Questions and aims: The research aims to investigate the effect of obesity on cancer risk, specifically mediated through insulin resistance and glucose control, in Chinese and UK populations. Through causal mediation analysis, the study will assess the mediating role of insulin resistance and glucose control indicators in the relationship between body mass index (BMI) and cancer incidence. The findings will enhance our understanding of population-specific pathways, providing insights that could help develop targeted cancer prevention strategies for different populations.
Background and scientific rationale!The link between obesity and increased cancer risk is well-established, with obesity now considered the second leading cause of cancer after smoking. Obesity-related cancers account for a significant burden worldwide, especially with rising obesity rates in both Western and Eastern populations. Our initial analyses indicate that China is likely to suffer the same obesity-related cancer epidemic as seen in western countries.
Insulin resistance and glucose control are two key potential mediators in the obesity-cancer link, as shown in recent studies. As a novel dimension, we note that there is increasing interest that cancer prevention strategies should be designed to be population-specific, and for example, for the relationship between obesity and cardiovascular mortality, Huang et al. recently demonstrated that this is mediated through blood pressure and glucose to a much greater extent in Chinese (49% versus 9% for blood pressure) compared with US populations. This study will examine these mediators in both the UK and Chinese cohorts, addressing the need for population-specific prevention strategies.