Wang Shuo, Lo Galbo Mark D, Blair Cindy, Thyagarajan Bharat, Anderson Kristin E, Lazovich DeAnn, Prizment Anna
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, United States; Children's Minnesota, Minneapolis, MN, United States.
Maturitas. 2021 Jan;143:190-196. doi: 10.1016/j.maturitas.2020.07.010. Epub 2020 Aug 11.
Many studies have reported a positive association between diabetes and kidney cancer. However, it is unclear whether diabetes is a risk factor for kidney cancer independent of other risk factors, such as obesity and hypertension. We comprehensively examined the association of diabetes and its duration with incident kidney cancer in the prospective cohort Iowa Women's Health Study (1986-2011).
Diabetes status was self-reported at baseline (1986) and on five follow-up questionnaires. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of baseline and time-dependent diabetes with the risk of incident kidney cancer.
During the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975 post-menopausal women. In an age-adjusted model, there was a significant association between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76 (1.26, 1.45)]; the association was attenuated after multivariable adjustment for age, body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity, diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35 (0.94, 1.94)]. However, among non-obese women or women with a waist circumference less than 34.6 in., diabetes was significantly associated with kidney cancer risk: for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with BMI < 30 kg/m and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in..
Our results suggest that diabetes is associated with kidney cancer risk among non-obese post-menopausal women.
许多研究报告了糖尿病与肾癌之间存在正相关。然而，尚不清楚糖尿病是否是独立于其他风险因素（如肥胖和高血压）之外的肾癌风险因素。我们在爱荷华州女性健康前瞻性队列研究（1986 - 2011年）中全面研究了糖尿病及其病程与新发肾癌的关联。
糖尿病状态通过基线（1986年）及五份随访问卷进行自我报告。采用Cox比例风险回归计算基线和随时间变化的糖尿病与新发肾癌风险关联的风险比（HR）和95%置信区间（CI）。
在25年的随访期间，36,975名绝经后女性中发生了245例肾癌。在年龄调整模型中，随时间变化的糖尿病与肾癌风险之间存在显著关联[HR（95%CI）= 1.76（1.26，1.45）]；在对年龄、体重指数（BMI）、腰臀比（WHR）、高血压、体力活动、利尿剂使用、吸烟包年数、酒精摄入量和总热量摄入进行多变量调整后，该关联减弱[HR = 1.35（0.94，1.94）]。然而，在非肥胖女性或腰围小于34.6英寸的女性中，糖尿病与肾癌风险显著相关：对于随时间变化的糖尿病，BMI < 30 kg/m²者的HR（95%CI）为1.82（1.10，3.00），腰围< 34.6英寸者的HR（95%CI）为2.18（1.08，4.38）。
我们的结果表明，糖尿病与非肥胖绝经后女性的肾癌风险相关。
