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FältnamnIndikatorerMetadata
00007550naa a22010453a 4500
00119660569
003SE-LIBR
00520160906175211.0
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008160906s2016 sw |||| o |||| ||eng c
0247 a http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1215932 uri
0247 a urn:nbn:se:umu:diva-1215932 urn
0247 a 10.1371/journal.pmed.10019882 doi
040 a S
0410 a eng
042 9 EPLK
1001 a Murphy, Neil4 aut
2451 0a A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)h [Elektronisk resurs]
260 c 2016
500 a Published
5060 a gratis
520 a Background Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. Methods and Findings The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m(2)), (2) metabolically healthy/overweight (BMI >= 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI >= 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [>= 80 cm for women and >= 94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of <0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed. Conclusions These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.
650 7a Medical and Health Sciences2 hsv
650 7a Clinical Medicine2 hsv
650 7a Cancer and Oncology2 hsv
650 7a Medicin och hälsovetenskap2 hsv
650 7a Klinisk medicin2 hsv
650 7a Cancer och onkologi2 hsv
650 7a Medical and Health Sciences2 hsv
650 7a Basic Medicine2 hsv
650 7a Cell and Molecular Biology2 hsv
650 7a Medicin och hälsovetenskap2 hsv
650 7a Medicinska grundvetenskaper2 hsv
650 7a Cell- och molekylärbiologi2 hsv
7001 a Cross, Amanda J.4 aut
7001 a Abubakar, Mustapha4 aut
7001 a Jenab, Mazda4 aut
7001 a Aleksandrova, Krasimira4 aut
7001 a Boutron-Ruault, Marie-Christine4 aut
7001 a Dossus, Laure4 aut
7001 a Racine, Antoine4 aut
7001 a Kuehn, Tilman4 aut
7001 a Katzke, Verena A.4 aut
7001 a Tjonneland, Anne4 aut
7001 a Petersen, Kristina E. N.4 aut
7001 a Overvad, Kim4 aut
7001 a Ramon Quiros, J.4 aut
7001 a Jakszyn, Paula4 aut
7001 a Molina-Montes, Esther4 aut
7001 a Dorronsoro, Miren4 aut
7001 a Huerta, Jose-Maria4 aut
7001 a Barricarte, Aurelio4 aut
7001 a Khaw, Kay-Tee4 aut
7001 a Wareham, Nick4 aut
7001 a Travis, Ruth C.4 aut
7001 a Trichopoulou, Antonia4 aut
7001 a Lagiou, Pagona4 aut
7001 a Trichopoulos, Dimitrios4 aut
7001 a Masala, Giovanna4 aut
7001 a Krogh, Vittorio4 aut
7001 a Tumino, Rosario4 aut
7001 a Vineis, Paolo4 aut
7001 a Panico, Salvatore4 aut
7001 a Bueno-de-Mesquita, H. Bas4 aut
7001 a Siersema, Peter D.4 aut
7001 a Peeters, Petra H.4 aut
7001 a Ohlsson, Bodil4 aut
7001 a Ericson, Ulrika4 aut
7001 a Palmqvist, Richard4 aut
7001 a Nyström, Hanna4 aut
7001 a Weiderpass, Elisabete4 aut
7001 a Skeie, Guri4 aut
7001 a Freisling, Heinz4 aut
7001 a Kong, So Yeon4 aut
7001 a Tsilidis, Kostas4 aut
7001 a Muller, David C.4 aut
7001 a Riboli, Elio4 aut
7001 a Gunter, Marc J.4 aut
7101 a Umeå universitetb Medicinska fakulteten4 pbl0 268483
7721 8i channel recordw 18813935
7730 i Värdpublikationt PLoS Medicineg 13 4x 1549-1277
8564 0u http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121593
8564 0u http://dx.doi.org/10.1371/journal.pmed.1001988
8564 0u http://umu.diva-portal.org/smash/get/diva2:941282/FULLTEXT01
9102 s6 710a Umeå universitet.b Medicinsk-odontologiska fakultetenu Umeå universitet.b Medicinska fakulteten
9102 s6 710a Medicinska fakulteten vid Umeå universitetu Umeå universitet.b Medicinska fakulteten
841 5 APISa x ab 160906||0000|||||001||||||000000e 1
0247 5 APISa urn:nbn:se:umu:diva-1215932 urn
852 5 APISb APIS
8564 05 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121593

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