Incidence of Diabetes After Cancer Development A Korean National Cohort Study
Incidence of Diabetes After Cancer Development A Korean National Cohort Study
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DOI：
10.1001/jamaoncol.2018.1684
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发表时间：
2018-08-01
期刊：
影响因子：
28.4
通讯作者：
Cho, Juhee
中科院分区：
文献类型：
--
作者：
Hwangbo, Yul;Kang, Danbee;Cho, Juhee
重要性：糖尿病是一种确定的致癌因素。有限的证据也表明，癌症会增加新发糖尿病病例的风险，但证据并不确凿。目的评价癌症的发生是否与后续糖尿病的风险增加相关。设计、环境和参与者本队列研究纳入了具有全国代表性的韩国普通人群样本，观察时间长达10年（2003年1月1日至2013年12月31日）。共有524089名年龄在20至70岁之间的男性和女性参与了这项研究，他们没有糖尿病，基线时也没有癌症病史。偶发性癌症（时变暴露）。主要结果和测量使用保险索赔代码的2型糖尿病事件。结果：在494 189人（50.0%为女性，平均[SD]年龄为41.8[12.5]岁）的3 492 935.6人年随访（中位随访时间为7.0年）中，有15 130人患癌症，26 610人患糖尿病。在调整年龄、性别、癌前糖尿病危险因素、代谢因素和合并症后，糖尿病与癌症发展相关的危险比（HR）为1.35 (95% CI, 1.26-1.45； P
IMPORTANCE Diabetes is an established risk factor for developing cancer. A limited body of evidence also suggests that cancer can increase the risk of developing new cases of diabetes, but the evidence is inconclusive.OBJECTIVE To evaluate whether the development of cancer is associated with increasing risk of subsequent diabetes.DESIGN, SETTING, AND PARTICIPANTS This cohort study included a nationally representative sample of the Korean general population observed for up to 10 years (January 1, 2003, to December 31, 2013). A total of 524 089 men and women 20 to 70 years of age without diabetes and with no history of cancer at baseline were included.EXPOSURES Incident cancer (time-varying exposure).MAIN OUTCOMES AND MEASURES Incident type 2 diabetes using insurance claim codes.RESULTS During 3 492 935.6 person-years of follow-up (median follow-up, 7.0 years) in 494 189 individuals (50.0% female; mean [SD] age, 41.8 [12.5] years), 15 130 participants developed cancer and 26 610 participants developed diabetes. After adjustment for age, sex, precancer diabetes risk factors, metabolic factors, and comorbidities, the hazard ratio (HR) for diabetes associated with cancer development was 1.35 (95% CI, 1.26-1.45; P