B. Balkau et al., Hyperinsulinemia predicts fetal liver cancer but is inversely associated with fatal cancer at some other sites - The Paris Prospective Study, DIABET CARE, 24(5), 2001, pp. 843-849
OBJECTIVE - To investigate whether insulin is a risk factor for death by si
te-specific cancers.
RESEARCH DESIGN AND METHODS - This was a prospective cohort study of 6,237
nondiabetic French working men between ages 44 and 55 years at baseline fro
m the Paris Prospective Study cohort. Death by site-specific cancers was in
vestigated in relation to baseline insulin concentrations during lasting an
d 2 h after a 75-g oral glucose tolerance test.
RESULTS - Of the original 6,237 men in the cohort, 1,739 died over the 23.8
years of follow-up, 778 (45%) from cancer. Baseline hyperinsulinemia. both
fasting and 2-h, was significantly associated with fatal liver cancer, wit
h age-adjusted standardized hazards ratios of 2.72 (95% CI 1.87-3.94) and 3
.41 (2.23-5.21). in contrast, lasting hyperinsulinemia was inversely associ
ated with fatal lip, ornl cavity, and pharynx cancer and larynx cancer, wit
h hazards ratios of 0.55 (0.41-0.75) and 0.63 (0.47-0.83), respectively; 2-
h insulin concentrations were inversely associated with stomach and larynx
cancers (hazards ratios 0.62 [0.43-0.90] and 0.66 [0.50-0.89], respectively
). These relationships were stable after adjusting for other risk factors.
Insulin concentrations remained negatively associated with deaths from thes
e cancers in analyses restricted to men who smoked and in those who were no
t chronic alcohol consumers.
CONCLUSIONS - Peripheral hyperinsulinemia, indicative of very high portal i
nsulin concentrations, predicted fatal liver cancer in these nondiabetic me
n, but was inversely associated with fatal lip, oral cavity, and pharynx ca
ncer; stomach cancer: and larynx cancer.