Diabetes and risk of incident colorectal cancer in a prospective cohort of women.
Diabetes and risk of incident colorectal cancer in a prospective cohort of women.
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DOI：
10.1007/s10552-010-9555-0
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
Schatzkin A
中科院分区：
文献类型：
--
作者：
Flood A;Strayer L;Schairer C;Schatzkin A
确定考虑糖尿病暴露的时间动态是否会改变结直肠癌的风险估计。我们分析了参加BCDDP随访队列研究的45516名妇女的数据。我们使用比例风险回归获得多变量调整后的风险估计，发病率为基线糖尿病和糖尿病作为一个时间依赖性变量的结肠直肠癌。与非糖尿病受试者相比，糖尿病受试者的结直肠癌风险在统计学上显著增加（RR = 1.60，95% CI 1.18-2.18）。当我们将暴露定义为队列退出时糖尿病暴露的持续时间时，我们发现在诊断后的前4年，风险与从未诊断过糖尿病的患者基本相同。然而，对于那些在4至8年前被诊断为糖尿病的人，我们观察到的RR为2.36（95% CI 0.96-5.79），而与未诊断为糖尿病的人相比，较长的暴露时间与较小的风险相关，然后没有变化。这些结果与高胰岛素血症可以至少部分解释糖尿病与结直肠癌的关联的理论一致，但以时间依赖的方式。
To determine whether accounting for the time dynamics of diabetes exposure will change the risk estimates for colorectal cancer. We analyzed data from the 45, 516 women enrolled in the BCDDP follow-up cohort study. We used proportional hazards regression to obtain multivariable-adjusted risk estimates for incident colorectal cancer for prevalent diabetes at baseline and diabetes as a time-dependent variable. Subjects with diabetes had a statistically significant increased risk of colorectal cancer compared to subjects without diabetes (RR = 1.60, 95% CI 1.18–2.18). When we defined exposure as duration of diabetes exposure at cohort exit, we found that in the first 4 years after diagnosis risk was essentially the same as in those never having had a diagnosis of diabetes. For those who had been diagnosed between 4 and 8 years previously, however, we observed a RR of 2.36 (95% CI 0.96–5.79), while longer duration of exposure was associated with smaller and then no change in risk compared to those without a diagnosis of diabetes. These results are consistent with the theory that hyperinsulinemia can explain, at least in part, the association of diabetes with colorectal cancer, but in a time-dependent manner.
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