Metabolically Defined Body Size Phenotypes and Risk of Endometrial Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)
Metadatos
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American Association for Cancer Research
Fecha
2022-07-01Referencia bibliográfica
Nathalie Kliemann... [et al.]. Metabolically Defined Body Size Phenotypes and Risk of Endometrial Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Epidemiol Biomarkers Prev 1 July 2022; 31 (7): 1359–1367. [https://doi.org/10.1158/1055-9965.EPI-22-0160]
Patrocinador
World Health Organization; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London; Danish Cancer Society; Ligue nationale contre le cancer; Institut Gustave Roussy; Mutuelle Generale de l'Education Nationale; Institut National de la Sante et de la Recherche Medicale (Inserm); Deutsche Krebshilfe; Helmholtz Association; German Institute of Human Nutrition PotsdamRehbruecke (DIfE); Federal Ministry of Education & Research (BMBF); Fondazione AIRC per la ricerca sul cancro; Compagnia di San Paolo; Consiglio Nazionale delle Ricerche (CNR); Dutch Ministry of Public Health, Welfare and Sports (VWS); Netherlands Cancer Registry (NKR); LK Research Funds; Dutch Prevention Funds Netherlands Organization for Scientific Research (NWO); World Cancer Research Fund (WCRF-ERC) 232997; Netherlands Government; Health Research Fund (FIS)-Instituto de Salud Carlos III (ISCIII); Junta de Andalucia; Principality of Asturias; Basque Government; Regional Government of Murcia; Regional Government of Navarra; Catalan Institute of OncologyICO (Spain); Swedish Cancer Society Swedish Research Council; European Commission; County Council of Skane; County Council of Vasterbotten (Sweden); Cancer Research UK 14136 C8221/A29017 C19335/A21351; UK Research & Innovation (UKRI); Medical Research Council UK (MRC); European Commission 1000143 MR/M012190/1Resumen
Background: Obesity is a risk factor for endometrial cancer but
whether metabolic dysfunction is associated with endometrial
cancer independent of body size is not known.
Methods: The association of metabolically defined body size
phenotypes with endometrial cancer risk was investigated in a
nested case–control study (817 cases/ 817 controls) within the
European Prospective Investigation into Cancer and Nutrition
(EPIC). Concentrations of C-peptide were used to define metabolically
healthy (MH; <1st tertile) and metabolically unhealthy
(MU; ≥1st tertile) status among the control participants.
These metabolic health definitions were combined with normal
weight (NW); body mass index (BMI)<25 kg/m2 or waist
circumference (WC)<80 cm or waist-to-hip ratio (WHR)<0.8)
and overweight (OW; BMI≥25 kg/m2 or WC≥80 cm or
WHR≥0.8) status, generating four phenotype groups for each
anthropometric measure: (i) MH/NW, (ii) MH/OW, (iii) MU/
NW, and (iv) MU/OW.
Results: In a multivariable-adjusted conditional logistic regression
model, compared withMH/NWindividuals, endometrial cancer risk
was higher among those classified as MU/NW [ORWC, 1.48; 95%
confidence interval (CI), 1.05–2.10 and ORWHR, 1.68; 95% CI, 1.21–
2.35] and MU/OW (ORBMI, 2.38; 95% CI, 1.73–3.27; ORWC, 2.69;
95% CI, 1.92–3.77 and ORWHR, 1.83; 95% CI, 1.32–2.54). MH/OW
individuals were also at increased endometrial cancer risk compared
with MH/NW individuals (ORWC, 1.94; 95% CI, 1.24–3.04).
Conclusions: Women with metabolic dysfunction appear to
have higher risk of endometrial cancer regardless of their body
size. However, OW status raises endometrial cancer risk even
among women with lower insulin levels, suggesting that obesityrelated
pathways are relevant for the development of this cancer
beyond insulin.
Impact: Classifying women by metabolic health may be of greater
utility in identifying those at higher risk for endometrial cancer than
anthropometry per se.