PhD Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
Diabetes Metab Syndr. 2023 Aug;17(8):102828. doi: 10.1016/j.dsx.2023.102828. Epub 2023 Jul 14.
Early-onset colorectal cancer (EoCRC) constitutes 2%-10% of all colorectal cancers and is becoming more common globally. Diabetes mellitus (DM) has increased substantially in younger adults; however, its involvement in EoCRC remains unclear. We conducted a systematic review and meta-analysis of observational studies to (1) explore the prevalence of DM in individuals with EoCRC and (2) investigate the association between DM and EoCRC.
A systematic literature search was conducted to identify studies published before May 2022 that evaluated the association between DM and EoCRC risk in four databases, including Medline (PubMed), Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. Results from the studies were summarized in meta-analyses using random effects models.
Nineteen eligible studies were included. A total of 33,359 EoCRC cases and 14,259,289 controls in 12 studies were included in the meta-analysis. The pooled odds ratio [OR] of 1.43 (95% confidence interval [CI]: 1.08-1.8) indicated significant positive association between DM and increased risk of EoCRC. Subgroup analysis demonstrated that diabetes severity was significantly associated with unmanaged DM (OR = 1.28, 95% CI: 1.02-1.6), but not with managed DM (OR = 1.04, 95% CI: 0.84-1.28).
Our results suggest that DM is a risk factor for EoCRC, and the higher prevalence of DM among younger adults may contribute to the increasing incidence of EoCRC. Interventions to reduce this bidirectional risk should be further investigated for the development of effective prevention and treatment strategies. PROSPERO registration: CRD42022306347.
早发性结直肠癌（EoCRC）占所有结直肠癌的 2%-10%，在全球范围内变得越来越常见。糖尿病（DM）在年轻人中的发病率显著增加；然而，其与 EoCRC 的关系尚不清楚。我们进行了一项系统综述和荟萃分析，以（1）探讨 EoCRC 患者中 DM 的患病率，（2）研究 DM 与 EoCRC 之间的关系。
系统地检索了四个数据库（包括 Medline（PubMed）、Embase、Web of Science 和 Cochrane 对照试验中心注册库）中发表于 2022 年 5 月之前的评估 DM 与 EoCRC 风险之间关系的研究，以识别研究。使用随机效应模型对研究结果进行汇总分析。
纳入了 19 项符合条件的研究。12 项研究共纳入了 33359 例 EoCRC 病例和 14259289 例对照，进行荟萃分析。1.43（95%置信区间 [CI]：1.08-1.8）的合并比值比 [OR]表明，DM 与 EoCRC 风险增加之间存在显著的正相关。亚组分析表明，糖尿病严重程度与未控制的 DM 显著相关（OR=1.28，95%CI：1.02-1.6），但与管理的 DM 不相关（OR=1.04，95%CI：0.84-1.28）。
我们的结果表明，DM 是 EoCRC 的一个危险因素，年轻患者中 DM 的更高患病率可能导致 EoCRC 的发病率增加。应进一步研究降低这种双向风险的干预措施，以制定有效的预防和治疗策略。PROSPERO 注册：CRD42022306347。
