Data from Metabolic Health Reduces Risk of Obesity-Related Cancer in Framingham Study Adults

Abstract

<div>Abstract<p><b>Background:</b> It is unknown whether the risk for obesity-related cancers differs between metabolically unhealthy and healthy overweight/obese adults.</p><p><b>Methods:</b> Data on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and random blood glucose in Framingham Heart Study adults (<i>n</i> = 3,763) ages 55 to 69 years were used to estimate risks of obesity-related cancers (<i>n</i> = 385), including postmenopausal breast, female reproductive, colon, liver, gallbladder, pancreas, and kidney cancers, as well as esophageal adenocarcinomas. Multivariable-adjusted Cox proportional hazards models were used to estimate risk for obesity-related cancers associated with body fat and metabolic health (as defined by glucose levels) among subjects in three risk groups (vs. referent group with normal weight/normal glucose): normal weight/elevated glucose, overweight/normal glucose, and overweight/elevated glucose.</p><p><b>Results:</b> Overweight adults [BMI ≥ 25 or WHtR ≥ 0.51 (men) and ≥0.57 (women)] with elevated glucose (≥125 mg/dL) had a statistically significant 2-fold increased risk of developing obesity-related cancer, whereas overweight adults with normal glucose had a 50% increased risk. Normal-weight adults with elevated glucose had no excess cancer risk. The effects of BMI and WHtR were independent of one another. Finally, overweight women with elevated blood glucose had a 2.6-fold increased risk [95% confidence interval (CI), 1.4–4.9] of female reproductive (cervical, endometrial, uterine cancers) and postmenopausal breast cancers, whereas overweight women with normal glucose levels had only a 70% increased risk (95% CI, 1.1–2.5).</p><p><b>Conclusion:</b> These results suggest that cancer risk may be lower among metabolically healthy overweight/obese older adults than among overweight/obese adults with metabolic dysfunction.</p><p><b>Impact:</b> Metabolic dysfunction and obesity act synergistically to increase cancer risk. <i>Cancer Epidemiol Biomarkers Prev; 23(10); 2057–65. ©2014 AACR</i>.</p></div>