Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands.
Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K. Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Diabetes Care. 2015 Mar;38(3):495-502. doi: 10.2337/dc14-1175. Epub 2014 Dec 31.
To assess the risk of colorectal cancer associated with type 2 diabetes, as compared with a nondiabetic reference population, and to study additional associations between treatment stage and duration of obesity and colorectal cancer risk.
We conducted an observational population-based cohort study within the Clinical Practice Research Datalink (1987-2012). All patients (≥18 years) with at least one prescription for an antidiabetic drug (n = 300,039) were matched (1:1) by birth year, sex, and practice to a comparison cohort without diabetes. Cox proportional hazards models were used to derive adjusted hazard ratios (HRs) for colorectal cancer associated with type 2 diabetes. Within the diabetic cohort, associations of colorectal cancer with treatment stages and duration of obesity (BMI ≥30 kg/m(2)) were studied.
After a median follow-up of 4.5 years, 2,759 cases of colorectal cancer were observed among the diabetic study population. Type 2 diabetes was associated with a 1.3-fold increased risk of colorectal cancer (HR 1.26 [95% CI 1.18-1.33]). Among diabetic patients, no association was found with treatment stages. A trend of increased colorectal cancer risk was observed with longer duration of obesity. Risk of colorectal cancer was significantly increased for patients with recorded duration of obesity of 4-8 years (HR 1.19 [1.06-1.34]) and >8 years (1.28 [1.11-1.49]).
Type 2 diabetes is associated with a moderately increased risk of colorectal cancer. Among diabetic patients, an increased risk was observed for patients who suffered from obesity for a total duration of 4 years or more.
评估 2 型糖尿病与结直肠癌风险之间的关系，并研究肥胖治疗阶段和持续时间与结直肠癌风险之间的其他关联。
我们在临床实践研究数据库（1987-2012 年）中进行了一项基于人群的观察性队列研究。所有至少有一次抗糖尿病药物处方的患者（≥18 岁）（n=300,039）按出生年份、性别和实践与无糖尿病的对照组进行 1:1 匹配。使用 Cox 比例风险模型得出与 2 型糖尿病相关的结直肠癌的调整后风险比（HR）。在糖尿病队列中，研究了肥胖（BMI≥30kg/m²）的治疗阶段和持续时间与结直肠癌的关联。
在中位随访 4.5 年后，在糖尿病研究人群中观察到 2759 例结直肠癌病例。2 型糖尿病与结直肠癌风险增加 1.3 倍相关（HR 1.26 [95%CI 1.18-1.33]）。在糖尿病患者中，与治疗阶段无关。随着肥胖持续时间的延长，结直肠癌的风险呈上升趋势。对于有记录的肥胖持续时间为 4-8 年（HR 1.19 [1.06-1.34]）和>8 年（1.28 [1.11-1.49]）的患者，结直肠癌的风险显著增加。
2 型糖尿病与结直肠癌风险中度增加相关。在糖尿病患者中，对于肥胖总持续时间为 4 年或以上的患者，风险增加。
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