Archives

  • 2019-10
  • 2019-11
  • 2020-03
  • 2020-07
  • 2020-08
  • br overweight obesity but only

    2020-08-14

    
    overweight/obesity, but only among Whites with overweight/obesity. CRP was associated with increased risk of cancer mortality among Whites with normal BMI, but not among Blacks despite those with over-weight/obesity having significantly higher mean CRP levels. This differ-ence may be because obese/overweight participants have other risk factors that cumulatively increase the risk of cancer mortality, and in-flammation due to CRP may not significantly further increase the risk in Concanamycin A with participants with normal BMI. A higher proportion of participants with normal BMI died of cancer in the REGARDS cohort
    Table 3
    Hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality by baseline inflammatory biomarkers.
    BMI categories
    pint with BMI
    Log transformed T3a
    Log transformed T3
    Crude model included the exposure and age.
    Model 1: Adjusted for age, gender, education, race, and income.
    Model 2: Additionally adjusted for exercise.
    Model 3: Additionally adjusted for smoking status, alcohol use, aspirin use, statin, and comorbidity score.
    Bold indicates significance at 0.05 alpha level.
    pint, p for the interaction of the log form with BMI. The p-values are from type 3 tests. p for the interaction is considered significant at alpha = 0.1.
    Table 4
    Hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality by baseline metabolic biomarkers.
    BMI categories
    pint with BMI
    Log-transformed T3a
    Log transformed T3
    Crude model included the exposure and age.
    Model 1 adjusted for age, gender, education, race, and income.
    Model 2 additionally adjusted for exercise.
    Model 3 additionally adjusted for smoking status, alcohol use, aspirin use, statin, and comorbidity score.
    Bold indicates significance at 0.05 alpha level.
    pint, p for the interaction of the log form with BMI. The p-values are from type 3 tests. p for the interaction is considered significant at alpha = 0.1.
    Table 5
    Hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality by inflammatory and metabolic biomarkers by race.
    BMI categories
    pint with BMI
    Log-transformeda Log transformeda
    Model 1
    CRP
    Resistin
    Resistin
    Crude model included the exposure and age.
    Model 1 adjusted for age, gender, education, and income.
    Model 2 additionally adjusted for exercise.
    Model 3 further adjusted for comorbidity scores, smoking, alcohol, aspirin, and statin use.
    Bold indicates significance at 0.05 alpha level.
    pint, p for the interaction of the log form with BMI. The p-values are from type 3 tests. p for the interaction is considered significant at alpha = 0.1.
    a Biomarkers (except CRP) were log-transformed due to non-normal distributions. p-Values were ≤0.01. p-Values were ≤0.05 while the rest of p-values were N0.05.
    compared with overweight/obes participants; however, excluding par-ticipants that died within 6 months of entry into the cohort did not ma-terially change the results. In a previous study, IL-6 was found to be associated with increased risk of cancer mortality in both Blacks and White participants, consistent with current findings [46]. However, our analysis was underpowered given the limited sample sizes to detect racial Concanamycin A differences in cancer mortality risk across BMI categories. Future studies with larger, racially diverse prospective cohorts, or including a larger subset of this cohort, are needed to definitively evaluate racial dif-ferences in the independent and potentially synergistic associations of inflammatory and metabolic biomarkers with cancer mortality risk. The finding from this study improves our understanding of the role of metabolic health status and obesity in cancer outcomes and adds to the limited but growing literature that will inform race-specific cancer prevention interventions.
    The strengths of the study include sensitivity analysis that excluded those who died of cancer within six months from baseline, the large bi-racial prospective cohort, and detailed baseline measures of the bio-markers of interest and covariates. REGARDS participants were re-cruited nationally across the US, although residents of the stroke belt were over-sampled, thus improving the generalizability of the study re-sults. This study also has some limitations relevant to the interpretation of the results. First, the mean follow-up period was 8 years, this also re-sulted in a limited number of events especially in stratified analysis, leading to reduced power to detect significant associations especially in the race-stratified analyses. Second, since REGARDS was originally designed to evaluate stroke outcomes, there is currently no data avail-able on cancer incidence. While cost-effective and convenient, the methods used to determine the assay levels in this study such as the BN II nephelometer, Milliplex MAP Human Cardiovascular Disease Panel 3, and Human Serum Adipokine Panel B LINCOplex Kit may have low sensitivity, especially for LP(a); however, in this study, there was satisfactory sensitivity with MDD well below 1% for each biomarker except for LP(a), and the methods have been used previously and had similar coefficients of variations as in our study [47,48]. Larger cohorts of racially diverse participants using other assay measurement methods may help to confirm these findings and potentially identify other rele-vant biomarkers that may vary by BMI and race.