Kakehi Eiichi, Kotani Kazuhiko, Nakamura Takashi, Takeshima Taro, Kajii Eiji
Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Curr Diabetes Rev. 2018;14(5):434-445. doi: 10.2174/1573399813666170711142035.
Although diabetes mellitus is a risk factor for cancer, the relationship of an increased glucose concentration at a non-diabetic glucose level with cancer mortality is yet to be determined.
The aim was to observe whether an increased glucose concentration and/or glucose intolerance at the non-diabetic glucose level can predict cancer mortality.
Population-based prospective cohort studies evaluating cancer mortality at the non-diabetic level (defined as fasting plasma glucose <7.0 mmol/L and two-hour plasma glucose <11.1mmol/L following an oral glucose tolerance test) were collected via a PubMed search with an additional Google scholar search between 1 January 1966 and 31 July 2016.
We identified seven studies, which met the defined criteria. Studies examining fasting/casual states indicated an increase in cancer mortality with a slight increase in fasting/casual glucose levels in men in particular. Not all, but some studies using a glucose tolerance test indicated an increase in cancer mortality with impaired glucose tolerance/prediabetes. Concerning cause-cancer mortality, glucose intolerance states appeared to have an increase in mortality, particularly due to the stomach, liver and pancreatic cancers.
In these studies reviewed, cancer mortality increased in individuals with an increased glucose concentration and an increased potential was seen in those patients with glucose intolerance even at non-diabetic glucose levels. The outcome of these findings is promising and forms the basis for further studies to directly address the relevance of increased (non-diabetic) glucose and glucose intolerance as a prognostic indicator of cancer mortality.
尽管糖尿病是癌症的一个风险因素，但非糖尿病血糖水平下血糖浓度升高与癌症死亡率之间的关系尚待确定。
旨在观察非糖尿病血糖水平下血糖浓度升高和/或葡萄糖耐量异常是否可预测癌症死亡率。
通过在PubMed上检索，并于2016年7月31日在谷歌学术上进行补充检索，收集了基于人群的前瞻性队列研究，这些研究评估了非糖尿病水平（定义为空腹血糖<7.0 mmol/L以及口服葡萄糖耐量试验后两小时血糖<11.1 mmol/L）时的癌症死亡率。
我们确定了7项符合既定标准的研究。对空腹/随机状态进行检查的研究表明，尤其是男性，空腹/随机血糖水平略有升高会导致癌症死亡率增加。并非所有使用葡萄糖耐量试验的研究，但部分研究表明，葡萄糖耐量受损/糖尿病前期会导致癌症死亡率增加。关于癌症死因死亡率，葡萄糖耐量异常状态的死亡率似乎有所增加，尤其是胃癌、肝癌和胰腺癌导致的死亡率。
在这些综述研究中，血糖浓度升高的个体癌症死亡率增加，即使在非糖尿病血糖水平下，葡萄糖耐量异常的患者也有更高的癌症死亡风险。这些研究结果很有前景，为进一步直接研究升高的（非糖尿病）血糖和葡萄糖耐量异常作为癌症死亡率预后指标的相关性奠定了基础。
