Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei (100), Taiwan, Republic of China.
Diabetologia. 2011 Aug;54(8):2009-15. doi: 10.1007/s00125-011-2171-z. Epub 2011 May 5.
AIMS/HYPOTHESIS: Studies on the link between diabetes and bladder cancer in Asians are rare. We investigated the association between diabetes and incidence of bladder cancer by using a large national insurance database.
A random sample of 1,000,000 individuals covered by the National Health Insurance was recruited. A total of 495,199 men and 503,748 women for all ages and 187,609 men and 189,762 women ≥40 years old and without bladder cancer at recruitment were followed from 2003 to 2005. Cox regression evaluated the adjusted relative risk for all ages and for age ≥40 years old.
The results were similar for all ages and for age ≥40 years. In Cox models, patients with diabetes consistently showed a significantly higher relative risk ranging from 1.36 to 1.51 after adjustment for age, sex and other potential confounders. Age, male sex, nephropathy, urinary tract diseases (infection and stone) and statin use were associated with bladder cancer, but occupation, hypertension, stroke, ischaemic heart disease, peripheral arterial disease, eye disease, dyslipidaemia and medications (oral glucose-lowering agents including sulfonylurea, metformin, acarbose and thiazolidinediones, insulin, fibrates, ACE inhibitors/angiotensin receptor blockers and calcium channel blockers) were not. Chronic obstructive pulmonary disease and living in regions other than Metropolitan Taipei were associated with lower risk.
Patients with diabetes have a higher risk of bladder cancer. The association with urinary tract diseases suggests a complex scenario in the link between bladder cancer and diabetes at different disease stages.
目的/假设：亚洲关于糖尿病与膀胱癌之间关联的研究较少。我们利用一个大型医疗保险数据库研究了糖尿病与膀胱癌发病率之间的关联。
招募了一个由 100 万医疗保险覆盖的随机抽样个体。对所有年龄段的 495199 名男性和 503748 名女性，以及≥40 岁且入组时无膀胱癌的 187609 名男性和 189762 名女性进行随访，随访时间从 2003 年至 2005 年。Cox 回归评估了所有年龄段和≥40 岁的年龄调整相对风险。
所有年龄段和≥40 岁的结果相似。在 Cox 模型中，患有糖尿病的患者在调整年龄、性别和其他潜在混杂因素后，始终表现出显著更高的相对风险，范围从 1.36 到 1.51。年龄、男性、肾病、下尿路疾病（感染和结石）和他汀类药物的使用与膀胱癌相关，但职业、高血压、中风、缺血性心脏病、外周动脉疾病、眼病、血脂异常和药物（包括磺脲类、二甲双胍、阿卡波糖和噻唑烷二酮、胰岛素、贝特类药物、ACE 抑制剂/血管紧张素受体阻滞剂和钙通道阻滞剂的口服降糖药）与膀胱癌无关。慢性阻塞性肺疾病和居住在大台北地区以外的地区与较低的风险相关。
糖尿病患者患膀胱癌的风险更高。与下尿路疾病的关联表明，在不同疾病阶段，膀胱癌与糖尿病之间的关联存在复杂情况。
