@article{b42b3670b3e54e9ba56bbab1860d31e0,
title = "Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women",
abstract = "Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR—a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5–<25.0, 25.0–<30.0 and ≥30.0 kg/m2) and presence of the metabolic syndrome into 6 phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). Neither BMI nor presence of the metabolic syndrome was associated with risk of colorectal cancer, whereas waist circumference showed a robust positive association. Relative to the MHNW phenotype, the MUNW phenotype was associated with increased risk, whereas no other phenotype showed an association. Furthermore, HOMA-IR was not associated with increased risk. Overall, our results do not support a direct role of metabolic dysregulation in the development of colorectal cancer; however, they do suggest that higher waist circumference is a risk factor, possibly reflecting the effects of increased levels of cytokines and hormones in visceral abdominal fat on colorectal carcinogenesis.",
keywords = "HOMA-IR, body mass index, colorectal cancer risk, metabolic status, postmenopausal women, waist circumference",
author = "Kabat, {Geoffrey C.} and Kim, {Mimi Y.} and Marcia Stefanick and Ho, {Gloria Y.F.} and Lane, {Dorothy S.} and Odegaard, {Andrew O.} and Simon, {Michael S.} and Bea, {Jennifer W.} and Juhua Luo and Sylvia Wassertheil-Smoller and Rohan, {Thomas E.}",
note = "Funding Information: Additional Contributions: The authors thank the Women's Health Initiative investigators, staff and the trial participants for their outstanding dedication and commitment. Women's Health Initiative Investigators: Program office: Jacques Roscoe, Shari Ludlum, Dale Burden, Joan McGowan, Leslie Ford and Nancy Geller (National Heart, Lung, and Blood Institute, Bethesda, MD) Clinical coordinating center: Garnet Anderson, Ross Prentice, Andrea LaCroix and Charles Kopperberg (Fred Hutchinson Cancer Research Center, Seattle, WA) Investigators and academic centers: JoAnn E. Manson, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Barbara V. Howard, MedStar Health Research Institute/Howard University, Washington, DC; Marcia L. Stefanick, Stanford Prevention Research Center, Stanford, CA; Rebecca Jackson, The Ohio State University, Columbus, OH; Cynthia A. Thompson, University of Arizona, Tucson/Phoenix, AZ; Jean Wactawski-Wende, University at Buffalo, Buffalo, NY; Marian Limacher, University of Florida, Gainesville/Jacksonville, FL; Robert Wallace, University of Iowa, Iowa City/Davenport, IA; Lewis Kuller, University of Pittsburgh, Pittsburgh, PA; Rowan T. Chlebowski, City of Hope Comprehensive Cancer Center, Duarte, CA; Sally Shumaker, Wake Forest University School of Medicine, Winston-Salem, NC Women's Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston Salem, NC) Sally Shumaker Additional information: A full list of all the investigators who have contributed to Women's Health Initiative science appears at https://www.whi.org/researchers/Documents%20%20Write%20a%20Paper/WHI%20Investigator%20Long%20List.pdf",
year = "2018",
month = aug,
day = "1",
doi = "10.1002/ijc.31345",
language = "English (US)",
volume = "143",
pages = "543--551",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "3",
}