Effect of adipose tissue quantity and dysfunction on the risk of cancer in individuals with and without type 2 diabetes
Helmink, Marga A.G.; Westerink, Jan; Hageman, Steven H.J.; Koopman, Miriam; van der Meer, Manon G.; Teraa, Martin; Ruigrok, Ynte M.; Visseren, Frank L.J.
(2023) Obesity Research and Clinical Practice, volume 17, issue 5, pp. 383 - 389
(Article)
Abstract
Objective: To determine the role of waist circumference and metabolic dysfunction in the risk of cancer in individuals with type 2 diabetes (T2D) and to compare this to individuals without T2D. Methods: Individuals with (n = 1925) and without T2D (n = 10,204) were included from the UCC-SMART cohort. Incident
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cancer diagnoses were obtained by linkage with the Netherlands Cancer Registry. Metabolic dysfunction was defined as ≥ 3 adapted NCEP ATP-III metabolic syndrome criteria. The effects of waist circumference and metabolic dysfunction on cancer were assessed using Cox proportional hazards models, adjusted for confounders. Results: During a median follow-up of 8.3 years (IQR 4.2–13.1), 1740 individuals were diagnosed with cancer. Incidence rates of total cancer were 19.3 and 15.5/1000 person-years for individuals with and without T2D, respectively. In individuals without T2D, a higher waist circumference was associated with an increased risk of colorectal (per standard deviation: HR 1.23; 95%CI 1.03–1.46), urinary tract (HR 1.28; 95%CI 1.05–1.56) and total cancer (HR 1.06; 95%CI 1.02–1.13). Metabolic dysfunction was related to an increased risk of colorectal (HR 1.35; 95%CI 1.01–1.82), lung (HR 1.37; 95%CI 1.07–1.75) and total cancer (HR 1.13; 95%CI 1.01–1.25) in individuals without T2D. In individuals with T2D, no significant associations were found. Conclusion: Incidence rates of cancer are higher among individuals with T2D. However, higher waist circumference and metabolic dysfunction are only associated with an increased cancer risk in patients without T2D. These findings provide novel insights into the role of metabolic dysfunction in the occurrence of cancer.
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Keywords: Adipose tissue dysfunction, Adipose tissue quantity, Cancer, Metabolic dysfunction, Obesity, Type 2 diabetes, Waist circumference, Endocrinology, Diabetes and Metabolism, Nutrition and Dietetics
ISSN: 1871-403X
Publisher: Elsevier
Note: Funding Information: The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the collection of data for the Netherlands Cancer Registry. In addition, the authors gratefully acknowledge the members of the UCC-SMART study group: M.J. Cramer, H.M. Nathoe and M.G. van der Meer (co-PI), Department of Cardiology; G.J. de Borst and M. Teraa (co-PI), Department of Vascular Surgery; M.L. Bots and M. van Smeden, Julius Center for Health Sciences and Primary Care; M.H. Emmelot-Vonk, Department of Geriatrics; P.A. de Jong, Department of Radiology; A.T. Lely, Department of Gynaecology and Obstetrics; N.P. van der Kaaij, Department of Cardiothoracic Surgery; L.J. Kappelle and Y.M. Ruigrok, Department of Neurology; M.C. Verhaar, Department of Nephrology & Hypertension; J.A.N. Dorresteijn (co-PI) and F.L.J. Visseren (PI), Department of Vascular Medicine, UMC Utrecht. Funding Information: The UCC-SMART study was financially supported by a grant of the University Medical Center Utrecht. The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The authors did not receive any specific funding for the current study. Publisher Copyright: © 2023 The Authors
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