101 (94-108) mg/dL, and 0.99 (0.69-1.98) for case subjects and 4.1 (2.7-6.1) mIU/L, 99 (93-107) mg/dL, and 1.02 (0.69-1.53) for non-case subjects, respectively. On the basis of comparison of the highest versus lowest quartiles for each biomarker, insulin (HR, 1.84; 95% CI, 1.03-3.30) and HOMA- IR (HR, 1.85; 95% CI, 1.06-3.24) were significantly associated with incident CRC, whereas glucose was marginally associated with incident CRC (HR, 1.70; 95% CI, 0.92-3.13) in age-adjusted risk models. However, trends across biomarker quartiles were somewhat inconsistent (P trend = .12, .04, and .12, respectively), and multivariable adjustment generally attenuated the observed risk estimates. Conclusions: Data from this prospective study of male smokers provide limited support for hyperinsulinemia, hyperglycemia, and/or insulin resistance as CRC risk factors.[1]


  1. Insulin, glucose, insulin resistance, and incident colorectal cancer in male smokers. Limburg, P.J., Stolzenberg-Solomon, R.Z., Vierkant, R.A., Roberts, K., Sellers, T.A., Taylor, P.R., Virtamo, J., Cerhan, J.R., Albanes, D. Clin. Gastroenterol. Hepatol. (2006) [Pubmed]
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