Huang Yi, Cai Xiaoyan, Qiu Miaozhen, Chen Peisong, Tang Hongfeng, Hu Yunzhao, Huang Yuli
Clinical Medicine Research Center, The First People's Hospital of Shunde, Penglai Road, Daliang Town, Shunde District, Foshan, 528300, People's Republic of China.
Diabetologia. 2014 Nov;57(11):2261-9. doi: 10.1007/s00125-014-3361-2. Epub 2014 Sep 11.
AIMS/HYPOTHESIS: The results from prospective cohort studies of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and risk of cancer are controversial. We conducted a meta-analysis to evaluate the risk of cancer in association with impaired fasting glucose and impaired glucose tolerance.
The PubMed, EMBASE and Cochrane Library databases were searched for prospective cohort studies with data on prediabetes and cancer. Two independent reviewers assessed the reports and extracted the data. Prospective studies were included if they reported adjusted RRs with 95% CIs for the association between cancer and prediabetes. Subgroup analyses were conducted according to endpoint, age, sex, ethnicity, duration of follow-up and study characteristics.
Data from 891,426 participants were derived from 16 prospective cohort studies. Prediabetes was associated with an increased risk of cancer overall (RR 1.15; 95% CI 1.06, 1.23). The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes. In a site-specific cancer analysis, prediabetes was significantly associated with increased risks of cancer of the stomach/colorectum, liver, pancreas, breast and endometrium (all p < 0.05), but not associated with cancer of the bronchus/lung, prostate, ovary, kidney or bladder. The risks of site-specific cancer were significantly different (p = 0.01) and were highest for liver, endometrial and stomach/colorectal cancer.
CONCLUSIONS/INTERPRETATION: Overall, prediabetes was associated with an increased risk of cancer, especially liver, endometrial and stomach/colorectal cancer.
目的/假设：关于糖尿病前期（空腹血糖受损和/或糖耐量受损）与癌症风险的前瞻性队列研究结果存在争议。我们进行了一项荟萃分析，以评估空腹血糖受损和糖耐量受损与癌症风险之间的关系。
检索了PubMed、EMBASE和Cochrane图书馆数据库，查找有关糖尿病前期和癌症数据的前瞻性队列研究。两名独立的评审员评估了报告并提取了数据。如果前瞻性研究报告了癌症与糖尿病前期之间关联的校正相对危险度（RR）及95%可信区间（CI），则纳入研究。根据终点、年龄、性别、种族、随访时间和研究特征进行亚组分析。
16项前瞻性队列研究纳入了891426名参与者的数据。总体而言，糖尿病前期与癌症风险增加相关（RR 1.15；95% CI 1.06，1.23）。在癌症终点、年龄、随访时间和种族方面，结果是一致的。不同糖尿病前期定义的癌症风险没有显著差异。在特定部位癌症分析中，糖尿病前期与胃癌/结直肠癌、肝癌、胰腺癌、乳腺癌和子宫内膜癌风险增加显著相关（均p < 0.05），但与支气管/肺癌、前列腺癌、卵巢癌、肾癌或膀胱癌无关。特定部位癌症的风险有显著差异（p = 0.01），其中肝癌、子宫内膜癌和胃癌/结直肠癌的风险最高。
结论/解读：总体而言，糖尿病前期与癌症风险增加相关，尤其是肝癌、子宫内膜癌和胃癌/结直肠癌。
