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Insulin resistance/hyperinsulinemia and cancer mortality: the Cremona study at the 15th year of follow-up

  • Perseghin, Gianluca1, 2
  • Calori, Giliola1
  • Lattuada, Guido1, 2
  • Ragogna, Francesca1
  • Dugnani, Erika3
  • Garancini, Maria Paola4
  • Crosignani, Paolo5
  • Villa, Marco6
  • Bosi, Emanuele1
  • Ruotolo, Giacomo1, 7
  • Piemonti, Lorenzo3
  • 1 Istituto Scientifico H San Raffaele, Division of Metabolic and Cardiovascular Sciences, Via Olgettina 60, Milan, 20132, Italy , Milan (Italy)
  • 2 Università degli Studi di Milano, Department of Sport Sciences, Nutrition and Health, Via Kramer 4/A, Milan, Italy , Milan (Italy)
  • 3 Istituto Scientifico H San Raffaele, Diabetes Research Institute, Milan, Italy , Milan (Italy)
  • 4 Istituto Scientifico H San Raffaele, Medical Direction, Via Olgettina 60, Milan, 20132, Italy , Milan (Italy)
  • 5 Istituto Nazionale dei Tumori, Via Venezian 1, Milan, 20133, Italy , Milan (Italy)
  • 6 Servizio Epidemiologia ASL della Provincia di Cremona, Milan, Italy , Milan (Italy)
  • 7 AstraZeneca R&D, Molndal, Sweden , Molndal (Sweden)
Published Article
Acta Diabetologica
Springer Milan
Publication Date
Jan 04, 2012
DOI: 10.1007/s00592-011-0361-2
Springer Nature


Type 2 diabetes is associated with risk of cancer. Hyperinsulinemia and insulin resistance may be the link with cancer, but whether this is independent of the diabetes status, obesity/visceral obesity and metabolic syndrome is uncertain and the present study wanted to address this issue. Fifteen-year all-cause, CVD and cancer mortality data were obtained through the Regional Health Registry in 2,011 out of 2,074 Caucasian middle-aged individuals of the Cremona Study, a population study on the prevalence of diabetes mellitus in Italy in which anthropometric and metabolic characteristics were collected. During the 15-year observation period, 495 deaths were registered: 221 CVD related and 180 cancer related. Age and sex were independently associated with all-cause, cancer and CVD mortality rates. Age- and sex-adjusted analysis showed that HOMA-IR, cigarette smoking and diabetes were independently associated with all-cause mortality; HOMA-IR, systolic blood pressure and fibrinogen were independently associated with CVD mortality; HOMA-IR and smoking habit were independently associated with cancer mortality. Individuals in the highest quintile of serum insulin had a 62% higher risk of cancer mortality (HR = 1.62 95% CI: 1.19–2.20; P < 0.0022) and 161% higher risk of gastrointestinal cancer mortality (HR = 2.61 95% CI: 1.73–3.94; P < 0.0001). Age- and sex-adjusted analysis showed that hyperinsulinemia/insulin resistance is associated with cancer mortality independently of diabetes, obesity/visceral obesity and the metabolic syndrome.

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