TY - JOUR
T1 - Obesity, inflammatory markers and endometrial cancer risk: a prospective case-control study
AU - Dossus, Laure
AU - Rinaldi, Sabina
AU - Becker, Susen
AU - Lukanova, Annekatrin
AU - Tjønneland, Anne
AU - Olsen, Anja
AU - Stegger, Jakob
AU - Overvad, Kim
AU - Chabbert-Buffet, Nathalie
AU - Jimenez-Corona, Aida
AU - Clavel-Chapelon, Françoise
AU - Rohrmann, Sabine
AU - Teucher, Birgit
AU - Boeing, Heiner
AU - Schütze, Madlen
AU - Trichopoulou, Antonia
AU - Benetou, Vassiliki
AU - Lagiou, Pagona
AU - Palli, Domenico
AU - Berrino, Franco
AU - Panico, Salvatore
AU - Tumino, Rosario
AU - Sacerdote, Carlotta
AU - Redondo, Maria-Luisa
AU - Travier, Noemie
AU - Sanchez, Maria-Jose
AU - Altzibar, Jone M
AU - Chirlaque, Maria-Dolores
AU - Ardanaz, Eva
AU - Bueno-de-Mesquita, H Bas
AU - van Duijnhoven, Franzel J B
AU - Onland-Moret, N Charlotte
AU - Peeters, Petra H M
AU - Hallmans, Goran
AU - Lundin, Eva
AU - Khaw, K-T
AU - Wareham, Nicholas
AU - Allen, Naomi
AU - Key, Tim
AU - Slimani, Nadia
AU - Hainaut, Pierre
AU - Romaguera, Dora
AU - Norat, Teresa
AU - Riboli, Elio
AU - Kaaks, Rudolf
PY - 2010
Y1 - 2010
N2 - Obesity, a major risk factor for endometrial cancer, is a low grade inflammatory state characterized by elevated concentrations of cytokines and acute phase reactants. The current study had two aims: first, to investigate the associations of C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1Ra) with endometrial cancer risk and second to examine to which extent these markers can influence the association between obesity and endometrial cancer. We conducted a case-control study, nested within the European Prospective Investigation into Cancer and Nutrition, that comprised 305 incident cases of endometrial cancer and 574 matched controls. CRP, IL-6 and IL-1Ra were measured in prospectively collected blood specimens by immunoassays. Data were analyzed using conditional logistic regression. All statistical tests were two-sided and P-values <0.05 were considered statistically significant. We observed a significant increase in risk of endometrial cancer with elevated levels of CRP (odds ratio [OR] for top versus bottom quartile: 1.58, 95%CI: 1.03-2.41, Ptrend=0.02), IL-6 (OR for top versus bottom quartile: 1.66, 95%CI: 1.08-2.54, Ptrend=0.008) and IL-1Ra (OR for top versus bottom category: 1.82, 95%CI: 1.22-2.73, Ptrend=0.004). After adjustment for BMI, the estimates were strongly reduced and became non-significant. The association between BMI and endometrial cancer was also substantially attenuated (~10-20%) after adjustment for inflammatory markers, even when the effects of C-peptide or estrone had already been taken into account. We provide epidemiologic evidence that chronic inflammation might mediate the association between obesity and endometrial cancer and that endometrial carcinogenesis could be promoted by an inflammatory milieu.
AB - Obesity, a major risk factor for endometrial cancer, is a low grade inflammatory state characterized by elevated concentrations of cytokines and acute phase reactants. The current study had two aims: first, to investigate the associations of C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1Ra) with endometrial cancer risk and second to examine to which extent these markers can influence the association between obesity and endometrial cancer. We conducted a case-control study, nested within the European Prospective Investigation into Cancer and Nutrition, that comprised 305 incident cases of endometrial cancer and 574 matched controls. CRP, IL-6 and IL-1Ra were measured in prospectively collected blood specimens by immunoassays. Data were analyzed using conditional logistic regression. All statistical tests were two-sided and P-values <0.05 were considered statistically significant. We observed a significant increase in risk of endometrial cancer with elevated levels of CRP (odds ratio [OR] for top versus bottom quartile: 1.58, 95%CI: 1.03-2.41, Ptrend=0.02), IL-6 (OR for top versus bottom quartile: 1.66, 95%CI: 1.08-2.54, Ptrend=0.008) and IL-1Ra (OR for top versus bottom category: 1.82, 95%CI: 1.22-2.73, Ptrend=0.004). After adjustment for BMI, the estimates were strongly reduced and became non-significant. The association between BMI and endometrial cancer was also substantially attenuated (~10-20%) after adjustment for inflammatory markers, even when the effects of C-peptide or estrone had already been taken into account. We provide epidemiologic evidence that chronic inflammation might mediate the association between obesity and endometrial cancer and that endometrial carcinogenesis could be promoted by an inflammatory milieu.
U2 - 10.1677/ERC-10-0053
DO - 10.1677/ERC-10-0053
M3 - Journal article
SN - 1351-0088
VL - 17
SP - 1007
EP - 1019
JO - Endocrine - Related Cancer
JF - Endocrine - Related Cancer
ER -