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Cancer Proneness Profile: A Study in Weight and Blood Glucose
Published in Geriatrics, Vol. 24, pp. 121-125, August 1969.
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An initial report of 262 subjects1 indicated that, with advancing age, subjects characterized by blood glucose levels of 80 to 95 mg. percent reported a higher incidence of cancer than those with blood glucose values between 60 to 75 mg. percent. A subsequent report2 restudied the problem in a larger sample of 507 subjects, with essentially the same results. Additionally, it was discovered that, with advancing age, subjects who indicated they were overweight reported more cancer than those who denied obesity. Also, individuals with slightly higher blood glucose levels and overweight reported more cancer than when these two variables were considered separately. The purpose of this report is twofold. First, an attempt will be made to study the frequency of reported cancer in terms of a height-weight ratio (ponderal index). Second, consideration will be given to the relationships between ponderal index and blood glucose versus the reported frequency of cancer.
Method of Investigation
Capillary blood glucose (Dextrostix method) was determined two to four hours following food or drink in 507 persons of the 8,940 participants in the November 1964 Diabetes Detection Drive3 in Birmingham, Ala.
Dextrostix (Ames Company, Inc.) is a reagent strip impregnated with an enzyme system specific for blood glucose and with an indicator system for color. The reagent area is covered with capillary or venous blood. After sixty seconds the reagent patch is washed and color-matched with a standardized chart. Glucose concentrations of 40 to 250 mg. percent may be determined.4,5 The 60- to 70-mg. percent group is identified on the standard color patch labeled 65 mg. percent and through interpolation of in-between colors on either side. Also, the 80- to 95-mg. percent group is identified in this fashion with the 90-mg. percent color patch.
Each of the subjects completed the Cornell Medical Index health questionnaire (CMI).6 A present or past history of cancer was specifically elicited by question No. 131, “Did a doctor ever treat you for tumor or cancer?” The ponderal index was determined from the patient’s statements regarding weight and height. The height divided by the cube root of the weight provided the ponderal index. Thus, it was possible to analyze the frequency of reported cancer in terms of ponderal index and blood glucose, separately and in combination.
Results
Figure 1 portrays the relationship of blood glucose and reported cancer. Three age groups appear on the abscissa, and the number of persons in each group is indicated. Described on the ordinate is the frequency of reported cancer. Four items deserve consideration. First, with advancing age, irrespective of blood glucose, the percentage of subjects reporting cancer progressively rose from zero in the youngest group to approximately 8% in the elderly category. Second, in the youngest group (0 to 29 years), there was no cancer in either of the blood glucose categories. Third, in those aged 30 to 49 years, the reported cancer was higher (8 vs. 3.1 %) in the group characterized by slightly lower blood glucose. Finally, in the oldest group, those with the higher blood glucose reported an incidence of cancer over twofold (11.8 vs. 5.5°%) that observed in the subjects with a relatively lower blood glucose.
Fig. 1. Relationship between blood glucose and reported cancer
An attempt has been made (Fig. 2) to compare the frequency of reported cancer to ponderal index, irrespective of blood glucose. Three items should be underlined. First, there was no cancer in the youngest age group. Second, in the middle age bracket, cancer was reported more frequently (8.1 vs. 2.3 %) in the subjects with lower ponderal indexes–those who were heavier in relation to their height. Lastly, the incidence of reported cancer in the oldest group was almost twofold higher among the heavier subjects, 11 vs. 6%.
Fig. 2. Relationship between ponderal index and reported cancer
Finally, the frequency of cancer in terms of both ponderal index and blood glucose is summarized in Figure 3. First, it will be noted that there was no reported cancer in any of the subgroups which comprise the youngest age category. Second, in the middle age group, the most cancer (12.2%) was found in those with a low ponderal index (relatively obese subjects) and relatively low blood glucose. The lowest cancer incidence (1.9%) was noted in the lighter subjects with slightly elevated blood glucose levels. The difference was about sixfold, 12.2 vs. 1.9%. Finally, in the oldest age category, the greatest prevalence of cancer (13.6%) was reported by those who were obese (lower ponderal index) and had higher blood glucose values; the lowest cancer figure (3.3%) was noted in the lighter subjects with the lower blood glucose.
Fig. 3. Relationship between both blood glucose and ponderal index and reported cancer
Discussion
Several points are worthy of mention. First, the point is abundantly clear that, with advancing age, reported cancer increases. Second, in the middle age category, relative hypoglycemia parallels the increase in cancer. Third, in the oldest age category, relative hyperglycemia correlates with an increase in cancer. Fourth, the lower ponderal index (heavier subjects) appears to be a cancer risk factor.
The evidence presented here lends some credence to the observation that hypoglycemia frequently antedates hyperglycemia.7,11 The data included in this report support the thesis that overweight is an overall risk factor and a possible cancer proneness variable.12 Finally, the information shown here supports the previously reported relationship that weight and blood glucose parallel cancer proneness.
Summary
A study of 507 subjects shows a relationship between an anthropometric assessment of weight (ponderal index) and an estimate of carbohydrate metabolism (blood glucose by the Dextrostix method) versus the incidence of reported carcinomatosis. No cancer was reported in the 0-29-year age group, regardless of ponderal index or blood glucose levels. In the 30- to 49-year group, however, an incidence of 12.2% was noted in the obese subjects with lower glucose levels. In the older age group (50 + years) 13.6% of the subjects reported cancer. These were essentially the overweight persons with relatively higher blood glucose levels.
The summer student assistant was supported under American Cancer Institutional Research grant IN-66 and by the Alabama Division of the American Cancer Society.
References Cited:
- Cheraskin, E., Ringsdorf, W. M., Jr., Setyaadmadja, A. T. S. H., and Barrett, R. A.: Clinical chemistry and predictive medicine. J. Med. Ass. Ala. 36:1337, 1967.
- Cheraskin, E., Ringsdorf, W. M., Jr., Setyaadmadja, A. T. S. H., Barrett, R. A., Aspray, D. W., and Curry, S.: Cancer proneness profile: A study in weight and blood glucose. Geriatrics 23:134, 1968.
- Cheraskin, E., Ringsdorf, W. M., Jr., Setyaadmadja, A. T. S. H., and Thielens, K. B.: The Birmingham, Alabama, 1964 Diabetes Detection Drive: I. General information. Ala. J. Med. Sci. 3:33, 1966.
- Rock, J. A., and Gerende, L. J.: Dextrostix method for determination of blood glucose levels: A statistical evaluation. J. Amer. Med. Ass. 198:231, 1966.
- Kaplan, Si.: The reagent-strip method for estimating blood glucose concentration. J. Amer. Dent. Ass. 74:1261, 1967.
- Brodman, K., Erdmann, A. J., Jr., and Wolff, H. C.: Cornell Medical Index Health Questionnaire: Manual. New York, Cornell University Medical College, 1949.
- Roberts, H. J.: The syndrome of narcolepsy and diabetogenic hyperinsulinism in the American Negro. J. Nat. Med. Ass. (N.Y.) 56:18, 1964.
- Roberts, H. J.: Afternoon glucose tolerance testing: A key to the pathogenesis, early diagnosis and prognosis of diabetogenic hyperinsulinism. J. Amer. Geriat. Soc. 12:423, 1964.
- Kimball, C. P.: The significance of a low blood sugar in a screening program for the detection of diabetes mellitus. Industr. Med. Surg. 33:652, 1964.
- Editorial: The importance of blood glucose determinations. Pictoclinic 12:5, 1965.
- Economou, P. G., Ryan, W. G., and Schwartz, T. B.: Mild diabetes and prediabetes: Response of the hypoglycemia to tolbutamide. Presby.-St. Luke’s Hosp. Med. Bull. (Chic.) 4:46, 1965.
- U. S. Department of Health, Education and Welfare: Obesity and Health. Public Health Service Publication No. 1485. Washington: U. S. Government Printing Office, 1966.