Metabolic Health Reduces Risk of Obesity-Related Cancer in Framingham Study Adults
Menée aux Etats-Unis auprès de 3 763 participants âgés de 55 à 69 ans, cette étude évalue l'association entre des indicateurs de corpulence, la glycémie et le risque de cancers liés à l'obésité
Background. It is unknown whether the risk for obesity-related cancers between metabolically unhealthy and healthy overweight/obese adults. Methods. Data on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and random blood glucose in Framingham Heart Study adults (n=3763) ages 55-69 were used to estimate risks of obesity-related cancers (n=385) including post-menopausal 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. Results. Overweight adults (BMI≥25 or WHtR≥0.51 (men) and ≥0.57 (women)) with elevated glucose (≥125 mg/dL) had a statistically significant two-fold increased risk of developing obesity-related cancer while 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% CI: 1.4-4.9) of female reproductive (cervical, endometrial, uterine cancers) and post-menopausal breast cancers while overweight women with normal glucose levels had only a 70% increased risk (95% CI: 1.1-2.5). Conclusion. These results suggest that cancer risk may be lower among metabolically-healthy overweight/obese older adults than among overweight/obese adults with metabolic dysfunction. Impact. Metabolic dysfunction and obesity act synergistically to increase cancer risk.