ASSOCIATION BETWEEN HOMA-IR AND CANCER
Background: Type 2 diabetes which has insulin resistance as a major risk factor among other non-communicable diseases is a major public health concern with increased significance and prevalence worldwide. Cancer on the other hand was a leading cause of death worldwide in 2008 based on data from the WHO and also 3rd leading cause of death in Malaysia ministry of health hospitals. Studies have found links between carcinogenesis and insulin resistance which has been attributed to hyperinsulinemia. However, studies on the South-east Asian/ Malaysia population are largely absent. Insulin sensitivity is known to differ across different ethnicities with South-east Asians and Asian Indians least insulin sensitive. The aim of this study was to determine the association between cancer and Insulin resistance (IR) regardless of the aforementioned trait.
Design: Case-control study.
Method: Fasting insulin and glucose concentrations (which were used to derive the Homeostasis model assessment insulin resistant HOMA-IR) were determined in 100 respondent of which 45 were cancer patients and 55 in the control group. Data on demographics, anthropometrics, lifestyle and physical activity level and metabolic parameters were also determined in all respondents. Independent sample t-test was used to check for association between cancer and HOMA-IR and logistic regression was used to control for other co-factors.
Results: From the results, there was significant difference between the mean HOMA-IR of the cancer group (3.00 ±1.52) compared to that of the controls (2.07 ±0.69) with a p-value of 0.001. Insulin Resistance was also independently associated with cancer (adjusted OR= 12.25. 95%CI = 3.20- 46.83) There was also significant association between obesity and cancer (adjusted OR = 3.33, 95% CI = 1.08 – 10.31).
Conclusion: Even though there were some justifiable discrepancies, significant association was seen between cancer and HOMA-IR in this Malaysian population. These results are in line with previous studies which check for association in select cancers.
Keywords: Cancer, Insulin Resistance, HOMA-IR, Non-diabetic, Malaysia, Epidemiology.