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Insulin resistance/hyperinsulinemia and cancer mortality: the Cremona study at the 15th year of follow-up

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Abstract

Type 2 diabetes is associated with risk of cancer. Hyperinsulinemia and insulin resistance may be the link with cancer, but whether this is independent of the diabetes status, obesity/visceral obesity and metabolic syndrome is uncertain and the present study wanted to address this issue. Fifteen-year all-cause, CVD and cancer mortality data were obtained through the Regional Health Registry in 2,011 out of 2,074 Caucasian middle-aged individuals of the Cremona Study, a population study on the prevalence of diabetes mellitus in Italy in which anthropometric and metabolic characteristics were collected. During the 15-year observation period, 495 deaths were registered: 221 CVD related and 180 cancer related. Age and sex were independently associated with all-cause, cancer and CVD mortality rates. Age- and sex-adjusted analysis showed that HOMA-IR, cigarette smoking and diabetes were independently associated with all-cause mortality; HOMA-IR, systolic blood pressure and fibrinogen were independently associated with CVD mortality; HOMA-IR and smoking habit were independently associated with cancer mortality. Individuals in the highest quintile of serum insulin had a 62% higher risk of cancer mortality (HR = 1.62 95% CI: 1.19–2.20; P < 0.0022) and 161% higher risk of gastrointestinal cancer mortality (HR = 2.61 95% CI: 1.73–3.94; P < 0.0001). Age- and sex-adjusted analysis showed that hyperinsulinemia/insulin resistance is associated with cancer mortality independently of diabetes, obesity/visceral obesity and the metabolic syndrome.

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Acknowledgments

This work was supported by Associazione Italiana per la Ricerca sul Cancro (AIRC, bando 5 × 1,000 N°12182 and Progetto IG N° 11783), by European Community’s Seventh Framework Programme (EPC-TM net, project number 256974), by INAIL Research Grant and by a liberal donation by Angela Musazzi and Mario Stellato family.

Conflict of interest

Authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Division of Metabolic and Cardiovascular Sciences, Istituto Scientifico H San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Gianluca Perseghin, Giliola Calori, Guido Lattuada, Francesca Ragogna, Emanuele Bosi & Giacomo Ruotolo

  2. Diabetes Research Institute, Istituto Scientifico H San Raffaele, Milan, Italy

    Erika Dugnani & Lorenzo Piemonti

  3. Medical Direction, Istituto Scientifico H San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Maria Paola Garancini

  4. Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy

    Paolo Crosignani

  5. AstraZeneca R&D, Molndal, Sweden

    Giacomo Ruotolo

  6. Department of Sport Sciences, Nutrition and Health, Università degli Studi di Milano, Via Kramer 4/A, Milan, Italy

    Gianluca Perseghin & Guido Lattuada

  7. Servizio Epidemiologia ASL della Provincia di Cremona, Milan, Italy

    Marco Villa

Authors
  1. Gianluca Perseghin
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  2. Giliola Calori
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  3. Guido Lattuada
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  4. Francesca Ragogna
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  5. Erika Dugnani
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  6. Maria Paola Garancini
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  7. Paolo Crosignani
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  8. Marco Villa
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  9. Emanuele Bosi
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  10. Giacomo Ruotolo
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  11. Lorenzo Piemonti
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Correspondence to Gianluca Perseghin or Lorenzo Piemonti.

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Perseghin, G., Calori, G., Lattuada, G. et al. Insulin resistance/hyperinsulinemia and cancer mortality: the Cremona study at the 15th year of follow-up. Acta Diabetol 49, 421–428 (2012). https://doi.org/10.1007/s00592-011-0361-2

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  • DOI: https://doi.org/10.1007/s00592-011-0361-2

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