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Pan J, Hu K, Yu X, Li W, Shen Y, Song Z, Guo Y, Yang M, Hu F, Xia Q, Du Z, Wu X. Beneficial associations between outdoor visible greenness at the workplace and metabolic syndrome in Chinese adults. ENVIRONMENT INTERNATIONAL 2024; 183:108327. [PMID: 38157607 DOI: 10.1016/j.envint.2023.108327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/13/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Greenness surrounding residential places has been found to significantly reduce the risk of diseases such as hypertension, obesity, and metabolic syndrome (MetS). However, it is unclear whether visible greenness exposure at the workplace has any impact on the risk of MetS. METHODS Visible greenness exposure was assessed using a Green View Index (GVI) based on street view images through a convolutional neural network model. We utilized logistic regression to examine the cross-sectional association between GVI and MetS as well as its components among 51,552 adults aged 18-60 in the city of Hangzhou, China, from January 2018 to December 2021. Stratified analyses were conducted by age and sex groups. Furthermore, a scenario analysis was conducted to investigate the risks of having MetS among adults in different GVI scenarios. RESULTS The mean age of the participants was 40.1, and 38.5% were women. We found a statistically significant association between GVI and having MetS. Compared to the lowest quartile of GVI, participants in the highest quartile of GVI had a 17% (95% CI: 11-23%) lower odds of having MetS. The protective association was stronger in the males, but we did not observe such differences in different age groups. Furthermore, we found inverse associations between GVI and the odds of hypertension, low high-density lipoprotein cholesterol, obesity, and high levels of FPG. CONCLUSIONS Higher exposure to outdoor visible greenness in the workplace environment might have a protective effect against MetS.
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Affiliation(s)
- Jiahao Pan
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
| | - Kejia Hu
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
| | - Xinyan Yu
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang, China
| | - Wenyuan Li
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
| | - Yujie Shen
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
| | - Zhenya Song
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang, China
| | - Yi Guo
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang, China
| | - Min Yang
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China
| | - Fang Hu
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang, China
| | - Qunke Xia
- School of Earth Sciences, Zhejiang University, Hangzhou 310027, China
| | - Zhenhong Du
- School of Earth Sciences, Zhejiang University, Hangzhou 310027, China; Zhejiang Provincial Key Laboratory of Geographic Information Science, Hangzhou 310028, China.
| | - Xifeng Wu
- Center for Clinical Big Data and Analytics School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang, China; The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang 310058, China; Cancer Center, Zhejiang University, Hangzhou, Zhejiang 310058 China.
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Guan J, Li F, Kang D, Anderson T, Pitcher T, Dalrymple-Alford J, Shorten P, Singh-Mallah G. Cyclic Glycine-Proline (cGP) Normalises Insulin-Like Growth Factor-1 (IGF-1) Function: Clinical Significance in the Ageing Brain and in Age-Related Neurological Conditions. Molecules 2023; 28:molecules28031021. [PMID: 36770687 PMCID: PMC9919809 DOI: 10.3390/molecules28031021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Insulin-like growth factor-1 (IGF-1) function declines with age and is associated with brain ageing and the progression of age-related neurological conditions. The reversible binding of IGF-1 to IGF binding protein (IGFBP)-3 regulates the amount of bioavailable, functional IGF-1 in circulation. Cyclic glycine-proline (cGP), a metabolite from the binding site of IGF-1, retains its affinity for IGFBP-3 and competes against IGF-1 for IGFBP-3 binding. Thus, cGP and IGFBP-3 collectively regulate the bioavailability of IGF-1. The molar ratio of cGP/IGF-1 represents the amount of bioavailable and functional IGF-1 in circulation. The cGP/IGF-1 molar ratio is low in patients with age-related conditions, including hypertension, stroke, and neurological disorders with cognitive impairment. Stroke patients with a higher cGP/IGF-1 molar ratio have more favourable clinical outcomes. The elderly with more cGP have better memory retention. An increase in the cGP/IGF-1 molar ratio with age is associated with normal cognition, whereas a decrease in this ratio with age is associated with dementia in Parkinson disease. In addition, cGP administration reduces systolic blood pressure, improves memory, and aids in stroke recovery. These clinical and experimental observations demonstrate the role of cGP in regulating IGF-1 function and its potential clinical applications in age-related brain diseases as a plasma biomarker for-and an intervention to improve-IGF-1 function.
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Affiliation(s)
- Jian Guan
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Centre for Brain Research, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Brain Research New Zealand, The Centre for Research Excellent, Dunedin 9016, New Zealand
- The cGP Lab Limited New Zealand, Auckland 1021, New Zealand
- Correspondence: ; Tel.: +64-9-923-6134
| | - Fengxia Li
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Centre for Brain Research, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Guangdong Pharmaceutical University, Guangzhou Higher Education Mega Center, Guangzhou 510075, China
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Dali Kang
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Centre for Brain Research, Faculty of Medicine and Health Sciences, School of Biomedical Sciences, The University of Auckland, Auckland 1142, New Zealand
- Brain Research New Zealand, The Centre for Research Excellent, Dunedin 9016, New Zealand
- Shenyang Medical College, Shenyang 110034, China
| | - Tim Anderson
- New Zealand Brain Research Institute, Christchurch 4710, New Zealand
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand
- Department of Neurology, Canterbury District Health Board, Christchurch 4710, New Zealand
| | - Toni Pitcher
- New Zealand Brain Research Institute, Christchurch 4710, New Zealand
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand
- Department of Neurology, Canterbury District Health Board, Christchurch 4710, New Zealand
| | - John Dalrymple-Alford
- Department of Neurology, Canterbury District Health Board, Christchurch 4710, New Zealand
- Department of Psychology, University of Canterbury, Christchurch 4710, New Zealand
| | - Paul Shorten
- AgResearch Ltd., Ruakura Research Centre, Hamilton 3214, New Zealand
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
| | - Gagandeep Singh-Mallah
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
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Podhorecka M. Metformin - its anti-cancer effects in hematologic malignancies. Oncol Rev 2021; 15:514. [PMID: 33747367 PMCID: PMC7967492 DOI: 10.4081/oncol.2021.514] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/26/2021] [Indexed: 02/08/2023] Open
Abstract
The main anti-diabetic effect of metformin mediated through stimulation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) is the inhibition of hepatic gluconeogenesis and triggering glucose uptake in skeletal muscles. Additionally, some new pathways, besides the AMPK activation, were discovered, that can explain wide-range properties of metformin. All these properties are now attracting the attention of researchers in the fields other than diabetes and the drug has been reported to have anti-cancer, immunoregulatory and anti-aging effects. Among others, the beneficial effects of metformin in hematological disorders like leukemias, lymphomas, and multiple myeloma were reported. Despite a great progress in therapy, these diseases are still incurable in most cases. Thus, there is an urgent need to discover novel, less toxic and more effective drugs especially for older or chemotherapy-resistant patients. In this review article, the current findings on the anti-cancer effect of metformin together with underlying possible mechanisms in blood cancers are discussed. However. to evaluate precisely these promising effects of metformin, more studies are required, because many of the published results are preclinical.
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Affiliation(s)
- Monika Podhorecka
- Department of Hematooncology and Bone Marrow Transplantation Medical University of Lublin, Poland
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4
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Sweeney MR, Applebaum KM, Arem H, Braffett BH, Poynter JN, Robien K. Medical Conditions and Modifiable Risk Factors for Myelodysplastic Syndrome: A Systematic Review. Cancer Epidemiol Biomarkers Prev 2019; 28:1502-1517. [DOI: 10.1158/1055-9965.epi-19-0106] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/13/2019] [Accepted: 06/13/2019] [Indexed: 11/16/2022] Open
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Sharma H, Kumar P, Deshmukh RR, Bishayee A, Kumar S. Pentacyclic triterpenes: New tools to fight metabolic syndrome. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2018; 50:166-177. [PMID: 30466975 DOI: 10.1016/j.phymed.2018.09.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/25/2018] [Accepted: 09/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Metabolic syndrome is a combination of dysregulated cardiometabolic risk factors characterized by dyslipidemia, impaired glucose tolerance, insulin resistance, inflammation, obesity as well as hypertension. These factors are tied to the increased risk for type-II diabetes and cardiovascular diseases including myocardial infarction in patients with metabolic syndrome. PURPOSE To review the proposed molecular mechanisms of pentacyclic triterpenes for their potential use in the metabolic syndrome. METHODS PubMed, Science Direct, and Google Scholar database were searched from commencement to April 2018. Following keywords were searched in the databases with varying combinations: "metabolic syndrome", "pentacyclic triterpenes", "transcription factors", "protein kinase", "lipogenesis", "adipogenesis", "lipolysis", "fatty acids", "gluconeogenesis", "cardiovascular", "mitochondria", "oxidative stress", "pancreas", "hepatic cells", "skeletal muscle", "3T3-L1", "C2C12", "obesity", "inflammation", "insulin resistance", "glucose uptake", "clinical studies" and "bioavailability". RESULTS Pentacyclic triterpenes, such as asiatic acid, ursolic acid, oleanolic acid, 18β-glycyrrhetinic acid, α,β-amyrin, celastrol, carbenoxolone, corosolic acid, maslinic acid, bardoxolone methyl and lupeol downregulate several metabolic syndrome components by regulating transcription factors, protein kinases and enzyme involved in the adipogenesis, lipolysis, fatty acid oxidation, insulin resistance, mitochondria biogenesis, gluconeogenesis, oxidative stress and inflammation. CONCLUSION In vitro and in vivo studies suggests that pentacyclic triterpenes effectively downregulate various factors related to metabolic syndrome. These phytochemicals may serve as promising candidates for clinical trials for the management of metabolic syndrome.
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Affiliation(s)
- Hitender Sharma
- Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra, 136 119 Haryana, India
| | - Pushpander Kumar
- Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra, 136 119 Haryana, India
| | - Rahul R Deshmukh
- School of Pharmacy, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Sunil Kumar
- Institute of Pharmaceutical Sciences, Kurukshetra University, Kurukshetra, 136 119 Haryana, India.
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Howden EJ, La Gerche A, Arthur JF, McMullen JR, Jennings GL, Dunstan DW, Owen N, Avery S, Kingwell BA. Standing up to the cardiometabolic consequences of hematological cancers. Blood Rev 2018; 32:349-360. [PMID: 29496356 DOI: 10.1016/j.blre.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/06/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022]
Abstract
Hematological cancer survivors are highly vulnerable to cardiometabolic complications impacting long-term health status, quality of life and survival. Elevated risk of diabetes and cardiovascular disease arises not only from the effects of the cancers themselves, but also from the toxic effects of cancer therapies, and deconditioning arising from reduced physical activity levels. Regular physical activity can circumvent or reverse adverse effects on the heart, skeletal muscle, vasculature and blood cells, through a combination of systemic and molecular mechanisms. We review the link between hematological cancers and cardiometabolic risk with a focus on adult survivors, including the contributing mechanisms and discuss the potential for physical activity interventions, which may act to oppose the negative effects of both physical deconditioning and therapies (conventional and targeted) on metabolic and growth signaling (kinase) pathways in the heart and beyond. In this context, we focus particularly on strategies targeting reducing and breaking up sedentary time and provide recommendations for future research.
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Affiliation(s)
- Erin J Howden
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - André La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Jane F Arthur
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia
| | - Julie R McMullen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Garry L Jennings
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia; Sydney Medical School, University of Sydney, NSW, Australia.
| | - David W Dunstan
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Neville Owen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Sharon Avery
- Malignant Hematology and Stem Cell Transplantation Service, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, Australia.
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
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Lamar ZS, Dothard A, Kennedy L, Isom S, Robinson M, Vaidya R, Hurd D, McClain D, Lesser G. Hyperglycemia during first-line R-CHOP or dose adjusted R-EPOCH chemotherapy for non-Hodgkin lymphoma is prevalent and associated with chemotherapy alteration - a retrospective study. Leuk Lymphoma 2017; 59:1871-1877. [PMID: 29252084 DOI: 10.1080/10428194.2017.1410889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
High-dose glucocorticoids such as prednisone are combined with cytotoxic chemotherapy in the R-CHOP or dose adjusted R-EPOCH regimens used for non-Hodgkin lymphoma (NHL). In this retrospective study, our primary objective was to evaluate the incidence of hyperglycemia during first-line R-CHOP or DA-EPOCH-R. The secondary objectives were to evaluate the incidence of chemotherapy alteration and overall survival in those with and without hyperglycemia. One hundred and sixty patients were eligible. We found that 47% of all patients had at least one hyperglycemic episode and hyperglycemia was associated with chemotherapy alteration (p = .028). Multivariate analysis revealed international prognostic index (IPI) ≥ 3 (p = .045) and chemotherapy alteration (p = .001) were associated with decreased overall survival. We conclude that hyperglycemia is common during first-line NHL treatment with R-CHOP or DA-EPOCH-R, even in the absence of known diabetes and is associated with alterations of chemotherapy. Baseline pre-PET scan fasting blood glucose of 100 mg/dL or higher may predict hyperglycemia during therapy.
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Affiliation(s)
- Zanetta S Lamar
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA.,b Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Andrew Dothard
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - LeAnne Kennedy
- c Department of Pharmacy , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Scott Isom
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA.,d Department of Biostatistical Sciences , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Mac Robinson
- b Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Rakhee Vaidya
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA.,b Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - David Hurd
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA.,b Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Donald McClain
- e Department of Internal Medicine - Section of Endocrinology and Metabolism , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
| | - Glenn Lesser
- a Department of Internal Medicine - Section of Hematology and Oncology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA.,b Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center , Winston-Salem , NC , USA
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8
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Impact of cachexia on outcomes in aggressive lymphomas. Ann Hematol 2017; 96:951-956. [PMID: 28417157 DOI: 10.1007/s00277-017-2958-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/13/2017] [Indexed: 01/27/2023]
Abstract
Cancer cachexia is defined as a state of involuntary weight loss, attributed to altered body composition with muscle mass loss and/or loss of adiposity. Identifying the association between cancer cachexia and outcomes may pave the way for novel agents that target the cancer cachexia process. Clinical parameters for measurement of cancer cachexia are needed. We conducted a single-institution retrospective analysis that included 86 NHL patients with the aim of identifying an association between cancer cachexia and outcomes in aggressive lymphomas using the cachexia index (CXI) suggested by Jafri et al. (Clin Med Insights Oncol 9:87-93, 15). Impact of cachexia factors on progression-free survival (PFS) and overall survival (OS) were assessed using log-rank test and Cox proportional hazards regression. Patients were dichotomized around the median CXI into "non-cachectic" (CXI ≥49.8, n = 41) and "cachectic" (CXI <49.8, n = 40) groups. Cachectic patients had significantly worse PFS (HR 2.18, p = 0.044) and OS (HR = 4.05, p = 0.004) than non-cachectic patients. Cachexia as defined by the CXI is prognostic in aggressive lymphomas and implies that novel therapeutic strategies directed at reversing cachexia may improve survival in this population.
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Karmali R, Gordon LI. Molecular Subtyping in Diffuse Large B Cell Lymphoma: Closer to an Approach of Precision Therapy. Curr Treat Options Oncol 2017; 18:11. [DOI: 10.1007/s11864-017-0449-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lipotoxicity-Related Hematological Disorders in Obesity. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 960:469-487. [DOI: 10.1007/978-3-319-48382-5_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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12
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Poynter JN, Richardson M, Blair CK, Roesler MA, Hirsch BA, Nguyen P, Cioc A, Warlick E, Cerhan JR, Ross JA. Obesity over the life course and risk of acute myeloid leukemia and myelodysplastic syndromes. Cancer Epidemiol 2016; 40:134-40. [PMID: 26720913 PMCID: PMC4738058 DOI: 10.1016/j.canep.2015.12.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 12/01/2015] [Accepted: 12/10/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Overweight and obesity are known risk factors for a number of cancers, with recent evidence suggesting that risk of hematologic cancer is also increased in obese individuals. We evaluated associations between body mass index (BMI) at differing time points during the life course in population-based case control studies of acute myeloid leukemia (AML) and myelodysplatic syndromes (MDS). METHODS Cases were identified by the Minnesota Cancer Surveillance System. Controls were identified through the Minnesota State driver's license/identification card list. BMI was calculated using self-reported height and weight at ages 18, 35, and 50 years and two years prior to interview, and categorized as normal (18.5-25 kg/m(2)), overweight (25-29.9 kg/m(2)), obese class I (30-34.9 kg/m(2)), and obese class II/III (35+ kg/m(2)). All analyses were stratified by sex. Unconditional logistic regression was used to calculate odds ratios and 95% confidence intervals. RESULTS We included 420 AML cases, 265 MDS cases and 1388 controls. Obesity two years prior to diagnosis was associated with AML in both males and females (OR=2.22, 95% CI 1.28, 3.85 and OR=1.85, 95% CI 1.08, 3.15 for BMI≥35 vs. BMI 18.5-24.9, respectively). In contrast, associations between obesity and MDS were observed only in females. Weight change in adulthood was not consistently associated with either outcome. CONCLUSION Our results extend the emerging literature suggesting that obesity is a risk factor for hematologic malignancy and provide evidence that that the association remains regardless of timing of obesity. Obesity in adulthood is a modifiable risk factor for both MDS and AML.
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Affiliation(s)
- Jenny N Poynter
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, United States; Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, United States.
| | - Michaela Richardson
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, United States
| | - Cindy K Blair
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55455, United States
| | - Michelle A Roesler
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, United States
| | - Betsy A Hirsch
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Phuong Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
| | - Adina Cioc
- VA Medical Center, Minneapolis, MN 55417, United States
| | - Erica Warlick
- Blood and Marrow Transplant Program, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN 55455, United States
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, United States
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, United States; Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, United States
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Chang CC, Lin MS, Chen YT, Tu LT, Jane SW, Chen MY. Metabolic syndrome and health-related behaviours associated with pre-oral cancerous lesions among adults aged 20-80 years in Yunlin County, Taiwan: a cross-sectional study. BMJ Open 2015; 5:e008788. [PMID: 26685025 PMCID: PMC4691787 DOI: 10.1136/bmjopen-2015-008788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To explore the associations of health-related behaviours, metabolic syndrome and risk factors in adults with pre-oral cancerous (POC) lesions in rural, disadvantaged communities with a high prevalence of oral cancer. DESIGN A cross-sectional observational study. SETTING Community-based health survey in the western coastal area of Yunlin County, Taiwan. PARTICIPANTS 5161 adult residents participated in this study. OUTCOME MEASURES Assessed parameters included oral leukoplakia, oral submucous fibrosis, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure and waist circumference. Statistical analyses included descriptive statistics, χ(2) tests and multivariate binary logistic regression. RESULTS A high percentage of participants were found to have metabolic syndrome (40%) and POC lesions (7.3%). Participants with POC lesions tended to be male (p<0.001), betel nut chewers (p<0.001) and cigarette smokers (p<0.001); have a low level of education (p<0.001); seldom undergo dental check-ups (p<0.01); irregularly participate in physical activity (p<0.01) and have metabolic syndrome (p<0.01). CONCLUSIONS Although male sex and disadvantaged socioeconomic status are non-modifiable factors associated with POC and metabolic syndrome in adults, several factors, notably health behaviours, are modifiable. Clinicians can reduce the incidence and consequences of POC by developing programmes for early detection, encouraging regular dental check-ups, and initiating individualised, health-promoting behaviour modification programmes for reducing risky behaviours associated with oral cancer.
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Affiliation(s)
- Chang-Cheng Chang
- Division of Plastic Surgery, Head and Neck Cancer Team, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shyan Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
| | - Yu-Tsung Chen
- Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Liang-Tse Tu
- Division of Dentistry, Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Su-Whi Jane
- Nursing Department, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Mei-Yen Chen
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
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