Intensive Weight Loss Intervention and Cancer Risk in Adults with Type 2 Diabetes: Analysis of the Look AHEAD Randomized Clinical Trial.

Autor: Yeh HC; Departments of Medicine, Epidemiology, and Oncology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA., Bantle JP; Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA., Cassidy-Begay M; National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA., Blackburn G; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Bray GA; Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA., Byers T; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Clark JM; Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA., Coday M; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Egan C; Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA., Espeland MA; Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Foreyt JP; Department of Medicine, Baylor College of Medicine, Houston, Texas, USA., Garcia K; Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Goldman V; Diabetes Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA., Gregg EW; Department of Epidemiology and Biostatistics, Imperial College London, London, UK., Hazuda HP; Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA., Hesson L; Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Hill JO; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA., Horton ES; Department of Medicine, Joslin Diabetes Center, Boston, Massachusetts, USA., Jakicic JM; Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Jeffery RW; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA., Johnson KC; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Kahn SE; Department of Medicine, VA Puget Sound Health Care System / University of Washington, Seattle, Washington, USA., Knowler WC; National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA., Korytkowski M; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Kure A; Department of Medicine, VA Puget Sound Health Care System / University of Washington, Seattle, Washington, USA., Lewis CE; Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA., Mantzoros C; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Meacham M; National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA., Montez MG; Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA., Nathan DM; Diabetes Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA., Pajewski N; Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Patricio J; Columbia University Medical Center, New York, New York, USA., Peters A; Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA., Xavier Pi-Sunyer F; Columbia University Medical Center, New York, New York, USA., Pownall H; Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA., Ryan DH; Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA., Safford M; Department of Medicine, Weill Cornell Medical College of Cornell University, New York, New York, USA., Sedjo RL; Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Steinburg H; Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Vitolins M; Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Wadden TA; Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Wagenknecht LE; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Wing RR; Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA., Wolff AC; Department of Oncology, The Johns Hopkins Sydney Kimmel Cancer Center, Baltimore, Maryland, USA., Wyatt H; Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Yanovski SZ; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Jazyk: angličtina
Zdroj: Obesity (Silver Spring, Md.) [Obesity (Silver Spring)] 2020 Sep; Vol. 28 (9), pp. 1678-1686.
DOI: 10.1002/oby.22936
Abstrakt: Objective: This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality.
Methods: Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer.
Results: After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25).
Conclusions: An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.
(© 2020 The Obesity Society.)
Databáze: MEDLINE
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