2型糖尿病患者的体力活动、遗传易感性与结直肠癌风险：一项基于人群的大型队列研究
Physical Activity, Genetic Susceptibility, and Risk of Colorectal Cancer in Type 2 Diabetes: A Large Population-Based Cohort Study.
作者信息
Wu Yanjun, Meng Meijun, Liu Yufeng, Zeng Ruijie, Feng Jing, Lian Qizhou, Ma Yuying, Zhang Lijun, Huang Wentao, Leung Felix W, Duan Chongyang, Sha Weihong, Chen Hao
机构信息
Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Guangzhou, China; Center for Medical Research on Innovation and Translation, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China; Shantou University Medical College, Shantou, Guangdong, China; Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; School of Medicine, South China University of Technology, Guangzhou, China; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California, USA; Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
出版信息
Dtsch Arztebl Int. 2025 Apr 4;122(7):186-192. doi: 10.3238/arztebl.m2025.0013.
BACKGROUND
It is crucial to identify modifiable preventive measures to mitigate the risk of colorectal cancer (CRC) among patients with type 2 diabetes (T2D), a high-risk group for CRC. We conducted a study to investigate the potential association between various levels of physical activity (PA) and the incidence of CRC, taking account of genetic susceptibility, in a T2D population cohort.
METHODS
The study was based on UK Biobank (UKB) data on persons diagnosed with T2D; the participants were tracked until 2022. Hazard ratios (HR) and 95% confidence intervals (95% CI) for CRC were calculated using Cox regression models.
RESULTS
The 33 733 patients with T2D were followed up for a median of 13.62 years. During this time, 551 patients were diagnosed with CRC. Compared with low PA, the multivariable adjusted HR for CRC among T2D patients was 0.81, 95% CI [0.66; 0.98] and 0.74 [0.58; 0.94] in the groups with moderate and high PA, respectively. In right colon cancer, moderate and high levels of PA were associated with 31% (HR 0.69; 95% CI [0.51; 0.93]) and 42% (HR 0.58; 95% CI [0.40: 0.85]) reductions in the risk of CRC. High PA (HR 0.54; 95% CI [0.35; 0.84] was associated with a lower risk of CRC even in patients with a high polygenic risk score (PRS). Persons with low PRS and high PA had the lowest risk of CRC.
CONCLUSION
Our study suggests that moderate to high PA helps to reduce the risk of CRC in T2D patients and that joint consideration of PA level and PRS could provide valuable insights for personalized strategies to prevent CRC.
背景
识别可改变的预防措施以降低2型糖尿病（T2D）患者（结直肠癌（CRC）的高危人群）患CRC的风险至关重要。我们开展了一项研究，在一个T2D人群队列中，考虑遗传易感性，调查不同水平的身体活动（PA）与CRC发病率之间的潜在关联。
方法
该研究基于英国生物银行（UKB）中被诊断为T2D的人群数据；对参与者进行追踪直至2022年。使用Cox回归模型计算CRC的风险比（HR）和95%置信区间（95%CI）。
结果
33733例T2D患者的中位随访时间为13.62年。在此期间，551例患者被诊断为CRC。与低PA组相比，T2D患者中PA水平为中等和高的组，CRC的多变量调整HR分别为0.81，95%CI[0.66；0.98]和0.74[0.58；0.94]。在右结肠癌中，中等和高水平的PA分别使CRC风险降低31%（HR 0.69；95%CI[0.51；0.93]）和42%（HR 0.58；95%CI[0.40：0.85]）。即使在多基因风险评分（PRS）高的患者中，高PA（HR 0.54；95%CI[0.35；0.84]）也与较低的CRC风险相关。PRS低且PA高的人患CRC的风险最低。
结论
我们的研究表明，中等至高水平的PA有助于降低T2D患者患CRC的风险，并且联合考虑PA水平和PRS可为预防CRC的个性化策略提供有价值的见解。
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