Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women

Geoffrey C. Kabat, Mimi Kim, Dorothy S. Lane, Oleg Zaslavsky, Gloria Y.F. Ho, Juhua Luo, Wanda K. Nicholson, Rowan T. Chlebowski, Wendy E. Barrington, Mara Z. Vitolins, Xiaochen Lin, Simin Liu, Thomas E. Rohan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Limited evidence suggests that hyperinsulinemia may contribute to the risk of breast, endometrial, and, possibly, ovarian cancer. The aim of this study was to assess the association of serum glucose and insulin with risk of these cancers in postmenopausal women, while taking into account potential confounding and modifying factors. We studied 21 103 women with fasting baseline insulin and glucose measurements in a subsample of the Women's Health Initiative. The subsample was composed of four studies within Women's Health Initiative with different selection and sampling strategies. Over a mean of 14.7 years of follow-up, 1185 breast cancer cases, 156 endometrial cancer cases, and 130 ovarian cancer cases were diagnosed. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) by quartile of glucose or insulin. Serum insulin was positively associated with breast cancer risk (multivariable-Adjusted HR for highest vs. lowest quartile 1.41, 95% CI: 1.16-1.72, Ptrend<0.0003), and glucose and insulin were associated with roughly a doubling of endometrial cancer risk (for glucose: HR: 2.00, 95% CI: 1.203.35, Ptrend=0.01; for insulin: HR: 2.39, 95% CI: 1.32-4.33, Ptrend=0.008). These associations remained unchanged or were slightly attenuated after mutual adjustment, adjustment for serum lipids, and assessment of possible reverse causation. Glucose and insulin showed no association with ovarian cancer. Our findings provide support for a role of insulin-related pathways in the etiology of cancers of the breast and endometrium. However, because of the unrepresentative nature of the sample, our results need confirmation in other populations.

Original languageEnglish (US)
Pages (from-to)261-268
Number of pages8
JournalEuropean Journal of Cancer Prevention
Volume27
Issue number3
DOIs
StatePublished - Jan 1 2018

Fingerprint

Endometrial Neoplasms
Ovarian Neoplasms
Insulin
Breast Neoplasms
Glucose
Serum
Confidence Intervals
Women's Health
Social Adjustment
Hyperinsulinism
Proportional Hazards Models
Causality
Fasting
Breast
Lipids
Population
Neoplasms

Keywords

  • Breast cancer
  • Cohort studies
  • Endometrial cancer
  • Glucose
  • Hyperinsulinemia
  • Insulin
  • Ovarian cancer
  • Postmenopausal women

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women. / Kabat, Geoffrey C.; Kim, Mimi; Lane, Dorothy S.; Zaslavsky, Oleg; Ho, Gloria Y.F.; Luo, Juhua; Nicholson, Wanda K.; Chlebowski, Rowan T.; Barrington, Wendy E.; Vitolins, Mara Z.; Lin, Xiaochen; Liu, Simin; Rohan, Thomas E.

In: European Journal of Cancer Prevention, Vol. 27, No. 3, 01.01.2018, p. 261-268.

Research output: Contribution to journalArticle

Kabat, GC, Kim, M, Lane, DS, Zaslavsky, O, Ho, GYF, Luo, J, Nicholson, WK, Chlebowski, RT, Barrington, WE, Vitolins, MZ, Lin, X, Liu, S & Rohan, TE 2018, 'Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women', European Journal of Cancer Prevention, vol. 27, no. 3, pp. 261-268. https://doi.org/10.1097/CEJ.0000000000000435
Kabat, Geoffrey C. ; Kim, Mimi ; Lane, Dorothy S. ; Zaslavsky, Oleg ; Ho, Gloria Y.F. ; Luo, Juhua ; Nicholson, Wanda K. ; Chlebowski, Rowan T. ; Barrington, Wendy E. ; Vitolins, Mara Z. ; Lin, Xiaochen ; Liu, Simin ; Rohan, Thomas E. / Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women. In: European Journal of Cancer Prevention. 2018 ; Vol. 27, No. 3. pp. 261-268.
@article{0fac4bebfd31456b9e090901e4ade88a,
title = "Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women",
abstract = "Limited evidence suggests that hyperinsulinemia may contribute to the risk of breast, endometrial, and, possibly, ovarian cancer. The aim of this study was to assess the association of serum glucose and insulin with risk of these cancers in postmenopausal women, while taking into account potential confounding and modifying factors. We studied 21 103 women with fasting baseline insulin and glucose measurements in a subsample of the Women's Health Initiative. The subsample was composed of four studies within Women's Health Initiative with different selection and sampling strategies. Over a mean of 14.7 years of follow-up, 1185 breast cancer cases, 156 endometrial cancer cases, and 130 ovarian cancer cases were diagnosed. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) by quartile of glucose or insulin. Serum insulin was positively associated with breast cancer risk (multivariable-Adjusted HR for highest vs. lowest quartile 1.41, 95{\%} CI: 1.16-1.72, Ptrend<0.0003), and glucose and insulin were associated with roughly a doubling of endometrial cancer risk (for glucose: HR: 2.00, 95{\%} CI: 1.203.35, Ptrend=0.01; for insulin: HR: 2.39, 95{\%} CI: 1.32-4.33, Ptrend=0.008). These associations remained unchanged or were slightly attenuated after mutual adjustment, adjustment for serum lipids, and assessment of possible reverse causation. Glucose and insulin showed no association with ovarian cancer. Our findings provide support for a role of insulin-related pathways in the etiology of cancers of the breast and endometrium. However, because of the unrepresentative nature of the sample, our results need confirmation in other populations.",
keywords = "Breast cancer, Cohort studies, Endometrial cancer, Glucose, Hyperinsulinemia, Insulin, Ovarian cancer, Postmenopausal women",
author = "Kabat, {Geoffrey C.} and Mimi Kim and Lane, {Dorothy S.} and Oleg Zaslavsky and Ho, {Gloria Y.F.} and Juhua Luo and Nicholson, {Wanda K.} and Chlebowski, {Rowan T.} and Barrington, {Wendy E.} and Vitolins, {Mara Z.} and Xiaochen Lin and Simin Liu and Rohan, {Thomas E.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/CEJ.0000000000000435",
language = "English (US)",
volume = "27",
pages = "261--268",
journal = "European Journal of Cancer Prevention",
issn = "0959-8278",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Serum glucose and insulin and risk of cancers of the breast, endometrium, and ovary in postmenopausal women

AU - Kabat, Geoffrey C.

AU - Kim, Mimi

AU - Lane, Dorothy S.

AU - Zaslavsky, Oleg

AU - Ho, Gloria Y.F.

AU - Luo, Juhua

AU - Nicholson, Wanda K.

AU - Chlebowski, Rowan T.

AU - Barrington, Wendy E.

AU - Vitolins, Mara Z.

AU - Lin, Xiaochen

AU - Liu, Simin

AU - Rohan, Thomas E.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Limited evidence suggests that hyperinsulinemia may contribute to the risk of breast, endometrial, and, possibly, ovarian cancer. The aim of this study was to assess the association of serum glucose and insulin with risk of these cancers in postmenopausal women, while taking into account potential confounding and modifying factors. We studied 21 103 women with fasting baseline insulin and glucose measurements in a subsample of the Women's Health Initiative. The subsample was composed of four studies within Women's Health Initiative with different selection and sampling strategies. Over a mean of 14.7 years of follow-up, 1185 breast cancer cases, 156 endometrial cancer cases, and 130 ovarian cancer cases were diagnosed. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) by quartile of glucose or insulin. Serum insulin was positively associated with breast cancer risk (multivariable-Adjusted HR for highest vs. lowest quartile 1.41, 95% CI: 1.16-1.72, Ptrend<0.0003), and glucose and insulin were associated with roughly a doubling of endometrial cancer risk (for glucose: HR: 2.00, 95% CI: 1.203.35, Ptrend=0.01; for insulin: HR: 2.39, 95% CI: 1.32-4.33, Ptrend=0.008). These associations remained unchanged or were slightly attenuated after mutual adjustment, adjustment for serum lipids, and assessment of possible reverse causation. Glucose and insulin showed no association with ovarian cancer. Our findings provide support for a role of insulin-related pathways in the etiology of cancers of the breast and endometrium. However, because of the unrepresentative nature of the sample, our results need confirmation in other populations.

AB - Limited evidence suggests that hyperinsulinemia may contribute to the risk of breast, endometrial, and, possibly, ovarian cancer. The aim of this study was to assess the association of serum glucose and insulin with risk of these cancers in postmenopausal women, while taking into account potential confounding and modifying factors. We studied 21 103 women with fasting baseline insulin and glucose measurements in a subsample of the Women's Health Initiative. The subsample was composed of four studies within Women's Health Initiative with different selection and sampling strategies. Over a mean of 14.7 years of follow-up, 1185 breast cancer cases, 156 endometrial cancer cases, and 130 ovarian cancer cases were diagnosed. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) by quartile of glucose or insulin. Serum insulin was positively associated with breast cancer risk (multivariable-Adjusted HR for highest vs. lowest quartile 1.41, 95% CI: 1.16-1.72, Ptrend<0.0003), and glucose and insulin were associated with roughly a doubling of endometrial cancer risk (for glucose: HR: 2.00, 95% CI: 1.203.35, Ptrend=0.01; for insulin: HR: 2.39, 95% CI: 1.32-4.33, Ptrend=0.008). These associations remained unchanged or were slightly attenuated after mutual adjustment, adjustment for serum lipids, and assessment of possible reverse causation. Glucose and insulin showed no association with ovarian cancer. Our findings provide support for a role of insulin-related pathways in the etiology of cancers of the breast and endometrium. However, because of the unrepresentative nature of the sample, our results need confirmation in other populations.

KW - Breast cancer

KW - Cohort studies

KW - Endometrial cancer

KW - Glucose

KW - Hyperinsulinemia

KW - Insulin

KW - Ovarian cancer

KW - Postmenopausal women

UR - http://www.scopus.com/inward/record.url?scp=85044857374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044857374&partnerID=8YFLogxK

U2 - 10.1097/CEJ.0000000000000435

DO - 10.1097/CEJ.0000000000000435

M3 - Article

VL - 27

SP - 261

EP - 268

JO - European Journal of Cancer Prevention

JF - European Journal of Cancer Prevention

SN - 0959-8278

IS - 3

ER -