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American Journal of Epidemiology 2005 161(12):1115-1122; doi:10.1093/aje/kwi131
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Iron, Lipids, and Risk of Cancer in the Framingham Offspring Cohort

Arch G. Mainous, III1, Brian J. Wells2, Richelle J. Koopman1, Charles J. Everett1 and James M. Gill3,4

1 Department of Family Medicine, Medical University of South Carolina, Charleston, SC
2 Department of Family Medicine, Cleveland Clinic, Cleveland, OH
3 Department of Family and Community Medicine, Christiana Care Health Services, Wilmington, DE
4 Departments of Family Medicine and of Health Policy, Jefferson Medical College, Philadelphia, PA

Correspondence to Dr. Arch G. Mainous III, Department of Family Medicine, Medical University of South Carolina, 295 Calhoun Street, Charleston, SC 29425 (e-mail: mainouag{at}musc.edu).

Iron and lipids combine to create oxidative stress, and oxidative stress has a role in the development of cancer. The objective was to determine the risk of cancer among persons who had both elevated iron and lipids. The authors conducted an analysis of the cohort available in the Framingham Offspring Study. Adults aged 30 or more years at baseline had serum iron and high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, and very low density lipoprotein cholesterol (VLDL-C) assessed in 1979–1982 and were followed for development of cancer until 1996–1997 (n = 3,278). Cox regression models were computed while controlling for age, gender, smoking status, and body mass index. In adjusted models, both elevated iron (hazard ratio (HR) = 1.66, 95% confidence interval (CI): 1.11, 2.46; 29 cases) and VLDL-C (HR = 1.54, 95% CI: 1.04, 2.28; 93 cases) had significant independent risks for development of cancer. When elevated iron was combined with elevated VLDL-C, the adjusted relative risk of cancer increased (HR = 2.68, 95% CI: 1.49, 4.83; 18 cases). Elevated iron and low HDL-C also had a significant adjusted relative risk of cancer (HR = 2.82, 95% CI: 1.50, 5.28; 14 cases). The results suggest that elevated serum iron levels coupled with either high VLDL-C or low HDL-C appear to interact to increase cancer risk in this cohort.

cohort studies; iron; lipids; neoplasms


Abbreviations: CI, confidence interval; HDL, high density lipoprotein; HDL-C, high density lipoprotein cholesterol; HR, hazard ratio; LDL, low density lipoprotein; LDL-C, low density lipoprotein cholesterol; VLDL, very low density lipoprotein; VLDL-C, very low density lipoprotein cholesterol


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