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Kabat GC, Kim MY, Stefanick M, Ho GYF, Lane DS, Odegaard AO, Simon MS, Bea JW, Luo J, Wassertheil-Smoller S, Rohan TE. Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women. Int J Cancer 2018; 143:543-551. [PMID: 29488210 DOI: 10.1002/ijc.31345] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/22/2017] [Accepted: 02/02/2018] [Indexed: 12/19/2022]
Abstract
Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-<25.0, 25.0-<30.0 and ≥30.0 kg/m2 ) and presence of the metabolic syndrome into 6 phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Neither BMI nor presence of the metabolic syndrome was associated with risk of colorectal cancer, whereas waist circumference showed a robust positive association. Relative to the MHNW phenotype, the MUNW phenotype was associated with increased risk, whereas no other phenotype showed an association. Furthermore, HOMA-IR was not associated with increased risk. Overall, our results do not support a direct role of metabolic dysregulation in the development of colorectal cancer; however, they do suggest that higher waist circumference is a risk factor, possibly reflecting the effects of increased levels of cytokines and hormones in visceral abdominal fat on colorectal carcinogenesis.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Mimi Y Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, NY
| | - Dorothy S Lane
- Department of Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY
| | - Andrew O Odegaard
- Department of Epidemiology, School of Medicine, University of California at Irvine, Irvine, CA
| | | | - Jennifer W Bea
- Department of Medicine, Arizona Cancer Center, Tucson, AZ
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, University of Indiana, Bloomington, IN
| | | | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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