Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies
Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies
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DOI：
10.1016/j.ejca.2011.03.003
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发表时间：
2011-09-01
影响因子：
8.4
通讯作者：
Li, Zhaoshen
中科院分区：
文献类型：
--
作者：
Ben, Qiwen;Xu, Maojin;Li, Zhaoshen
背景：糖尿病（DM）被广泛认为与胰腺癌（PaC）风险相关，然而，糖尿病是胰腺癌的病因还是其结果仍存在争议。我们通过对队列研究进行详细的荟萃分析来检验这种关联。
方法：通过检索截至2010年11月30日的Medline和Embase数据库来确定研究。使用随机效应模型计算汇总相对风险（RRs）及其相应的95%置信区间（CIs）。
结果：这项荟萃分析共纳入了35项队列研究。糖尿病与胰腺癌风险增加相关（汇总RRs = 1.94；95% CI，1.66 - 2.27），这些研究之间存在显著的异质性证据（p < 0.001，I² = 93.6%）。亚组分析显示，胰腺癌风险增加与地理位置、性别、研究设计、饮酒量、体重指数（BMI）和吸烟状况无关。此外，胰腺癌的相对风险与糖尿病病程呈负相关，在确诊糖尿病不到1年的患者中胰腺癌风险最高。不存在显著的发表偏倚（Egger回归不对称检验p = 0.136）。
结论：这项荟萃分析的结果有力地支持了糖尿病与男性和女性胰腺癌风险增加均相关，并且糖尿病既是胰腺癌的早期表现，也是其病因。（C）2011 Elsevier Ltd.保留所有权利。
Background: Diabetes mellitus (DM) is widely considered to be associated with risk of pancreatic cancer (PaC), however, whether DM is a cause or a consequence of PaC is still controversial. We examined this association by conducting a detailed meta-analysis of cohort studies.Methods: Studies were identified by searching Medline and Embase through November 30, 2010. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model.Results: A total of thirty-five cohort studies were included in this meta-analysis. DM was associated with an increased risk of PaC (the summary RRs = 1.94; 95% CI, 1.66-2.27), with significant evidence of heterogeneity among these studies (p < 0.001, I-2 = 93.6%). Subgroup analyses revealed that the increased risk of PaC was independent of geographic locations, sex, study design, alcohol consumption, body mass index (BMI) and smoking status. In addition, the relative risk of PaC was correlated negatively with the duration of DM, with the highest risk of PaC found among patients diagnosed within less than 1 year. There was no significant publication bias (p = 0.136 for Egger's regression asymmetry test).Conclusions: Findings from this meta-analysis strongly support that diabetes is associated with an increased risk of PaC in both males and females and that DM is both an early manifestation and an etiologic factor of pancreatic cancer. (C) 2011 Elsevier Ltd. All rights reserved.