Abstract 2231: Insulin and multi-system alterations in non-diabetic American adults: NHANES 1999-2016

Abstract

Abstract Epidemiological evidence for a relationship between insulin resistance and cancer is emerging, and insulins' complex actions suggest that its dysregulation results in multisystem alterations. Using cross-sectional demographic and laboratory data from the continuous NHANES conducted from 1999-2016. we surveyed the range of multisystem alterations observed in normal (not diabetic or prediabetic) adult subjects in relation to variation in insulin and glucose levels. The homeostatic model of insulin resistance (HOMA-IR) was used as the key outcome measure of insulin resistance. We examined cardiovascular (BP), respiratory (FEV1, FVC), renal (BUN, creatinine), inflammatory (C-reactive protein, fibrinogen), lipid (triglycerides, LDL, HLD), hematologic (WBC, hemoglobin, cell counts), and nutritional (vitamin levels) factors in relation to HOMA-IR, C-peptide, Hgb1Ac and fasting glucose levels after adjustment for demographic (age, gender, smoking, alcohol, race, SES) and anthropometric (BMI) factors. Every system exhibited highly significant associations with insulin/glucose measures. Strong correlations (p < 0.0001, Pearson, accounting for sample weights) of HOMA-IR were observed with waist size, systolic and diastolic blood pressure, triglycerides, HDL (inverse), LDL and inflammatory markers: fibrinogen, C-reactive protein, ferritin. Measured serum levels of vitamin C, vitamin D, and folate (RBC), were inversely associated with HOMA-IR. The relationship for selected variables, to HOMA-IR quartiles is shown below. In a broad, representative sample of up to 9000 non-diabetic US subjects, we relate insulin resistance to adverse changes in anthropometric, cardiovascular, renal, metabolic, inflammatory and nutritional markers. Analyses accounting for NHANES sample design, confounding and potential interactions will be reported. Our preliminary results suggest that insulin resistance is linked to perturbations in normal function across numerous systems. HOMA-IR Quartiles, adjusted (95% CI)1st2nd3rd4thFerritin79.1(71-87)75.9 (70-82)82.3 (76-89)96.2 (82-110)BP (d)69.7 (69-71)71.8 (70-73)71.4 (70-73)73.2 (72-75)HDL60.8 (60-62)56.3 (56-57)54.1 (53-55)51.3 (50-52)WBC6.37 (6.3-6.5)6.44 (6.3-6.6)6.68 (6.5-6.8)6.96 (6.8-7.1) Citation Format: Neil E. Caporaso, Rena R. Jones, Lisa L. Kahle, Barry I. Graubard. Insulin and multi-system alterations in non-diabetic American adults: NHANES 1999-2016 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2231.