Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China.
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Endocr J. 2021 Mar 28;68(3):281-289. doi: 10.1507/endocrj.EJ20-0138. Epub 2020 Oct 20.
Diabetes mellitus (DM) is widely considered to be associated with the risk of diverse cancers; however, the association between DM and the risk of leukemia is still controversial. Thus, a detailed meta-analysis of cohort studies was conducted to elucidate this association. Eligible studies were screened through the electronic searches in PubMed, Web of Science, and Embase from their inception to August 11, 2020. Summary relative risks (RRs) and 95% confidence intervals (CIs) were computed through the random-effects model. Eighteen articles involving 10,516 leukemia cases among a total of 4,094,235 diabetic patients were included in this meta-analysis. Overall, twenty-five RRs were synthesized for type 2 diabetes mellitus (T2DM) and yielded a summary RR of 1.33 (95%CI, 1.21-1.47; p < 0.001). For type 1 diabetes mellitus (T1DM), 7 RRs were combined, however, the pooled RR was insignificant (RR, 1.08; 95%CI, 0.87-1.34; p = 0.48). Interestingly, the summary RR for East Asia (RR, 1.83, 95%CI, 1.63-2.06) was significantly higher than that for Europe (RR, 1.11, 95%CI, 1.06-1.15), Western Asia (RR, 1.40, 95%CI, 1.25-1.54), North America (RR, 1.14, 95%CI, 1.08-1.20), and Australia (RR, 1.47, 95%CI, 1.25-1.71). Moreover, we found that patients with a shorter T2DM duration (1-5 years) had a higher risk of leukemia compared to those with a longer duration (5.1-10 years). Overall, this meta-analysis suggests there is a moderately increased risk of leukemia among T2DM patients, but not in T1DM patients. Further investigation is warranted.
糖尿病（DM）被广泛认为与多种癌症的风险相关；然而，DM 与白血病风险之间的关系仍存在争议。因此，进行了一项详细的队列研究荟萃分析以阐明这种关联。通过电子检索在 PubMed、Web of Science 和 Embase 中筛选符合条件的研究，检索时间从成立到 2020 年 8 月 11 日。通过随机效应模型计算汇总相对风险（RR）和 95％置信区间（CI）。这项荟萃分析纳入了 18 项研究，共涉及 4094235 例糖尿病患者中的 10516 例白血病病例。总体而言，合成了 25 个 2 型糖尿病（T2DM）RR，汇总 RR 为 1.33（95％CI，1.21-1.47；p < 0.001）。对于 1 型糖尿病（T1DM），合并了 7 个 RR，但汇总 RR 无统计学意义（RR，1.08；95％CI，0.87-1.34；p = 0.48）。有趣的是，东亚地区的汇总 RR（RR，1.83，95％CI，1.63-2.06）明显高于欧洲（RR，1.11，95％CI，1.06-1.15）、西亚（RR，1.40，95％CI，1.25-1.54）、北美（RR，1.14，95％CI，1.08-1.20）和澳大利亚（RR，1.47，95％CI，1.25-1.71）。此外，我们发现 T2DM 病程较短（1-5 年）的患者发生白血病的风险高于病程较长（5.1-10 年）的患者。总体而言，这项荟萃分析表明，T2DM 患者患白血病的风险适度增加，但 T1DM 患者则不然。需要进一步研究。
