Rinaldi Sabina, Rohrmann Sabine, Jenab Mazda, Biessy Carine, Sieri Sabina, Palli Domenico, Tumino Rosario, Mattiello Amalla, Vineis Paolo, Nieters Alexandra, Linseisen Jakob, Pischon Tobias, Boeing Heiner, Hallmans Göran, Palmqvist Richard, Manjer Jonas, Wirfält Elisabet, Crowe Francesca L, Khaw Kay-Tee T, Bingham Sheila, Tjønneland Anne, Olsen Anja, Overvad Kim, Lund Eiliv, Skeie Guri, Clavel-Chapelon Francoise, Boutron-Ruault Marie-Christine, de Lauzon-Guillain Blandine, Ardanaz Eva, Jakszyn Paula, Ramon Quiros Jose, Chirlaque Maria-Dolores, Sanchez Maria-Jose, Dorronsoro Miren, Trichopoulou Antonia, Lagiou Pagona, Trichopoulos Dimitrious, Bueno-de-Mesquita H Bas, van Duijnhoven Fränzel J B, Peeters Petra H M, Slimani Nadia, Ferrari Pietro, Byrnes Graham B, Riboli Elio, Kaaks Rudolf
IARC, 150, cours Albert Thomas, Lyon, 69372 Lyon Cedex 08, France.
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3108-15. doi: 10.1158/1055-9965.EPI-08-0495.
Although large-scale prospective cohort studies have related hyperglycemia to increased risk of cancer overall, studies specifically on colorectal cancer have been generally small. We investigated the association between prediagnostic levels of glycosylated hemoglobin (HbA1c), a marker for average glucose level in blood, and colorectal cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort. One thousand and twenty-six incident colorectal cancer cases (561 men and 465 women) and 1,026 matched controls were eligible for the study. Multivariate conditional logistic regression was used to estimate odds ratios (ORS) adjusted for possible confounders. Increasing HbA1c percentages were statistically significantly associated with a mild increase in colorectal cancer risk in the whole population [OR, 1.10; 95% confidence interval (CI), 1.01,1.19 for a 10% increase in HbA1c]. In women, increasing HbA1c percentages were associated with a statistically significant increase in colorectal cancer risk (OR, 1.16; 95% CI, 1.01, 1.32 for a 10% increase in HbA1c) and with a borderline statistically significant increase in rectum cancer (OR, 1.22; 95% CI, 0.99,1.50 for a 10% increase in HbA1c). No significant association with cancer risk was observed in men. The results of the current study suggest a mild implication of hyperglycemia in colorectal cancer, which seems more important in women than in men, and more for cancer of the rectum than of the colon.
尽管大规模前瞻性队列研究已将高血糖与总体癌症风险增加联系起来，但专门针对结直肠癌的研究规模通常较小。在欧洲癌症与营养前瞻性调查队列中的一项病例对照研究中，我们调查了血液中平均葡萄糖水平的标志物糖化血红蛋白（HbA1c）的诊断前水平与结直肠癌风险之间的关联。1026例新发结直肠癌病例（561例男性和465例女性）和1026例匹配对照符合研究条件。采用多变量条件逻辑回归来估计经可能的混杂因素调整后的比值比（OR）。在整个人口中，HbA1c百分比增加与结直肠癌风险轻度增加在统计学上显著相关[OR，1.10；95%置信区间（CI），HbA1c增加10%时为1.01,1.19]。在女性中，HbA1c百分比增加与结直肠癌风险在统计学上显著增加相关（OR，HbA1c增加10%时为1.16；95%CI，1.01,1.32），与直肠癌风险增加接近统计学显著性相关（OR，HbA1c增加10%时为1.22；95%CI，0.99,1.50）。在男性中未观察到与癌症风险的显著关联。本研究结果表明高血糖在结直肠癌中存在轻度影响，这在女性中似乎比在男性中更重要，对直肠癌的影响比对结肠癌的影响更大。
