Body mass index, abnormal glucose metabolism, and mortality from hematopoietic cancer

Background: High body mass index (BMI) and diabetes have been linked to risk of non-Hodgkin's lymphoma (NHL), but results are inconsistent and most studies use self-reported information. No study has evaluated the association of NHL with postload plasma glucose (PLG) levels, which are positively associated with BMI. We analyzed data from a cohort study to investigate associations of interviewer-measured BMI and PLG with risk of NHL mortality and to explore associations with leukemia and multiple myeloma. Methods: Employees of 84 Chicago-area organizations, with an average age of 40 years at baseline, were screened from 1967 to 1973. Height and weight were measured by study nurses. A 50-g oral glucose load was administered to nondiabetic participants. Of the at-risk cohort of 35,420 men and women, 129 died of NHL, 151 died of leukemia, and 66 died of multiple myeloma during an average of 31 years of follow-up. Hazard Ratios (HR) and 95% confidence intervals (95% CI) were derived from Cox proportional hazards regression models. Results: Among men, there were positive dose-response relations of BMI with mortality from NHL (HR, 2.57; 95% Cl, 1.24-5.34 for the highest versus lowest quartile; P-trend=0.01) and leukemia (HR, 1.98; 1.07-3.69; P-trend=0.02). PLG also was positively related to NHL mortality (HR, 2.86; 95% Cl, 1.35-6.06 for the highest versus lowest category; P-trend=0.004). For women, a higher BMI was positively associated with leukemia mortality (HR, 2.47; 95% Cl, 0.96-6.36; P-trend=0.02) and the highest level of PLG was associated with-risk of mortality from multiple myeloma (HR, 3.06; 95% Cl, 1.05-8.93). The risk estimates for BMI and PLG remained unchanged after adjustment for each factor. Conclusions: High BMI and/or abnormal PLG is associated with higher risk of mortality from NHL and possibly leukemia and from myeloma in women. These findings might have public health significance because BMI and glucose levels are amenable to modification.