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Plasma insulin,C‐peptide and blood glucose and the risk of gastric cancer: The Japan Public Health Center‐based prospective study
Authors:Akihisa Hidaka  Shizuka Sasazuki  Atsushi Goto  Norie Sawada  Taichi Shimazu  Taiki Yamaji  Motoki Iwasaki  Manami Inoue  Mitsuhiko Noda  Hisao Tajiri  Shoichiro Tsugane  for the JPHC Study Group
Affiliation:1. Epidemiology and Prevention Group, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan;2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan;3. Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan;4. Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Abstract:To date, the association between diabetes mellitus (DM) and gastric cancer has been controversial, including the underlying mechanism. We investigated the association between plasma diabetic biomarkers (insulin, C‐peptide, and blood glucose) and gastric cancer risk. In addition, homeostasis model assessment of insulin resistance (HOMA‐IR) and homeostasis model assessment of β‐cell function (HOMA‐β) were calculated. A total of 36,745 subjects aged 40–69 years in the Japan Public Health Center‐based prospective study (JPHC) who returned the baseline questionnaire and provided blood samples were followed from 1990 to 2004. In the present analysis, 477 cases and 477 matched controls were used. The odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) for developing gastric cancer were calculated using conditional logistic regression models. Plasma insulin was positively associated with increased risk of gastric cancer; compared to tertile 1, ORs were 1.69 (95% CI = 1.11–2.59) and 2.01 (1.19–3.38) for tertiles 2 and 3, respectively (p for trend = 0.009). In men, C‐peptide was also positively associated with a significant risk; corresponding ORs were 1.42 (0.85–2.38) and 1.91 (1.03–3.54), respectively (p for trend = 0.04). These findings were confirmed for blood samples from the fasting group (≥8 hr after a meal). Higher HOMA‐IR was also associated with increased risk, whereas no association was observed for blood glucose. Our findings suggest that Japanese population with higher insulin and C‐peptide levels derived from insulin resistance have an elevated risk of gastric cancer.
Keywords:gastric cancer risk  plasma insulin  plasma C‐peptide  plasma blood glucose  prospective study
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