Goossens Maria E, Zeegers Maurice P, Bazelier Marloes T, De Bruin Marie L, Buntinx Frank, de Vries Frank
Department of General Practice, KU Leuven, Leuven, Belgium.
Department of Complex Genetics, University of Maastricht, NUTRIM School of Nutrition, Translational Research in Metabolism, Maastricht, The Netherlands.
BMJ Open. 2015 Jun 1;5(6):e007470. doi: 10.1136/bmjopen-2014-007470.
The objective of this study was to examine the association between diabetes, and both urinary bladder cancer (UBC) risk and mortality.
We conducted a retrospective cohort study using data from the UK Clinical Practice Research Datalink (CPRD) linked to the Office of National Statistics (ONS). Patients diagnosed with diabetes mellitus type 1 or 2, or using antidiabetic drugs (ADDs), were compared to matched non-diabetic controls. Cox proportional hazards models were used to estimate the risk and mortality of UBC. We adjusted for age, sex, smoking status and body mass index.
The cohort included 329,168 patients using ADD, and 307,315 controls with 1295 and 1071 patients, respectively, diagnosed as having UBC during follow-up. The adjusted HRs of UBC were 0.77 (95% CI 0.57 to 1.05) and 1.04 (95% CI 0.96 to 1.14) for type 1 and 2 diabetes, respectively. These results were similar if we restricted our analysis to an inception cohort. We noticed a small increased risk during the first year after diagnosis (HR=1.26 (95% CI 1.05 to 1.52)), which could be explained by detection bias. There was no influence of the severity of diabetes as measured by the glycated haemoglobin. Mortality of UBC was not increased for patients with either type 1 (HR=0.95 (95% CI 0.39 to 2.34)) or type 2 diabetes (HR=1.16 (95% CI 0.91 to 1.46)).
Neither the risk of UBC nor the mortality from UBC was increased in patients with type 1 and patients with type 2 diabetes in the CPRD data.
本研究旨在探讨糖尿病与膀胱癌（UBC）风险及死亡率之间的关联。
我们进行了一项回顾性队列研究，使用了与英国国家统计局（ONS）相关联的英国临床实践研究数据链（CPRD）中的数据。将诊断为1型或2型糖尿病或使用抗糖尿病药物（ADDs）的患者与匹配的非糖尿病对照组进行比较。采用Cox比例风险模型来估计UBC的风险和死亡率。我们对年龄、性别、吸烟状况和体重指数进行了调整。
该队列包括329,168名使用ADD的患者和307,315名对照组，分别有1295名和1071名患者在随访期间被诊断为患有UBC。1型和2型糖尿病患者UBC的调整后风险比分别为0.77（95%可信区间0.57至1.05）和1.04（95%可信区间0.96至1.14）。如果我们将分析限制在起始队列中，这些结果是相似的。我们注意到在诊断后的第一年风险略有增加（风险比=1.26（95%可信区间1.05至1.52）），这可能是由检测偏倚所解释。糖化血红蛋白所衡量的糖尿病严重程度没有影响。1型（风险比=0.95（95%可信区间0.39至2.34））或2型糖尿病（风险比=1.16（95%可信区间0.91至1.46））患者的UBC死亡率没有增加。
在CPRD数据中，1型和2型糖尿病患者的UBC风险和UBC死亡率均未增加。
