Department of Public Health, University of Helsinki, PL41, Mannerheimintie 172, Helsinki, Finland.
Diabetologia. 2010 Sep;53(9):1867-76. doi: 10.1007/s00125-010-1796-7. Epub 2010 May 21.
AIMS/HYPOTHESIS: We aimed to investigate the risk of cancer mortality in relation to the glucose tolerance status classified according to the 2 h OGTT.
Data from 17 European population-based or occupational cohorts involved in the DECODE study comprising 26,460 men and 18,195 women aged 25-90 years were collaboratively analysed. The cohorts were recruited between 1966 and 2004 and followed for 5.9 to 36.8 years. Cox proportional hazards analysis with adjustment for cohort, age, BMI, total cholesterol, blood pressure and smoking status was used to estimate HRs for cancer mortality.
Compared with people in the normal glucose category, multivariable adjusted HRs (95% CI) for cancer mortality were 1.13 (1.00, 1.28), 1.27 (1.02, 1.57) and 1.71 (1.35, 2.17) in men with prediabetes, previously undiagnosed diabetes and known diabetes, respectively; in women they were 1.11 (0.94, 1.30), 1.31 (1.00, 1.70) and 1.43 (1.01, 2.02), respectively. Significant increases in deaths from cancer of the stomach, colon-rectum and liver in men with prediabetes and diabetes, and deaths from cancers of the liver and pancreas in women with diabetes were also observed. In individuals without known diabetes, the HR (95% CI) for cancer mortality corresponding to a one standard deviation increase in fasting plasma glucose was 1.06 (1.02, 1.09) and in 2 h plasma glucose was 1.07 (1.03, 1.11).
CONCLUSIONS/INTERPRETATION: Diabetes and prediabetes were associated with an increased risk of cancer death, particularly death from liver cancer. Mortality from all cancers rose linearly with increasing glucose concentrations.
目的/假设：我们旨在研究根据 2 小时 OGTT 分类的葡萄糖耐量状态与癌症死亡率之间的关系。
对参与 DECODE 研究的 17 个欧洲基于人群或职业的队列中的数据进行了协作分析，这些队列包括 26460 名男性和 18195 名女性，年龄在 25-90 岁之间。这些队列于 1966 年至 2004 年期间招募，并随访了 5.9 至 36.8 年。使用 Cox 比例风险分析，根据队列、年龄、BMI、总胆固醇、血压和吸烟状况进行调整，以估计癌症死亡率的 HR。
与正常葡萄糖组相比，男性中糖尿病前期、未确诊糖尿病和已知糖尿病患者的多变量调整 HR（95%CI）分别为 1.13（1.00，1.28）、1.27（1.02，1.57）和 1.71（1.35，2.17）；女性分别为 1.11（0.94，1.30）、1.31（1.00，1.70）和 1.43（1.01，2.02）。在糖尿病前期和糖尿病男性中，还观察到胃癌、结肠直肠和肝癌死亡人数增加，以及糖尿病女性肝癌和胰腺癌死亡人数增加。在没有已知糖尿病的个体中，空腹血浆葡萄糖增加一个标准差对应的癌症死亡率 HR（95%CI）为 1.06（1.02，1.09），2 小时血浆葡萄糖为 1.07（1.03，1.11）。
结论/解释：糖尿病和糖尿病前期与癌症死亡风险增加相关，特别是肝癌死亡风险增加。所有癌症的死亡率与葡萄糖浓度的线性增加相关。
