Insights into insulin resistance, lifestyle and anthropometric measures of patients with prior colorectal cancer compared to controls: A National Health and Nutrition Examination Survey (NHANES) Study

Publication date: Available online 5 January 2018
Source:Current Problems in Cancer
Author(s): Kenneth Obi, Ramsey Mitchell, Alice Hinton, Peter Stanich, Darrell M. Gray, Somashekar Krishna, Samer El-Dika, Hisham Hussan
BackgroundInsulin resistance (IR) increases the risk of index colorectal cancer (CRC) development. Limited data exist on IR values, lifestyle and anthropometric alterations of patients after CRC diagnosis, a population at high risk for CRC recurrence.MethodsThis is a retrospective cohort study using the National Health and Nutrition Examination Survey (NHANES), 1999–2010. We identified patients with and without prior CRC above age 50. Our outcomes were lifestyle, anthropometric measures and insulin resistance measured using the triglyceride to high-density lipoprotein (TG/HDL) ratio and the homeostasis model assessment (HOMA-IR).ResultsThere were 146,841 patients with prior CRC and 26,979,507 without prior cancer (controls) in our cohort. Prior CRC patients were significantly older than controls (75.8 vs 62.3, p<0.01), however there were no significant differences in gender, ethnicity, income, caloric intake, tobacco use or alcohol consumption between both groups. Multivariate analysis revealed no difference between prior CRC patients and controls in TG/HDL ratio (Adjusted percent change = -2.17; 95% confidence interval [CI]: -27.96, 18.43) or HOMA-IR (Adjusted percent change = -6.85; 95% CI: -35.74, 15.90). Despite similar weight at age 25, prior CRC subjects had lower weights compared to controls (at time of NHANES survey, one and 10 years prior to survey and greatest weight). Furthermore prior CRC subjects gained less weight in the 10 years prior to survey.ConclusionPatients with prior CRC above age 50 have no conclusive evidence of increased insulin resistance compared to non-CRC controls. This is possibly due to lesser weight gain in the peri-CRC diagnosis or treatment period. Future efforts should focus on alternate etiologies for the increased CRC recurrence in this high risk group.



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