Yamashiro Kenji, Takahashi Hiroshi, Hayashino Yasuaki, Origasa Hideki, Izumi Kazuo, Tajima Naoko, Nishimura Rimei
Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8641 Japan.
Department of Endocrinology, Tenri Hospital, Nara, Japan.
Diabetol Int. 2024 May 23;15(3):315-326. doi: 10.1007/s13340-024-00725-6. eCollection 2024 Jul.
In the large-scale, prospective, observational JDCP study, a total of 5944 people with type 2 diabetes (mean age at baseline, 61.4 years old; women, 39.9%; and duration of diabetes, 10.8 years) were followed up for incidence of malignancy. During a mean 5.38 ± 2.92 years of follow-up, malignancies occurred in 322 individuals, accounting for a crude incidence of 10.35/1000 person-years. The 3 most frequently reported malignancies included colorectal cancers (20.4%), breast cancer (16.5%) and lung cancers (13.6%) in women, and gastric cancers (18.3%), colorectal cancers (15.7%) and lung/prostate cancers (12.7%) in men. During follow-up, men had a significantly higher relative risk for malignancy than women. In contrast, women had a significantly shorter time to the first diagnosis of malignancy following a diagnosis of diabetes than men (13.79 ± 7.90 and 17.11 ± 8.50 years, respectively), although there was no marked difference in the age at the diagnosis of malignancy (67.39 ± 7.27 and 68.44 ± 6.62 years, respectively). Cox proportional hazard models revealed that increasing age, a history of drinking and a history of acute myocardial infarction were significantly associated with an increased risk of malignancy. This report may be of interest in that it provides valuable insight into which malignancies Japanese people with type 2 diabetes are likely to be at risk of developing over time.
在大规模、前瞻性、观察性的日本糖尿病并发症预防（JDCP）研究中，共有5944名2型糖尿病患者（基线平均年龄61.4岁；女性占39.9%；糖尿病病程10.8年）接受了恶性肿瘤发病率的随访。在平均5.38±2.92年的随访期间，322人发生了恶性肿瘤，粗发病率为10.35/1000人年。最常报告的3种恶性肿瘤在女性中包括结直肠癌（20.4%）、乳腺癌（16.5%）和肺癌（13.6%），在男性中包括胃癌（18.3%）、结直肠癌（15.7%）和肺癌/前列腺癌（12.7%）。在随访期间，男性发生恶性肿瘤的相对风险显著高于女性。相比之下，女性在糖尿病诊断后至首次诊断恶性肿瘤的时间明显短于男性（分别为13.79±7.90年和17.11±8.50年），尽管在恶性肿瘤诊断时的年龄没有明显差异（分别为67.39±7.27岁和68.44±6.62岁）。Cox比例风险模型显示，年龄增加、饮酒史和急性心肌梗死病史与恶性肿瘤风险增加显著相关。该报告可能具有参考价值，因为它为2型糖尿病的日本患者随着时间推移可能发生哪些恶性肿瘤提供了有价值的见解。
