@article{6b6c80ce370b484bb0df7a3a49848caa,
title = "A Prospective Study of Obesity, Metabolic Health, and Cancer Mortality",
abstract = "Objective: This study examined whether metabolic health status is associated with risk of cancer mortality and whether this varies by body mass index (BMI) category. Methods: A prospective study of 22,514 participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort was performed. Metabolically unhealthy status was defined as having three or more of the following: (1) elevated fasting glucose, (2) high triglycerides, (3) dyslipidemia, (4) hypertension, and (5) elevated waist circumference. Participants were categorized into normal weight (BMI 18.5-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obesity (BMI ≥ 30 kg/m2) groups. Cox proportional hazards regression was performed to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) for cancer mortality during follow-up. Results: Among participants with normal weight, participants who were metabolically unhealthy had an increased risk of cancer mortality (HR: 1.65; 95% CI: 1.20-2.26) compared with metabolically healthy participants. The overall mortality risk for participants who were metabolically unhealthy and had normal weight was stronger for obesity-related cancers (HR: 2.40; 95% CI: 1.17-4.91). Compared with participants with normal weight, those who were metabolically healthy and overweight were at a reduced risk of any cancer mortality (adjusted HR: 0.79; 95% CI: 0.63-0.99). Conclusions: There was an increased risk of overall and obesity-related cancer mortality among metabolically unhealthy participants with normal weight.",
author = "Tomi Akinyemiju and Moore, {Justin Xavier} and Maria Pisu and Judd, {Suzanne E.} and Michael Goodman and Shikany, {James M.} and Howard, {Virginia J.} and Monika Safford and Gilchrist, {Susan C.}",
note = "Funding Information: Funding agencies: This study was supported by award R01-NR012726 from the National Institute for Nursing Research, UL1-RR025777 from the National Center for Research Resources, K08HL096841 from the National Heart, Lung, and Blood Institute, and by grants from the Center for Clinical and Translational Science and the Lister Hill Center for Health Policy of the University of Alabama at Birmingham. The REGARDS study was supported by cooperative agreement U01-NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Department of Health and Human Service. TA was supported by grants U54 CA118948 and K01 TW010271-01A1 from NIH. JM received grant support from grants R25 CA47888 and T32CA190194 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Disclosure: MS reports salary support to study patterns of statin use in Medicare and other large databases from Amgen; salary support for a research grant on lipids and CHD outcomes from diaDexus; consulting to help with FDA application from diaDexus; salary support for research grants from NIH and AHRQ. The other authors declared no conflict of interest. Author contributions: TA led the design, analysis, interpretation of data, and writing of the manuscript. TA and JM conducted the statistical analysis and drafting of the manuscript. TA, JM, MP, SJ, MG, JS, VH, MS, SG contributed to the interpretation of data and writing and reviewing of the manuscript. All authors have read and approved the final version of the manuscript. Additional Supporting Information may be found in the online version of this article. Received: 10 April 2017; Accepted: 6 October 2017; Published online 27 November 2017. doi:10.1002/oby.22067 Publisher Copyright: {\textcopyright} 2017 The Obesity Society",
year = "2018",
month = jan,
doi = "10.1002/oby.22067",
language = "English (US)",
volume = "26",
pages = "193--201",
journal = "Obesity",
issn = "1930-7381",
publisher = "Wiley-Blackwell",
number = "1",
}
