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

Abstract

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.

Effects of high-fat diet on 1,2-dimethylhydrazine-induced aberrant crypt foci and colorectal tumours in rats

“…Relevant studies have shown that obese populations with high blood sugar levels have almost double the risk of developing obesity-related cancers, while obese populations with normal blood sugar levels only carry a 50% increased risk of developing cancers. In addition, metabolic dysfunction also increases the risk of cancer in obese individuals (15). In the present study, CRC was induced in rats using DMH.…”

The Pediatric Obesity Epidemic and the Role of the Corporation: Why Work Conditions and Faith in Meritocracy Matter

“…Chronic inlammation is thought to provide one such pathway. In recent analysis of Framingham Study adults, Denis has shown that "metabolically healthy obese" adults, who have atenuated inlammatory proiles, also appear to be protected from certain obesity-associated cancers [5,10].…”

“…Obesity is an alarming epidemic because of its comorbidities, which include diabetes, cardiovascular disease [4], and based on new evidence, increased risk of some forms of cancer [5,6]. Obesity-driven diabetes, or Type 2 diabetes, was previously only a problem for adults and was termed "adult-onset" diabetes, to distinguish it from "childhood" diabetes, or Type 1 diabetes, which is primarily immunological in origin.…”

Is obesity an advantage in patients with colorectal cancer?

“…How obesity factors in with other modifiable factors such as physical activity and diet in terms of increasing or decreasing the risk of colon cancer, respectively, are important observations [24][25][26]. However, it is not just the BMI or obesity or being underweight that are solely responsible; but likely more so the dynamic changes in weight with time in patients with metastatic colorectal cancer that are likely to be playing a role and reflective of other comorbidities and nutritional status in this patient population.…”

“…Incorporating surrogate radiological measures is also an accurate and cost-effective method, as patients with colon cancer might receive several CT scans during the course of their disease [30,32]. Furthermore, it is important to note that a proportion of overweight/obese patients may still be 'metabolically healthy' (normal glucose tolerance, lipid levels, and blood pressure as well as less ectopic fat) compared with those with 'metabolic dysfunction,' with overall higher risk and poorer outcomes in the latter group [26].…”