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Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey

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Abstract

Insulin and glucose may influence cancer mortality via their proliferative and anti-apoptotic properties. Using longitudinal data from the nationally representative Third National Health and Nutrition Examination Survey (NHANES III; 1988–1994), with an average follow-up of 8.5 years to death, we evaluated markers of glucose and insulin metabolism, with cancer mortality, ascertained using death certificates or the National Death Index. Plasma glucose, insulin, C-peptide, and lipid concentrations were measured. Anthropometrics, lifestyle, medical, and demographic information was obtained during in-person interviews. After adjusting for age, race, sex, smoking status, physical activity, and body mass index, for every 50 mg/dl increase in plasma glucose, there was a 22% increased risk of overall cancer mortality. Insulin resistance was associated with a 41% (95% confidence interval (CI) (1.07–1.87; p = 0.01) increased risk of overall cancer mortality. These associations were stronger after excluding lung cancer deaths for insulin-resistant individuals (HR: 1.67; 95% CI: 1.15–2.42; p = 0.01), specifically among those with lower levels of physical activity (HR: 2.06; 95% CI: 1.4–3.0; p = 0.0001). Similar associations were observed for other blood markers of glucose and insulin, albeit not statistically significant. In conclusion, hyperglycemia and insulin resistance may be ‘high-risk’ conditions for cancer mortality. Managing these conditions may be effective cancer control tools.

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Acknowledgments

This study was supported by the National Institutes of Health Award 1RO3CA132127 and the Cancer Institute of New Jersey Core Grant NCI CA-72720-10.

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Authors and Affiliations

  1. Department of Nutrition, Food Studies, and Public Health, New York University, 35 W4th Street, Room 1077F, New York, NY, 10012, USA

    Niyati Parekh

  2. The Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey (UMDNJ), 195 Little Albany Street, Room #5536, New Brunswick, NJ, 08901, USA

    Yong Lin

  3. School of Public Health, #214, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, 08854, USA

    Yong Lin

  4. New York University, Cancer Institute, New York, NY, 10016, USA

    Richard B. Hayes

  5. Division of Epidemiology, Department of Environmental Medicine, NYU School of Medicine, New York, NY, 10016, USA

    Richard B. Hayes

  6. College of Physicians and Surgeons, St. Luke’s Roosevelt Hospital Center, Columbia University, New York, NY, 10019, USA

    Jeanine B. Albu

  7. The Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey (UMDNJ), 195 Little Albany Street, Room #5534, New Brunswick, NJ, 08901, USA

    Grace L. Lu-Yao

  8. Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA

    Grace L. Lu-Yao

  9. School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, 08854, USA

    Grace L. Lu-Yao

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  1. Niyati Parekh
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  2. Yong Lin
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  3. Richard B. Hayes
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  4. Jeanine B. Albu
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  5. Grace L. Lu-Yao
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Correspondence to Grace L. Lu-Yao.

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Parekh, N., Lin, Y., Hayes, R.B. et al. Longitudinal associations of blood markers of insulin and glucose metabolism and cancer mortality in the third National Health and Nutrition Examination Survey. Cancer Causes Control 21, 631–642 (2010). https://doi.org/10.1007/s10552-009-9492-y

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  • DOI: https://doi.org/10.1007/s10552-009-9492-y

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