Acta Diabetologica

, Volume 49, Issue 6, pp 421–428 | Cite as

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

  • Gianluca Perseghin
  • Giliola Calori
  • Guido Lattuada
  • Francesca Ragogna
  • Erika Dugnani
  • Maria Paola Garancini
  • Paolo Crosignani
  • Marco Villa
  • Emanuele Bosi
  • Giacomo Ruotolo
  • Lorenzo Piemonti
Original Article

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.

Keywords

Cancer Hyperinsulinemia Diabetes mellitus Hyperglycemia Obesity Metabolic syndrome 

Notes

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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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Gianluca Perseghin
    • 1
    • 6
  • Giliola Calori
    • 1
  • Guido Lattuada
    • 1
    • 6
  • Francesca Ragogna
    • 1
  • Erika Dugnani
    • 2
  • Maria Paola Garancini
    • 3
  • Paolo Crosignani
    • 4
  • Marco Villa
    • 7
  • Emanuele Bosi
    • 1
  • Giacomo Ruotolo
    • 1
    • 5
  • Lorenzo Piemonti
    • 2
  1. 1.Division of Metabolic and Cardiovascular SciencesIstituto Scientifico H San RaffaeleMilanItaly
  2. 2.Diabetes Research InstituteIstituto Scientifico H San RaffaeleMilanItaly
  3. 3.Medical DirectionIstituto Scientifico H San RaffaeleMilanItaly
  4. 4.Istituto Nazionale dei TumoriMilanItaly
  5. 5.AstraZeneca R&DMolndalSweden
  6. 6.Department of Sport Sciences, Nutrition and HealthUniversità degli Studi di MilanoMilanItaly
  7. 7.Servizio Epidemiologia ASL della Provincia di CremonaMilanItaly

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