Shanghai Minhang Center for Disease Control and Prevention, 965 Zhong Yi Road, Shanghai 201101, People's Republic of China.
Department of Epidemiology, School of Public Health and Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, People's Republic of China.
Diabetes Res Clin Pract. 2021 Jan;171:108552. doi: 10.1016/j.diabres.2020.108552. Epub 2020 Nov 23.
Long-term glycemic variation in diabetes patients may have contributed to cancer incidence.
In this study we aimed at the association between annual glycemic variation and the risk of cancer in Chinese patients with type 2 diabetes mellitus (T2DM).
Subjects of this study were from an established population-based cohort of T2DM patients in Minhang District of Shanghai, China. Incident cancer were obtained from the Shanghai Cancer Registry. Glycemic variation was evaluated using the annual fasting glucose coefficient of variation (FG-CV), which was used as a time-dependent variable in a Cox regression model to estimate the associations with the cancer risk. Restricted cubic splines were used to explore potential non-linear associations.
A total of 2,140 incident cancers (1100 men and 1040 women) were identified from the 46,202 diabetes patients during 12-year follow-up. The annual FG-CV remained significantly associated with an increased risk of cancer, even after adjusting for the annual mean FG level. A significant non-linear association was found in male T2DM patients, and a significant linear association in female patients.
The positive association of the annual FG-CV with the risk of cancer in T2DM patients indicate the importance to stabilize the FG level.
糖尿病患者的长期血糖变化可能导致癌症的发生。
本研究旨在探讨中国 2 型糖尿病（T2DM）患者血糖年度变化与癌症风险之间的关系。
本研究的对象来自中国上海市闵行区一个已建立的基于人群的 T2DM 患者队列。癌症发病情况来自上海市癌症登记处。血糖变化采用空腹血糖变异系数（FG-CV）的年度值进行评估，该值作为 Cox 回归模型中的时变变量，用于估计与癌症风险的关系。限制性三次样条用于探索潜在的非线性关系。
在 12 年的随访中，从 46202 例糖尿病患者中发现了 2140 例癌症（男性 1100 例，女性 1040 例）。即使在调整了年度平均 FG 水平后，年度 FG-CV 仍与癌症风险的增加显著相关。在男性 T2DM 患者中发现了显著的非线性关系，而在女性患者中则发现了显著的线性关系。
T2DM 患者年度 FG-CV 与癌症风险的正相关表明稳定 FG 水平的重要性。
