Luo Juhua, Phillips Lawrence, Liu Simin, Wactawski-Wende Jean, Margolis Karen L
Department of Epidemiology and Biostatistics (J.L.), School of Public Health, Indiana University, Bloomington, Indiana 47405; Division of Endocrinology (L.P.), Emory University, Atlanta, Georgia 30322; School of Public Health (S.L.), The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island 02912; Department of Social and Preventive Medicine (J.W.-W.), University at Buffalo, Buffalo, New York 14214; and HealthPartners Institute for Education and Research (K.L.M.), Minneapolis, Minnesota 55440.
J Clin Endocrinol Metab. 2016 Mar;101(3):1243-8. doi: 10.1210/jc.2015-3901. Epub 2016 Jan 13.
The objective of this study was to assess the relationships among diabetes, diabetes treatment and thyroid cancer risk using a large prospective cohort, the Women's Health Initiative.
A total of 147 934 women who were free of known cancer at baseline were followed prospectively. Diabetes status and diabetes treatment at baseline and during follow-up were ascertained. Incident cases of thyroid cancers were confirmed by physician review of central medical records and pathology reports. Time-dependent Cox proportional hazards regressions were used to estimate hazard ratios and 95% confidence intervals for thyroid cancer risk associated with diabetes status, diabetes treatment, and duration of diabetes.
With a median follow-up time of 15.9 years, 391 incident thyroid cancers were identified. We found no significant associations between thyroid cancer and diabetes (hazard ratio = 1.09; 95% confidence interval, 0.79-1.52), diabetes treatment, or duration of diabetes.
Our findings do not support the hypothesis that diabetes, or treatment of diabetes is associated with risk of thyroid cancer among postmenopausal women. Studies to investigate the specific effects of hyperinsulinemia and insulin resistance on thyroid cancer risk may provide additional information.
本研究的目的是利用大型前瞻性队列“女性健康倡议”评估糖尿病、糖尿病治疗与甲状腺癌风险之间的关系。
对总共147934名基线时无已知癌症的女性进行前瞻性随访。确定基线时及随访期间的糖尿病状态和糖尿病治疗情况。甲状腺癌的发病病例经医生查阅中央医疗记录和病理报告确诊。采用时间依赖性Cox比例风险回归来估计与糖尿病状态、糖尿病治疗及糖尿病病程相关的甲状腺癌风险的风险比和95%置信区间。
中位随访时间为15.9年,共识别出391例甲状腺癌发病病例。我们发现甲状腺癌与糖尿病(风险比=1.09;95%置信区间为0.79 - 1.52)、糖尿病治疗或糖尿病病程之间无显著关联。
我们的研究结果不支持糖尿病或糖尿病治疗与绝经后女性甲状腺癌风险相关的假设。研究高胰岛素血症和胰岛素抵抗对甲状腺癌风险的具体影响可能会提供更多信息。