Colorectal cancer: Another complication of diabetes mellitus?
Colorectal cancer: Another complication of diabetes mellitus?
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DOI：
10.1093/oxfordjournals.aje.a009534
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发表时间：
1998-05-01
影响因子：
5
通讯作者：
Calle, EE
中科院分区：
文献类型：
--
作者：
Will, JC;Galuska, DA;Calle, EE
延迟粪便运输和其他胃肠道异常通常在糖尿病患者中观察到，并且也已知与结直肠癌相关。以前关于糖尿病对结直肠癌发病率和死亡率的影响的研究受到样本量小和未能调整协变量的限制，1959-1972年的癌症预防研究有超过100万的受访者，提供了一个独特的机会来探索糖尿病患者是否（n = 15，487）在13年的随访期间比没有糖尿病的人（n = 850，946）更容易患结直肠癌。调整后，对于结直肠癌危险因素，如种族、教育水平、体重指数、吸烟、饮酒、饮食摄入、阿司匹林使用、体力活动和结直肠癌家族史糖尿病与非糖尿病人群结直肠癌发病密度比为1.30（95%置信区间1.03-1.65）男性和1.16（95%置信区间0.87-1.53）女性。然而，糖尿病与更高的病死率无关。未来的研究应探索促癌胃肠道环境的可能性，包括延迟的盗血转运和粪便胆汁酸浓度升高，与高血糖症和糖尿病神经病变相关。
Delayed stool transit and other gastrointestinal abnormalities are commonly observed in persons with diabetes mellitus and are also known to be associated with colorectal cancer. Previous studies of the contribution of diabetes to colorectal cancer incidence and mortality have been limited by small sample sizes and failure to adjust for covariates, With more than 1 million respondents, the 1959-1972 Cancer Prevention Study provided a unique opportunity to explore whether persons with diabetes (n = 15,487) were more likely to develop colorectal cancer during a 13-year follow-up period than were persons without diabetes (n = 850,946). After adjustment, for colorectal cancer risk factors, such as race, educational level, body mass index, smoking, alcohol use, dietary intake, aspirin use, physical activity, and family history of colorectal cancer, the incidence density ratio comparing colorectal cancer in those with diabetes and those without diabetes was 1.30 (95% confidence interval 1.03-1.65) for men and 1.16 (95% confidence interval 0.87-1.53) for women. However, diabetes was not associated with greater case fatality. Future studies should explore the possibility of a cancer-promoting gastrointestinal milieu, including delayed steal transit and elevated fecal bile acid concentrations, associated with hyperglycemia and diabetic neuropathy.