Table 2. HRs for CRC-specific and overall mortality among patients with colorectal cancer by quintile of post-diagnosis dietary insulin score.
| Dietary insulin score | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Ptrend |
|---|---|---|---|---|---|---|
|
Dietary insulin load | ||||||
| Median (range) | ||||||
| Nurses’ Health Study | 582 (298–625) | 652 (626–674) | 697 (675–714) | 736 (715–763) | 804 (765–1104) | |
| Health Professionals Follow-up Study | 693 (428–748) | 783 (749–810) | 837 (811–862) | 888 (863–923) | 967 (924–1258) | |
| CRC-specific mortality | ||||||
| Events/patients | 47/401 | 69/404 | 77/400 | 72/402 | 78/399 | |
| Age-adjusted HR (95% CI) | Referent | 1.44 (0.99–2.08) | 1.62 (1.13–2.33) | 1.42 (0.99–2.06) | 1.70 (1.18–2.44) | 0.01 |
| Multivariable-adjusted HR (95% CI)a | Referent | 1.31 (0.89–1.94) | 1.55 (1.04–2.29) | 1.48 (0.99–2.21) | 1.82 (1.20–2.75) | 0.006 |
| Overall mortality | ||||||
| Events/patients | 145/401 | 166/404 | 157/400 | 171/402 | 176/399 | |
| Age-adjusted HR (95% CI) | Referent | 1.09 (0.87–1.37) | 1.02 (0.81–1.28) | 1.02 (0.82–1.28) | 1.11 (0.89–1.39) | 0.48 |
| Multivariable-adjusted HR (95% CI)a | Referent | 1.13 (0.89–1.43) | 1.11 (0.87–1.41) | 1.17 (0.92–1.50) | 1.33 (1.03–1.72) | 0.03 |
|
Dietary insulin index | ||||||
| Median (range) | ||||||
| Nurses’ Health Study | 36 (20–39) | 41 (39–42) | 44 (42–45) | 46 (45–48) | 50 (48–70) | |
| Health Professionals Follow-up Study | 35 (21–37) | 39 (37–40) | 42 (41–43) | 44 (43–46) | 48 (46–63) | |
| CRC-specific mortality | ||||||
| Events/patients | 50/400 | 62/401 | 74/402 | 82/402 | 75/401 | |
| Age-adjusted HR (95% CI) | Referent | 1.21 (0.84–1.76) | 1.42 (0.99–2.04) | 1.58 (1.11–2.25) | 1.51 (1.05–2.16) | 0.008 |
| Multivariable-adjusted HR (95% CI)a | Referent | 1.17 (0.79–1.73) | 1.32 (0.89–1.95) | 1.60 (1.09–2.36) | 1.66 (1.10–2.50) | 0.004 |
| Overall mortality | ||||||
| Events/patients | 142/400 | 160/401 | 156/402 | 186/402 | 171/401 | |
| Age-adjusted HR (95% CI) | Referent | 1.09 (0.87–1.36) | 1.00 (0.79–1.25) | 1.17 (0.94–1.46) | 1.08 (0.86–1.35) | 0.39 |
| Multivariable-adjusted HR (95% CI)a | Referent | 1.17 (0.92–1.49) | 1.07 (0.83–1.37) | 1.35 (1.06–1.72) | 1.32 (1.02–1.71) | 0.02 |
Abbreviations: CI=confidence interval; CRC=colorectal cancer; HR=hazard ratio.
a
Adjusted for age at diagnosis (continuous), sex, race (White, Black, other, unknown), smoking status (never, past, current, unknown), body mass index (<18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, ⩾35.0 kg m−2, or unknown), physical activity (quintiles or unknown), alcohol intake (0, 0.1–4.9, 5.0–14.9, ⩾15.0 g d−1), cancer stage (I–IV or unknown), grade of tumour differentiation (well, moderate, poor, unknown), location of primary tumour (proximal, distal, rectum, unknown) and year of diagnosis (continuous).