Ding Lilu, Qian Jing, Dai Ruoqi, Zhang Hui, Miao Jingyou, Wang Jing, Yu Min, Tan Xiao, Li Yingjun
Department of Epidemiology and Health Statistics, School of Public Health, Hangzhou Medical College, 481 Binwen Road, Hangzhou, 310053, China.
Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China.
BMC Cancer. 2025 Jan 10;25(1):58. doi: 10.1186/s12885-025-13470-z.
Pancreatic cancer poses a significant challenge in individuals with diabetes, prompting a reevaluation of established risk factors beyond conventional glycemic control measures.
To explore the complex interplay of metabolic and psychosocial determinants in pancreatic cancer risk among individuals with diabetes, challenging prevailing perspectives and advocating for a comprehensive approach.
A total of 21,945 UK Biobank participants with baseline diabetes diagnosis were analyzed. Social isolation was assessed through a questionnaire capturing five factors: household size, social activities, friend/family visits, loneliness, and confiding in others. Incident pancreatic cancer was identified using ICD codes. Baseline characteristics, insulin use, and other relevant factors were analyzed. Hazard ratios and mediation analyses were conducted to determine the relationship between social isolation, inflammation, and pancreatic cancer risk.
Individuals with high social isolation were more likely to be male, smokers, non-drinkers, and have shorter sleep duration. They also had an increased risk of pancreatic cancer (HR = 2.65, 95% CI = 1.12-6.24) compared to those with low social isolation. Mediation analyses highlighted inflammation as a crucial mediator, with the proportion mediated by inflammation being 19.44% for insulin use, 10.34% for smoking, and 8.33% for social isolation.
Our findings highlight the importance of psychosocial factors in pancreatic cancer risk and underscore the need for further research to elucidate the underlying mechanisms.
胰腺癌给糖尿病患者带来了重大挑战，促使人们重新评估传统血糖控制措施之外的既定风险因素。
探讨糖尿病患者中胰腺癌风险的代谢和心理社会决定因素之间的复杂相互作用，挑战主流观点并倡导采用综合方法。
对英国生物银行中21945名基线诊断为糖尿病的参与者进行了分析。通过一份问卷评估社会隔离情况，该问卷涵盖五个因素：家庭规模、社交活动、朋友/家人来访、孤独感以及向他人倾诉。使用国际疾病分类代码确定新发胰腺癌病例。分析了基线特征、胰岛素使用情况及其他相关因素。进行了风险比和中介分析，以确定社会隔离、炎症与胰腺癌风险之间的关系。
社会隔离程度高的个体更可能为男性、吸烟者、不饮酒者，且睡眠时间较短。与社会隔离程度低的个体相比，他们患胰腺癌的风险也更高（风险比=2.65，95%置信区间=1.12 - 6.24）。中介分析强调炎症是一个关键中介因素，胰岛素使用情况中由炎症介导的比例为19.44%，吸烟情况中为10.34%，社会隔离情况中为8.33%。
我们的研究结果凸显了心理社会因素在胰腺癌风险中的重要性，并强调需要进一步研究以阐明其潜在机制。
