Vulcan Alexandra, Manjer Jonas, Ohlsson Bodil
Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Internal Medicine, Jan Waldenströms gata 14, 205 02, Malmö, Sweden.
Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Surgery, Inga Marie Nilssons gata 47, 205 02, Malmö, Sweden.
BMC Cancer. 2017 Dec 12;17(1):842. doi: 10.1186/s12885-017-3874-4.
High levels of blood glucose are thought to be associated with colorectal cancer (CRC) and hyperinsulinemia, an interstage in the development of CRC. The purpose of this study was to examine associations between incident CRC and blood glucose; plasma insulin; and the homeostasis model assessment for insulin resistance (HOMA2-IR), respectively, and to determine whether these associations were dependent on sex and cancer site.
The Malmö Diet and Cancer cardiovascular cohort comprises 6103 individuals. During 81,781 person-years of follow-up, 145 cases of CRC were identified. The hazard ratio of measured blood glucose and plasma insulin and calculated HOMA2-IR were estimated with Cox proportional hazard regression.
An association was found between high levels of blood glucose and risk of CRC (HR: 1.72 for the highest compared with the lowest quartile; 95% CI: 1.05, 2.84; p = 0.044), and colon cancer (HR: 1.70 for the highest compared with the lowest quartile; 95% CI: 0.87, 3.33; p = 0.032). In men, an association was found between blood glucose and CRC (HR: 2.80 for the highest compared with the lowest quartile; 95% CI: 1.37, 5.70; p = 0.001), and colon cancer (HR: 4.48 for the highest compared with the lowest quartile; 95% CI: 1.27, 15.84; p = 0.007), but this was not found in women. No associations between plasma insulin, or HOMA2-IR, and CRC, were found.
High levels of blood glucose in men are associated with risk of colon cancer. The findings contribute to facilitating to identify those most in need of prevention and screening.
高血糖水平被认为与结直肠癌（CRC）以及高胰岛素血症相关，高胰岛素血症是结直肠癌发展过程中的一个中间阶段。本研究的目的是分别检验新发结直肠癌与血糖、血浆胰岛素以及胰岛素抵抗稳态模型评估（HOMA2-IR）之间的关联，并确定这些关联是否依赖于性别和癌症部位。
马尔默饮食与癌症心血管队列包括6103名个体。在81781人年的随访期间，共确诊了145例结直肠癌病例。采用Cox比例风险回归估计测量的血糖和血浆胰岛素以及计算得到的HOMA2-IR的风险比。
发现高血糖水平与结直肠癌风险之间存在关联（最高四分位数与最低四分位数相比，HR：1.72；95%CI：1.05，2.84；p = 0.044），以及与结肠癌风险之间存在关联（最高四分位数与最低四分位数相比，HR：1.70；95%CI：0.87，3.33；p = 0.032）。在男性中，发现血糖与结直肠癌之间存在关联（最高四分位数与最低四分位数相比，HR：2.80；95%CI：1.37，5.70；p = 0.001），以及与结肠癌之间存在关联（最高四分位数与最低四分位数相比，HR：4.48；95%CI：1.27，15.84；p = 0.007），但在女性中未发现这种关联。未发现血浆胰岛素或HOMA2-IR与结直肠癌之间存在关联。
男性高血糖水平与结肠癌风险相关。这些发现有助于确定那些最需要预防和筛查的人群。
