Risk of cancer in a large cohort of U.S. veterans with diabetes.
Risk of cancer in a large cohort of U.S. veterans with diabetes.
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DOI：
10.1002/ijc.25362
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发表时间：
2011-02-01
影响因子：
6.4
通讯作者：
McGlynn, Katherine A.
中科院分区：
文献类型：
--
作者：
Atchison, Elizabeth A.;Gridley, Gloria;Carreon, J. Daniel;Leitzmann, Michael F.;McGlynn, Katherine A.
先前对糖尿病男性癌症风险的研究报告了不一致的结果。目前调查的目的是评估在退伍军人事务部医院住院的黑人和白色美国退伍军人的一个大队列（n= 4，501，578）中癌症的风险。将糖尿病男性（n= 594，815）的癌症风险与非糖尿病男性（n= 3，906，763）的风险进行比较。Poisson回归用于估计调整后的相对风险（RR）和95%置信区间（CI）。总体而言，男性糖尿病患者患癌症的风险显著降低（RR=0.93，95%CI=0.93-0.94）。然而，患有糖尿病的男性患肝癌的风险增加，（RR=1.95，95%CI=1.82-20.9），胰腺（RR=1.50，95%CI=1.42-1.59），胆道（RR=1.41，95%CI=1.22-1.62），结肠（RR=1.20，95%CI=1.16-1.25），直肠（RR=1.12，95%CI=1.07-1.18）和肾（RR=1.09，95%CI=1.03-1.16），以及白血病（RR=1.14，95%CI=1.08-1.21）和黑色素瘤（RR=1.13，95%CI=1.03-1.24）。相比之下，患有糖尿病的男性患前列腺癌的风险降低，（RR=0.89，95%CI=0.87-0.91），脑（RR=0.91，95%CI=0.81-0.99），颊腔（RR=0.85，95%CI=0.82-0.89）、肺（RR=0.79，95%CI=0.77-0.80）、食管（RR=0.77，95%CI= 0.072 -0.82）和喉（RR=0.76，95%CI=0.71-0.80）。这些研究结果表明，患有糖尿病的黑人和白色男性患癌症的风险显著降低，患肺癌和前列腺癌是美国男性中最常见的两种癌症。然而，这些降低的风险被几个部位癌症风险的增加所抵消。高胰岛素血症可以解释消化道癌症风险增加的原因，而前列腺癌的睾丸激素水平较低，肺癌的BMI较高，可以解释这些肿瘤风险降低的原因。
Prior studies of cancer risk among diabetic men have reported inconsistent findings. The aim of the current investigation was to assess the risk of cancer among a large cohort (n=4,501,578) of black and white U.S. veterans admitted to Veterans Affairs hospitals. The cancer risk among men with diabetes (n=594,815) was compared to the risk among men without diabetes (n=3,906,763). Poisson regression was used to estimate adjusted relative risks (RRs) and 95% confidence intervals (CIs). Overall, men with diabetes had a significantly lower risk of cancer (RR=0.93, 95%CI=0.93-0.94). Men with diabetes, however, had increased risks of cancers of the liver (RR=1.95, 95%CI=1.82-20.9), pancreas (RR=1.50, 95%CI=1.42-1.59), biliary tract (RR=1.41, 95%CI=1.22-1.62), colon (RR=1.20, 95%CI=1.16-1.25), rectum (RR=1.12, 95%CI=1.07-1.18), and kidney (RR=1.09, 95%CI=1.03-1.16), as well as leukemia (RR=1.14, 95%CI=1.08-1.21) and melanoma (RR=1.13, 95%CI=1.03-1.24). In contrast, men with diabetes had decreased risks of cancers of the prostate (RR=0.89, 95%CI=0.87-0.91), brain (RR=0.91, 95%CI=0.81-0.99), buccal cavity (RR=0.85, 95%CI=0.82-0.89), lung (RR=0.79, 95%CI=0.77-0.80), esophagus (RR=0.77, 95%CI=.072-0.82), and larynx (RR=0.76, 95%CI=0.71-0.80). These findings indicate that black and white men with diabetes are at significantly lower risk of total cancer and of two of the most common cancers among U.S. males; lung and prostate cancers. These decreased risks were offset, however, by increased risks of cancer at several sites. Hyperinsulinemia may explain the increased risks of the digestive cancers, while lower testosterone levels, in the case of prostate cancer, and higher BMI, in the case of lung cancer, may explain the decreased risks of those tumors.
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