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Insulin and endometrial cancer
R Troisi1, N Potischman, R N Hoover
1Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-7374, USA.
American Journal of Epidemiology
|September 18, 1997
Summary
Obesity increases endometrial cancer risk, but high insulin levels do not appear to be the primary mediator. Body mass index remains a significant risk factor, independent of insulin levels in postmenopausal women.
Area of Science:
- Endocrinology
- Oncology
- Epidemiology
Background:
- Obesity is a known risk factor for endometrial cancer in postmenopausal women.
- Elevated insulin levels have been hypothesized to mediate this increased risk.
Purpose of the Study:
- To investigate whether elevated insulin levels mediate the association between obesity and endometrial cancer risk.
- To examine the relationship between fasting C-peptide levels, obesity, and endometrial cancer.
Main Methods:
- Case-control study involving 165 postmenopausal endometrial cancer cases and 180 controls.
- Measurement of serum sex hormones and fasting C-peptide levels.
- Statistical analyses including age-adjustment, body mass index (BMI) adjustment, and adjustment for other risk factors.
Main Results:
- Fasting C-peptide levels were positively correlated with BMI and certain sex hormones in controls.
- An initial association between higher C-peptide levels and endometrial cancer risk was observed.
- This association was substantially attenuated and ultimately eliminated after adjusting for BMI and other risk factors.
- BMI remained a significant independent risk factor for endometrial cancer, even after adjusting for C-peptide levels.
Conclusions:
- The data do not support the hypothesis that high insulin levels mediate the effect of obesity on endometrial cancer risk.
- Body mass index is a significant and independent risk factor for endometrial cancer in postmenopausal women.