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Fitness related to lower cancer mortality in men with pre-diabetes, diabetes
Compared with pre-diabetic men with low levels of fitness, those with higher levels of cardiorespiratory fitness may have a lower risk for cancer mortality, especially mortality from gastrointestinal tract cancers.
Researchers from the United States and Canada assessed 18,858 men with pre-diabetes and 2,805 men with diabetes to determine the relationship between fitness and mortality for all-cause and site-specific cancer mortality. The researchers followed the patients for about 16.4 years.
In an adjusted model, the researchers found a correlation between moderate and high fitness and a lower risk of cancer mortality in men with pre-diabetes, compared with those in the low-fitness group. Hazard ratios were 0.71 for moderate fitness and 0.76 for high fitness. A similar correlation was found in those with diabetes (HR 0.53 for moderate fitness and HR 0.44 for high).
Fitness was also related to a lower risk of mortality from gastrointestinal (HR 0.55), colorectal (HR 0.53), liver (HR 0.22) and lung cancer (HR 0.43) in all men, according to the researchers. – by Stacey L. Adams
Diabetes Care. 2008;31:764-769.
This is an interesting finding from a large cohort observational study. The main finding is that better aerobic fitness in men with impaired glucose tolerance or diabetes is associated with decreased cancer mortality, relative to those with poorer fitness. Since this is an epidemiological investigation, it should be interpreted as hypothesis-generating rather than hypothesis-confirming. The authors speculate that individuals with better fitness may experience lower levels of insulin, insulin-like growth factor-1 or pro-inflammatory cytokines, and that these changes, if verified, might underlie the observed mortality difference. Much work needs to be done to demonstrate that the reported observations reflect something more than a preexisting stratification of the cohort.
– Robert Blank, MD, PhD
Endocrine Today Editorial Board member