Abnormal glucose metabolism and pancreatic cancer mortality
Abnormal glucose metabolism and pancreatic cancer mortality
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DOI：
10.1001/jama.283.19.2552
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发表时间：
2000-05-17
影响因子：
120.7
通讯作者：
Dyer, A
中科院分区：
文献类型：
--
作者：
Gapstur, SM;Gann, PH;Dyer, A
背景以前的研究报道了糖尿病患者患胰腺癌的风险增加。然而，关于负荷后血糖浓度与胰腺癌的关系，目的探讨血糖负荷后血糖浓度与胰腺癌死亡风险之间的独立相关性，为研究血糖负荷后血糖浓度与胰腺癌死亡风险之间的关系提供理论依据。设计：前瞻性队列研究。背景和参与者：84个芝加哥地区组织的雇员，基线时平均年龄为40岁，从1963年到1973年进行了筛查，并进行了平均25年的随访。在20475名男性和15183名女性中，分别有96名男性和43名女性死于胰腺癌。主要结果测量胰腺癌死亡率与负荷后血糖水平的关系。（119 mg/ dL）或更低，并在调整年龄、种族、吸烟和体重指数后，的相对风险胰腺癌死亡率（95%可信区间）为1.65（1.05-2.60），对于6.7（120）和8.8（159）mmol/L（mg/dL）之间的负荷后血糖水平; 1.60对于8.9（160）和11.0（199）之间的水平，P = 0.95-2.70;对于11.1（200）或更高的水平，P = 2.15（1.22-3.80）;趋势P = 0.01。这种关联似乎对男性比对女性更强。在排除了前5年随访期间死于胰腺癌的11名男性和2名女性后，估计值仅略低。仅在男性中，较高的体重指数和血清尿酸浓度也独立与胰腺癌死亡率的风险增加。结论这些结果表明，与糖代谢异常相关的因素可能在胰腺癌的病因中发挥重要作用。
Context Previous studies reported an increased risk of pancreatic cancer among persons with diabetes. Few data exist, however, on the association of postload plasma glucose concentration with pancreatic cancer, which could provide insight into the role of abnormal glucose metabolism in the etiology of pancreatic cancer.Objective To determine the independent association between postload plasma glucose concentration and risk of pancreatic cancer mortality among persons without self-reported diabetes.Design Prospective cohort study.Setting and Participants Employees of 84 Chicago-area organizations, with an average age of 40 years at baseline, were screened from 1963 to 1973 and followed up for an average of 25 years. A total of 96 men and 43 women died of pancreatic cancer among 20475 men and 15 183 women, respectively.Main Outcome Measures Relationship of pancreatic cancer mortality with postload plasma glucose levels.Results Compared with a postload plasma glucose level of 6.6 mmol/L (119 mg/ dL) or less and after adjusting for age, race, cigarette smoking, and body mass index, the relative risks (95% confidence intervals) of pancreatic cancer mortality were 1.65 (1.05-2.60) for postload plasma glucose levels between 6.7 (120) and 8.8 (159) mmol/L (mg/dL); 1.60 (0.95-2.70) for levels between 8.9 (160) and 11.0 (199); and 2.15 (1.22-3.80) for levels of 11.1 (200) or more; P far trend = .01. An association appeared to be stronger for men than women. Estimates were only slightly lower after excluding 11 men and 2 women who died of pancreatic cancer during the first 5 years of followup. In men only, higher body mass index and serum uric acid concentration also were independently associated with an elevated risk of pancreatic cancer mortality.Conclusion These results suggest that factors associated with abnormal glucose metabolism may play an important role in the etiology of pancreatic cancer.