Metabolic Factors and the Risk of Pancreatic Cancer: A Prospective Analysis of almost 580,000 Men and Women in the Metabolic Syndrome and Cancer Project

Abstract

Background: The aim of this study was to investigate the association between factors in metabolic syndrome (MetS; single and combined) and the risk of pancreatic cancer.Methods: The Metabolic Syndrome and Cancer Project is a pooled cohort containing data on body mass index, blood pressure, and blood levels of glucose, cholesterol, and triglycerides. During follow-up, 862 individuals were diagnosed with pancreatic cancer. Cox proportional hazards analysis was used to calculate relative risks (RR) with 95% confidence intervals using the abovementioned factors categorized into quintiles and transformed into z-scores. All z-scores were summarized and a second z-transformation creating a composite z-score for MetS was done. All risk estimates were calibrated to correct for a regression dilution bias.Results: The trend over quintiles was positively associated with the risk of pancreatic cancer for mid-blood pressure (mid-BP) and glucose in men and for body mass index, mid-BP, and glucose in women. The z-score for the adjusted mid-BP (RR, 1.10; 1.01-1.20) and the calibrated z-score for glucose (RR, 1.37; 1.14-1.34) were positively associated with pancreatic cancer in men. In women, a positive association was found for calibrated z-scores for mid-BP (RR, 1.34; 1.08-1.66), for the calibrated z-score for glucose (RR, 1.98; 1.41-2.76), and for the composite z-score for MetS (RR, 1.58; 1.34-1.87).Conclusion: Our study adds further evidence to a possible link between abnormal glucose metabolism and risk of pancreatic cancer.Impact: To our knowledge, this is the first study on MetS and pancreatic cancer using prediagnostic measurements of the examined factors. Cancer Epidemiol Biomarkers Prev; 19(9); 2307-17. ©2010 AACR.

Diabetes mellitus als prognostischer Marker beim Oropharynx- und Larynxkarzinom

“…das Vorhandensein eines metabolischen Syndroms (Bluthochdruck, Hyperinsulinämie/Hyperglykämie, Dyslipidämie und ein hoher Körperfettanteil) mit einem erhöhten Risiko vergesellschaftet ist, an Leber- [33], Pankreas- [12], Brust- [35], Darm- [2] oder Blutkrebs zu erkranken [31], damit einen Risikofaktor für die Entstehung von Krebs darstellt und häufig mit einer schlechteren Prognose korreliert ist [10]. In einer Metaanalyse wurde bei etwa 9 % der HNSCCPatienten ein DM festgestellt [25].…”

Diabetes and pancreatic cancer

“…More recently, large prospective cohort studies with a long duration of follow-up have been conducted in the USA showing a positive association between high BMI and the risk of PC (adjusted RR 1.13-1.54; Jiao et al 2010, Johansen et al 2010, suggesting the role of obesity and overweight as conferring a higher risk for the development and eventual death due to PC. Among the many possible mechanisms involved, hyperinsulinemia, diet and nutritional factors, and other hormone abnormalities have been suggested as causal factors.…”

A critical evaluation of body composition modalities used to assess adipose and skeletal muscle tissue in cancer

“…Requiring only weight and height, which are 2 routine clinical measures, BMI is an expedient measure of overall body size. Recent evidence suggests that visceral adiposity may be a more important risk factor for cancer than overall obesity (Donohoe et al 2011;Johansen et al 2010, Zilli et al 2011. BMI alone cannot provide a distribution of body fat; however, waist circumference and waist-to-hip ratio are common anthropometric measures employed as surrogates of fat distribution.…”

“…In contrast, a lower waist-to-hip ratio suggests decreased visceral adiposity and decreased risk of cardiovascular disease (Pouliot et al 1994). Visceral adiposity is associated with increased risk of advanced cancer, like pancreatic (Johansen et al 2010), and has been associated with poorer survival outcomes in these patients (Balentine et al 2010).…”