Everhart J, Wright D
Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md 20892-6600, USA.
JAMA. 1995;273(20):1605-9.
To evaluate diabetes mellitus as a risk factor for pancreatic cancer with the consideration that diabetes may also be a consequence of pancreatic cancer.
Pertinent studies of diabetes mellitus and pancreatic cancer published between 1975 and 1994 were identified from a MEDLINE search and from citations in articles and books.
Twenty of a total of 30 case-control and cohort studies met the two inclusion criteria: cases with a duration of diabetes of at least 1 year prior to either pancreatic cancer diagnosis or death and the ability to calculate an appropriate relative risk (RR) estimate and variance.
The pooled RR and 95% confidence interval (CI) of pancreatic cancer for diabetics relative to nondiabetics was 2.1 (1.6 to 2.8). There was a tendency for a higher RR for the nine cohort studies (RR, 2.6; 95% CI, 1.6 to 4.1) than for the 11 case-control studies (RR, 1.8; 95% CI, 1.1 to 2.7). Requiring diabetes duration of at least 5 years resulted in an RR of 2.0 (95% CI, 1.2 to 3.2).
Pancreatic cancer occurs with increased frequency among persons with long-standing diabetes.
鉴于糖尿病可能也是胰腺癌的一种后果，评估糖尿病作为胰腺癌危险因素的情况。
通过医学文献数据库检索以及文章和书籍中的参考文献，确定了1975年至1994年间发表的关于糖尿病和胰腺癌的相关研究。
总共30项病例对照研究和队列研究中的20项符合两项纳入标准：在胰腺癌诊断或死亡前糖尿病病程至少1年，并且能够计算适当的相对风险（RR）估计值和方差。
糖尿病患者患胰腺癌的合并RR及95%置信区间（CI）为2.1（1.6至2.8）。9项队列研究的RR（RR为2.6；95%CI为1.6至4.1）有高于11项病例对照研究（RR为1.8；95%CI为1.1至2.7）的趋势。要求糖尿病病程至少5年时，RR为2.0（95%CI为1.2至3.2）。
长期糖尿病患者中胰腺癌的发生频率增加。
