Sökning: WFRF:(Montes D.) > A Nested Case-Contr...
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000 | 07550naa a22010453a 4500 | |
001 | 19660569 | |
003 | SE-LIBR | |
005 | 20160906175211.0 | |
007 | cr|||||||||||| | |
008 | 160906s2016 sw |||| o |||| ||eng c | |
024 | 7 | a http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1215932 uri |
024 | 7 | a urn:nbn:se:umu:diva-1215932 urn |
024 | 7 | a 10.1371/journal.pmed.10019882 doi |
040 | a S | |
041 | 0 | a eng |
042 | 9 EPLK | |
100 | 1 | a Murphy, Neil4 aut |
245 | 1 0 | a 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 | |
506 | 0 | 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 | 7 | a Medical and Health Sciences2 hsv |
650 | 7 | a Clinical Medicine2 hsv |
650 | 7 | a Cancer and Oncology2 hsv |
650 | 7 | a Medicin och hälsovetenskap2 hsv |
650 | 7 | a Klinisk medicin2 hsv |
650 | 7 | a Cancer och onkologi2 hsv |
650 | 7 | a Medical and Health Sciences2 hsv |
650 | 7 | a Basic Medicine2 hsv |
650 | 7 | a Cell and Molecular Biology2 hsv |
650 | 7 | a Medicin och hälsovetenskap2 hsv |
650 | 7 | a Medicinska grundvetenskaper2 hsv |
650 | 7 | a Cell- och molekylärbiologi2 hsv |
700 | 1 | a Cross, Amanda J.4 aut |
700 | 1 | a Abubakar, Mustapha4 aut |
700 | 1 | a Jenab, Mazda4 aut |
700 | 1 | a Aleksandrova, Krasimira4 aut |
700 | 1 | a Boutron-Ruault, Marie-Christine4 aut |
700 | 1 | a Dossus, Laure4 aut |
700 | 1 | a Racine, Antoine4 aut |
700 | 1 | a Kuehn, Tilman4 aut |
700 | 1 | a Katzke, Verena A.4 aut |
700 | 1 | a Tjonneland, Anne4 aut |
700 | 1 | a Petersen, Kristina E. N.4 aut |
700 | 1 | a Overvad, Kim4 aut |
700 | 1 | a Ramon Quiros, J.4 aut |
700 | 1 | a Jakszyn, Paula4 aut |
700 | 1 | a Molina-Montes, Esther4 aut |
700 | 1 | a Dorronsoro, Miren4 aut |
700 | 1 | a Huerta, Jose-Maria4 aut |
700 | 1 | a Barricarte, Aurelio4 aut |
700 | 1 | a Khaw, Kay-Tee4 aut |
700 | 1 | a Wareham, Nick4 aut |
700 | 1 | a Travis, Ruth C.4 aut |
700 | 1 | a Trichopoulou, Antonia4 aut |
700 | 1 | a Lagiou, Pagona4 aut |
700 | 1 | a Trichopoulos, Dimitrios4 aut |
700 | 1 | a Masala, Giovanna4 aut |
700 | 1 | a Krogh, Vittorio4 aut |
700 | 1 | a Tumino, Rosario4 aut |
700 | 1 | a Vineis, Paolo4 aut |
700 | 1 | a Panico, Salvatore4 aut |
700 | 1 | a Bueno-de-Mesquita, H. Bas4 aut |
700 | 1 | a Siersema, Peter D.4 aut |
700 | 1 | a Peeters, Petra H.4 aut |
700 | 1 | a Ohlsson, Bodil4 aut |
700 | 1 | a Ericson, Ulrika4 aut |
700 | 1 | a Palmqvist, Richard4 aut |
700 | 1 | a Nyström, Hanna4 aut |
700 | 1 | a Weiderpass, Elisabete4 aut |
700 | 1 | a Skeie, Guri4 aut |
700 | 1 | a Freisling, Heinz4 aut |
700 | 1 | a Kong, So Yeon4 aut |
700 | 1 | a Tsilidis, Kostas4 aut |
700 | 1 | a Muller, David C.4 aut |
700 | 1 | a Riboli, Elio4 aut |
700 | 1 | a Gunter, Marc J.4 aut |
710 | 1 | a Umeå universitetb Medicinska fakulteten4 pbl0 268483 |
772 | 1 8 | i channel recordw 18813935 |
773 | 0 | i Värdpublikationt PLoS Medicineg 13 4x 1549-1277 |
856 | 4 0 | u http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121593 |
856 | 4 0 | u http://dx.doi.org/10.1371/journal.pmed.1001988 |
856 | 4 0 | u http://umu.diva-portal.org/smash/get/diva2:941282/FULLTEXT01 |
910 | 2 s | 6 710a Umeå universitet.b Medicinsk-odontologiska fakultetenu Umeå universitet.b Medicinska fakulteten |
910 | 2 s | 6 710a Medicinska fakulteten vid Umeå universitetu Umeå universitet.b Medicinska fakulteten |
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024 | 7 | 5 APISa urn:nbn:se:umu:diva-1215932 urn |
852 | 5 APISb APIS | |
856 | 4 0 | 5 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121593 |
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