Department of Chronic and Non-communicable Disease Control and Prevention, Changning District Center for Disease Control and Prevention, Shanghai 200051, China
Abstract:Objective To examine the association between prediabetes and the risk of cancer, so as to provide insights into precision cancer prevention. Methods Based on the project of Early Screening and Comprehensive Interventions among Population at A High Risk of Cardiovascular Diseases in Changning District, Shanghai Municipality, baseline data were captured from permanent community residents at ages of 35 to 75 years from 2016 to 2019, including demographics, physical examinations, previous medical history and used of medications. The development of cancers was used as a outcome measure, and the follow-up was terminated by May 2021. The development of cancer was collected through the Changning Cancer Registration System, and the association between prediabetes and the risk of cancer was examined using a multivariable logistic regression model. Results A total of 9 503 participants were finally included, with a mean age of (57.12±10.89) years. The participants included 2 167 cases with prediabetes (22.80%) and 7 336 individuals with normal glucose (77.20%), and included 3 713 men (39.07%) and 5 790 women (60.93%). A total of 114 new cases with cancers were diagnosed until the final follow-up, including 37 cases among prediabetic patients (1.71%) and 77 cases among participants with normal blood glucose (1.05%). Multivariable logistic regression analysis showed that after adjustment for age, gender, marital status, educational level, family annual income, smoking, alcohol consumption, body mass index, hypertension, administration of antihypertensive agents, dyslipidemia, administration of lipid-lowering agents and medical history of cardio-cerebrovascular diseases, a higher risk of cancers was detected among prediabetic patients than among participants with normal blood glucose (OR=1.528, 95%CI: 1.025-2.277), and prediabetes had no significant interactions with age, gender, smoking or alcohol consumption (all P>0.05). Conclusion Prediabetes is statistically associated with the risk of cancer.
[1] SUNG H,FERLAY J,SIEGEL R L,et al.Global Cancer Statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin,2021,71(3):209-249. [2] 裘凤黔,杜娟,纪云芳,等. 2012—2016年黄浦区恶性肿瘤发病和死亡分析[J]. 预防医学,2021,33(7):697-700. [3] PEARSON-STUTTARD J,PAPADIMITRIOU N,MARKOZANNES G,et al.Type 2 diabetes and cancer:an umbrella review of observational and mendelian randomization studies[J]. Cancer Epidemiol Biomarkers Prev,2021,30(6):1218-1228. [4] 高明妃,胡如英,胡崇高. 中国糖尿病死亡流行特征研究进展[J]. 预防医学,2022,34(7):692-695. [5] LI Y,TENG D,SHI X,et al. Prevalence of diabetes recorded in mainland China using2018 diagnostic criteria from the American Diabetes Association:national cross sectional study[J/OL]. BMJ,2020,369[2023-09-22]. https://doi.org/10.1136/bmj.m997. [6] HUANG Y,CAI X,QIU M,et al.Prediabetes and the risk of cancer:a meta-analysis[J]. Diabetologia,2014,57(11):2261-2269. [7] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56. [8] 诸骏仁,高润霖,赵水平,等. 中国成人血脂异常防治指南(2016年修订版)[J]. 中华心血管病杂志,2016,44(10):833-853. [9] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志,2021,37(4):311-398. [10] ZHU B,QU S.The relationship between diabetes mellitus and cancers and its underlying mechanisms[J/OL]. Front Endocrinol(Lausanne),2022,13[2023-09-22]. https://doi.org/10.3389/fendo.2022.800995. [11] SCHLESINGER S,NEUENSCHWANDER M,BARBARESKO J,et al.Prediabetes and risk of mortality,diabetes-related complications and comorbidities:umbrella review of meta-analyses of prospective studies[J]. Diabetologia,2022,65(2):275-285. [12] 应焱燕,纪威,崔军,等. 不同糖代谢水平人群恶性肿瘤的患病情况[J]. 中国老年学杂志,2017,37(6):1390-1392. [13] 缪雅,刘丽丽,侯田志超,等. 上海糖尿病前期人群恶性肿瘤发病风险分析[J]. 内科理论与实践,2022,17(6):435-440. [14] SCAPPATICCIO L,MAIORINO M I,BELLASTELLA G,et al.Insights into the relationships between diabetes,prediabetes,and cancer[J]. Endocrine,2017,56(2):231-239. [15] SCHROTER D,HOHN A.Role of advanced glycation end products in carcinogenesis and their therapeutic implications[J]. Curr Pharm Des,2018,24(44):5245-5251. [16] 赵明,习阳,步世忠. 2型糖尿病与结直肠癌相关性的研究进展[J]. 生命科学研究,2016,20(4):365-370. [17] 周韩,盛德乔. 糖尿病与肿瘤关系的研究进展[J]. 肿瘤防治研究,2022,49(11):1107-1111. [18] 刘建刚,张积仁. 糖尿病与癌症潜在相关性讨论[J]. 现代肿瘤医学,2014,22(2):470-472.