Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Lexington, MA, United States.
Pancreatology. 2019 Jun;19(4):578-586. doi: 10.1016/j.pan.2019.03.006. Epub 2019 Mar 26.
To evaluate the potential of blood glucose levels and weight change before the onset of diabetes as predictors of pancreatic cancer among subjects with new-onset diabetes, that is, cancer-related diabetes versus normal type 2 diabetes.
We conducted a case-control study among subjects with new diabetes in the United Kingdom-based Clinical Practice Research Datalink. Cases were pancreatic cancer subjects with diabetes for ≤2 years before the cancer diagnosis (i.e., cancer-related diabetes). Controls were cancer-free, type 2 diabetic subjects matched to cases on age, sex, and diabetes duration. We calculated adjusted odds ratios (aORs) for pancreatic cancer as a function of both weight change and blood glucose before the onset of diabetes.
Weight loss of 10.0%-14.9% at diabetes onset was associated with an aOR for pancreatic cancer of 3.58 (95% CI 2.31-5.54), loss of ≥15.0%, with an aOR of 4.56 (95% CI 2.82-7.36), compared with stable weight. Blood glucose levels of ≤5.1 mmol/L or 5.2-5.6 mmol/L before diabetes onset were associated with an increased risk of a pancreatic cancer diagnosis, with aORs of 2.42 (95% CI 1.60-3.66) and 2.20 (95% CI 1.45-3.35), respectively, when compared with blood glucose levels ≥6.3 mmol/L within >2-3 years before cancer detection.
Weight loss as well as blood glucose levels in the normal range (and thus rapid development of hyperglycemia) before diabetes onset may be predictive of pancreatic cancer-related diabetes and may help target which subjects with new diabetes to refer for pancreatic cancer screening examinations.
评估糖尿病发病前血糖水平和体重变化的潜在作用，作为新发糖尿病患者（即与癌症相关的糖尿病与普通 2 型糖尿病）中胰腺癌的预测指标。
我们在英国临床实践研究数据链中进行了一项新诊断糖尿病患者的病例对照研究。病例为癌症诊断前≤2 年内患有糖尿病的胰腺癌患者（即与癌症相关的糖尿病）。对照组为无癌症、与病例年龄、性别和糖尿病病程相匹配的 2 型糖尿病患者。我们计算了体重变化和糖尿病发病前血糖水平与胰腺癌的调整比值比（aOR）。
糖尿病发病时体重减轻 10.0%-14.9%与胰腺癌的 aOR 为 3.58（95%CI 2.31-5.54），体重减轻≥15.0%与 aOR 为 4.56（95%CI 2.82-7.36），与体重稳定相比。糖尿病发病前血糖水平≤5.1mmol/L 或 5.2-5.6mmol/L 与胰腺癌诊断风险增加相关，aOR 分别为 2.42（95%CI 1.60-3.66）和 2.20（95%CI 1.45-3.35），与癌症检出前>2-3 年内血糖水平≥6.3mmol/L 相比。
糖尿病发病前体重减轻以及正常范围内的血糖水平（即快速发展为高血糖）可能是与癌症相关的糖尿病的预测指标，并可能有助于确定哪些新发糖尿病患者需要进行胰腺癌筛查检查。
