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Predictors of fasting serum insulin and glucose and the risk of pancreatic cancer in smokers

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Abstract

Objectives

A history of type 2 diabetes is one of few consistent risk factors for pancreatic cancer. Potentially modifiable factors related to fasting insulin and glucose concentrations may influence pancreatic cancer risk.

Methods

Multiple linear regression models were used to identify anthropometric, clinical, behavioral, and dietary factors associated with fasting insulin and glucose in a subcohort of non-diabetics in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (n = 366). Hazards ratios (HRs) and 95% confidence intervals (CIs) were calculated among the larger cohort (n = 27,035).

Results

During follow-up (median 16.1 years), 305 participants developed pancreatic cancer. Fasting insulin and/or glucose were positively associated with body mass index (BMI), height, and dietary total and saturated fat and inversely associated with serum high-density lipoprotein cholesterol (HDL) and dietary available carbohydrates, sucrose, and alcohol. Comparing highest to lowest quintiles, total fat (HR = 1.54, 95% CI 1.05–2.25, p-trend = 0.01) and saturated fat (HR = 1.38, 95% CI 0.97–1.98, p-trend = 0.06) were positively associated and available carbohydrates (HR = 0.63, 95% CI 0.44–0.90, p-trend = 0.01), particularly sucrose (HR = 0.62, 95% CI 0.43–0.89, p-trend = 0.09), were inversely associated with risk of pancreatic cancer. BMI, HDL, height, and alcohol were not associated with pancreatic cancer risk.

Conclusion

Dietary fat is associated with higher fasting insulin concentrations and may increase pancreatic cancer risk in smokers.

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Acknowledgments

This research was supported in part by the Intramural Research Program of the NIH and the National Cancer Institute. Additionally, this research was supported by U.S. Public Health Service contracts N01-CN-45165, N01-RC-45035, and N01-RC-37004 from the National Cancer Institute, Department of Health and Human Services. We thank Dr. Elizabeth Platz and Dr. Kala Visvanathan of the Johns Hopkins School of Public Health for helpful comments during preparation of this manuscript.

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Authors and Affiliations

  1. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, 6120 Executive Blvd, Rockville, MD, 20852, USA

    Cari L. Meinhold, Demetrius Albanes, Stephanie J. Weinstein & Rachael Z. Stolzenberg-Solomon

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Cari L. Meinhold

  3. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, Rockville, MD, USA

    Amy Berrington de Gonzalez

  4. Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, Rockville, MD, USA

    Philip R. Taylor

  5. Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland

    Jarmo Virtamo

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  1. Cari L. Meinhold
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  2. Amy Berrington de Gonzalez
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  4. Stephanie J. Weinstein
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  7. Rachael Z. Stolzenberg-Solomon
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Correspondence to Cari L. Meinhold.

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Meinhold, C.L., de Gonzalez, A.B., Albanes, D. et al. Predictors of fasting serum insulin and glucose and the risk of pancreatic cancer in smokers. Cancer Causes Control 20, 681–690 (2009). https://doi.org/10.1007/s10552-008-9281-z

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