Cai Jie, Chen Hongda, Lu Ming, Zhang Yuhan, Lu Bin, Luo Chenyu, Feng Xiaoshuang, You Lei, Dai Min, Zhao Yupei
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Cancers (Basel). 2022 Jul 13;14(14):3403. doi: 10.3390/cancers14143403.
Hyperglycemia has been reported to increase the risk of pancreatic cancer (PC), while the association between glycemic change and PC risk has rarely been explored. Using data from a prospective cohort study conducted in China since 2006, 138,870 males with available fasting blood glucose (FBG) levels, including 106,632 males with at least two FBG measurements, were analyzed. The associations between FBG (level, change, and stability) and PC incidence were evaluated using Cox proportional hazard regression and restricted cubic splines. Baseline (p = 0.109) and recent (p = 0.070) FBG levels and incident PC were not significantly associated. U-shaped associations were observed between the annual FBG change and PC risk. Compared with stable FBG, participants with annual FBG change rates <−0.05 mmol/L or >0.15 mmol/L had about four-fold (HR, 4.010; 95% CI: 1.920−8.375) and six-fold (HR, 5.897; 95% CI: 2.935−11.848) higher PC risks, respectively. The PC risk increased by 2.5% (HRlinear = 1.025, 95% CI:1.009−1.042) for every 1% increase in the coefficient of variation for FBG. A subgroup analysis of males without diabetes at baseline showed stronger associations. Temporal FBG changes may be an important factor for identifying populations with high PC risks.
据报道，高血糖会增加患胰腺癌（PC）的风险，而血糖变化与PC风险之间的关联却鲜有研究。利用自2006年以来在中国进行的一项前瞻性队列研究的数据，对138870名有空腹血糖（FBG）水平数据的男性进行了分析，其中包括106632名至少有两次FBG测量值的男性。使用Cox比例风险回归和受限立方样条评估FBG（水平、变化和稳定性）与PC发病率之间的关联。基线（p = 0.109）和近期（p = 0.070）FBG水平与PC发病无显著关联。观察到年度FBG变化与PC风险之间呈U形关联。与稳定的FBG相比，年度FBG变化率<-0.05 mmol/L或>0.15 mmol/L的参与者患PC的风险分别高出约四倍（HR，4.010；95%CI：1.920-8.375）和六倍（HR，5.897；95%CI：2.935-11.848）。FBG变异系数每增加1%，PC风险增加2.5%（HRlinear = 1.025，95%CI：1.009-1.042）。对基线时无糖尿病的男性进行的亚组分析显示关联更强。FBG的时间变化可能是识别PC高风险人群的一个重要因素。
